When do you recommend consolidative XRT for patients with advanced stage (III-IV) DLBCL who achieve CR to chemoimmunotherapy?

Topics: Hematologic Malignancies • Radiation Oncology • Medical Oncology • Lymphoma • Hematology

What XRT dose do you use? Does the location of the disease (e.g., mediastinum) affect your decision when taking toxicity into account? would you offer it to non-bulky disease?

Answer from: Radiation Oncologist at Academic Institution

The cornerstone of therapy for advanced DLBCL is chemoimmunotherapy (R-CHOP). Efforts to improve upon this with systemic therapy have been largely unsuccessful (dose-dense chemotherapy, maintenance R, more intensive chemotherapy, high-dose chemotherapy and autologous SCT, etc.). There are increasing...

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Medical Oncologist at Florida Cancer Specialists and Research Institute
@Christopher R. Kelsey, Both UNFOLDER and RICOVER...

Answer from: at Academic Institution

In 31 years of practice, I have never seen a case with III-IV presentations and limited disease extent in which all sites of disease can be safely encompassed. Even if they existed, I believe no data exists to support RT in this setting, either as an addition to systemic therapy, or instead of syste...

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