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

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

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.

0360-3016
652-669
Ng, Andrea K.
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Yahalom, Joachim
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Goda, Jayant S.
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Constine, Louis S.
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Pinnix, Chelsea C.
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Kelsey, Chris R.
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Hoppe, Bradford
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Oguchi, Masahiko
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Suh, Chang Ok
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Wirth, Andrew
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Qi, Shunan
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Davies, Andrew
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Moskowitz, Craig H.
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Laskar, Siddhartha
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Li, Yexiong
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Mauch, Peter M.
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Specht, Lena
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Illidge, Timothy
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Ng, Andrea K.
89b3d0c2-7d15-4ea5-a045-aa862efb438f
Yahalom, Joachim
a64b1d0f-5b7e-472a-bb9d-86596bce296c
Goda, Jayant S.
b6dfd1c6-9c15-4a5b-a053-117c47a991bf
Constine, Louis S.
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Pinnix, Chelsea C.
b255b9bc-f2ce-49eb-88cf-fccfc204009f
Kelsey, Chris R.
19ad7a56-b348-47f8-a970-5cc93128b39e
Hoppe, Bradford
06d05054-5cd7-4540-bda4-c76595eead6a
Oguchi, Masahiko
423e1653-221d-4e50-b82f-ae03abb77a3a
Suh, Chang Ok
bca8ac97-c4db-43c3-aeb0-d96cff90a3d5
Wirth, Andrew
a398264d-0ae4-4002-b0fd-d54dceeb96a5
Qi, Shunan
6260d767-7718-445d-927e-1e2196d4656b
Davies, Andrew
0fe6a40a-10d1-4ade-a7e6-d1dceb2470af
Moskowitz, Craig H.
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Laskar, Siddhartha
847df81f-d423-42ab-9b06-250baa6fa626
Li, Yexiong
7692d9b0-c0f8-4ae3-878c-6e29acd0dca4
Mauch, Peter M.
7090b70b-f508-483b-88cb-36ac9b2a284b
Specht, Lena
a810ecdb-cf56-490e-aaf0-5a77a77ea84b
Illidge, Timothy
9abbc831-d66d-4288-8dc4-d2e1ad45d782

Ng, Andrea K., Yahalom, Joachim, Goda, Jayant S., Constine, Louis S., Pinnix, Chelsea C., Kelsey, Chris R., Hoppe, Bradford, Oguchi, Masahiko, Suh, Chang Ok, Wirth, Andrew, Qi, Shunan, Davies, Andrew, Moskowitz, Craig H., Laskar, Siddhartha, Li, Yexiong, Mauch, Peter M., Specht, Lena and Illidge, Timothy (2018) Role of Radiation Therapy in Patients With Relapsed/Refractory Diffuse Large B-Cell Lymphoma: Guidelines from the International Lymphoma Radiation Oncology Group. International Journal of Radiation: Oncology, Biology, Physics, 100 (3), 652-669. (doi:10.1016/j.ijrobp.2017.12.005).

Record type: Review

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.

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More information

Accepted/In Press date: 3 December 2017
Published date: 1 March 2018

Identifiers

Local EPrints ID: 419424
URI: https://eprints.soton.ac.uk/id/eprint/419424
ISSN: 0360-3016
PURE UUID: f9116e34-199d-437c-8200-f45bb710b505

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Date deposited: 12 Apr 2018 16:30
Last modified: 13 Mar 2019 18:38

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Contributors

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

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