Is there any role for post chemotherapy (R CHOP x 6) radiation therapy after a splenectomy for a stage IE diffuse large B-cell lymphoma involving only the spleen?

Quite an interesting presentation in terms of extranodal site and age. I would say no for consolidative RT here.

For Lugano PET CR after R-CHOPx6, the added benefit of ISRT in a young patient is low and counterbalanced by a real long term 2nd malignacy risk.

Other than bulky >7.5cm sites, 'special' ...