What is the role of consolidative RT to initially bulky sites (>8cm) in a patient with stage III triple hit lymphoma who has tolerated only 4 cycles of DA-EPOCH-R?

I am going to expand the question to consider the role of RT in the curative rx of stage III/IV DLBCL triple hit or not. Conventional wisdom, e.g. NCCN guidelines suggest no role but I respectfully disagree. We reviewed the data in 2014 (Oncology 1074-1082, Dec 2014) and also recommend Dabaja et al ...

Patient's prognosis is very poor as they rarely have a CR at the radiated site, but most important, they fail soon an distant sites. CAR-T cell treatment should be considered, radiation used only as a temporary measure.

Thank you for all the comments. The patient in question had two sites of disease at presentation: conglomeration of 10cm LN's Left Neck and 10 cm mid abdomen. Left Neck CR biologic/radiographic. Mid-abdomen Pre-chemo SUV=13 and now SUV=4.5 (size dropped to 6cm).

Medical Oncologist not offering addit...