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What ISRT volume/dose would you use for Stage I DLBCL of the bilateral tonsil after (diagnostic) tonsilectomy and 3 cycles of RCHOP. Transformed CLL, btw.
Is anyone aware of any recently published data (randomized Phase III) involving the use of INRT s/p R-CHOP based chemotherapy for DLBCL?
Glad to see you even got the referral considering the underserved hatred for xrt from some med oncs in early dlbcl lately
http://m.jco.ascopubs.org/content/33/32/3684
http://m.jco.ascopubs.org/content/33/32/3684 states: "Apparently physicians believe the randomized trial results."
Well does the author of the editorial believe the randomized trial results? Or would the author argue that an overall survival benefit is necessary to offer an intervention?
I guess it depends on the interventionhttp://m.jco.ascopubs.org/content/33/32/3684 states: "Apparently physicians believe the randomized trial results."
Or would the author argue that an overall survival benefit is necessary to offer an intervention?
Well the Med Oncs would argue that R-CHOP >> CHOP.
Yes. PET neg, both pre- and post- chemo. What volume? Just all of Waldeyer's Ring.
There are two "problems" in DLBCL: Rituximab & PET-triggered therapy.
I don't believe in RT after 6x R-CHOP and a negative PET-CT. I think it's simple not worth it and it will still add significant toxicity, especially in areas like neck & chest.
I firmly believe in RT for stage I & limited stage II disease with 3x R-CHOP. The patients can skip quite some chemo with that and if you are irradiating only the axilla or the pelvis with 30 Gy, such an approach offers quite good efficacy/toxicity balance.
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I wish the guideline came close to answering the question.Read the guideline...