Anyone palliated a primary effusion lymphoma before?

[emt409]

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I'm worried boom boom isn't enough for a lesion this size. Maybe 2Gy x 5?

Background: 37yo s/p liver transplant for HCV/etoh cirrhosis who developed HH8 effusion lymphoma thereafter. Has bad CKD, so can longer get much cytotoxic therapy. CD20 negative, so can't get rituximab.

 

[nkmiami]

That sounds reasonable. I have given similar palliative doses for visceral kaposi to large fields in the chest and abdomen, which is also hh8 related- never heard of this entity before. If you are giving a really large field to the abdomen, consider a bit of decadron and zofran prior to each treatment.

 

[KHE88]

Why try to get cute with palliation? Just do 2 Gy x 10 IMO.

 

[emt409]

Why try to get cute with palliation? Just do 2 Gy x 10 IMO.

Because it's a big volume in a sick patient with a borrowed liver, bad kidneys, and extensive abdominal surgery history, I prefer to give only what I need to meaningfully palliate

 

[Ray D. Ayshun]

View attachment 236642

I'm worried boom boom isn't enough for a lesion this size. Maybe 2Gy x 5?

Background: 37yo s/p liver transplant for HCV/etoh cirrhosis who developed HH8 effusion lymphoma thereafter. Has bad CKD, so can longer get much cytotoxic therapy. CD20 negative, so can't get rituximab.

Have done 4 gy x 2 to larger fields for lymhoma. Effective quickly and shorter treatment duration than 5. Room for more with either if ever necessary, though I get the impression it probably won’t be.

Edit: to answer your initial question, no.

 

[evilbooyaa]

I'm not overtly familiar with HH8 effusion lymphoma, but is it high grade lymphoma? I thought 2Gy x 2 was only used for palliating indolent lymphoma? I'd just do 2-3Gy x 5-10. Either opposed laterals or IMRT.