When would you offer PMRT to a patient after prior TNI for lymphoma?

It would depend on total dose. If the dose in the past was in the 30s, in these patients I have usually been reluctant to treat the supraclavicular area again to decrease risk of plexopathy. I have treated the chest wall with extra precaution to decrease the dose to the heart (larger conformal block) in treating the left sided chest wall. I have limited the dose to 45 Gy in 25 fractions to a larger volume. If the original dose was 2100cGy, then I would also treat the s/c to 45 Gy in 25 fractions.