Role of Radiation Therapy in Patients With Relapsed/Refractory Diffuse Large B-Cell Lymphoma: Guidelines from the International Lymphoma Radiation Oncology Group

Andrea K Ng, Joachim Yahalom, Jayant S Goda, Louis S Constine, Chelsea C Pinnix, Chris R Kelsey, Bradford Hoppe, Masahiko Oguchi, Chang-Ok Suh, Andrew Wirth, Shunan Qi, Andrew Davies, Craig H Moskowitz, Siddhartha Laskar, Yexiong Li, Peter M Mauch, Lena Specht, Timothy Illidge

26 Citations (Scopus)

Abstract

Approximately 30% to 40% of patients with diffuse large B-cell lymphoma (DLBCL) will have either primary refractory disease or relapse after chemotherapy. In transplant-eligible patients, those with disease sensitive to salvage chemotherapy will significantly benefit from high-dose therapy with autologous stem cell transplantation. The rationale for considering radiation therapy (RT) for selected patients with relapsed/refractory DLBCL as a part of the salvage program is based on data regarding the patterns of relapse and retrospective series showing improved local control and clinical outcomes for patients who received peritransplant RT. In transplant-ineligible patients, RT can provide effective palliation and, in selected cases, be administered with curative intent if the relapsed/refractory disease is localized. We have reviewed the indications for RT in the setting of relapsed/refractory DLBCL and provided recommendations regarding the optimal timing of RT, dose fractionation scheme, and treatment volume in the context of specific case scenarios.

Original languageEnglish
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume100
Issue number3
Pages (from-to)652-669
ISSN0360-3016
DOIs
Publication statusPublished - 1 Mar 2018

Keywords

  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Cyclophosphamide/administration & dosage
  • Dose Fractionation, Radiation
  • Doxorubicin/administration & dosage
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Lymphoma, Large B-Cell, Diffuse/diagnostic imaging
  • Neoplasm, Residual
  • Prednisone/administration & dosage
  • Recurrence
  • Rituximab/administration & dosage
  • Salvage Therapy/methods
  • Vincristine/administration & dosage

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