Consolidation radiotherapy to bulky disease in aggressive NHL. results of the NHL B-94 trial of the German high grade NHL study group(DSHNHL)

Rübe, Christian; Nguyen, Theresa; Klöss, Marita; Löffler, Markus; Trümper, Lorenz; Brinkmann, R.; Speiser-Held, Irene; Pfreundschuh, Michael

doi:10.1016/s0360-3016(01)01950-2

Cited by 4 publications

(5 citation statements)

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“…In general, brief chemotherapy plus involved-field radiotherapy is tolerated reasonably well [7,15,24]. In our own experience, the addition of radiotherapy to bulky disease and extranodal areas after 6 cycles of CHOP or CHOEP chemotherapy was tolerated well with only 6% WHO grade III/IV toxicities and no radiation-associated death [30]. Nevertheless, higher doses of chemotherapy such as 6-8 cycles of chemotherapy or high-dose chemotherapy are associated with a higher toxicity rate when combined with involved-field radiotherapy [16,27,33,41].…”

Section: Toxicitymentioning

confidence: 78%

“…In the German NHL B-94 trial of the DSHNHL, all patients with bulky disease (defined as ≥7.5 cm) underwent radiation therapy with 36 Gy following complete remission after 6 cycles of CHOP or CHOEP chemotherapy [30]. For the total group of 513 patients with nodal disease only, bulky lesions were associated with a significantly shorter time to treatment failure.…”

Section: Bulky Diseasementioning

confidence: 99%

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The Value of Radiation Therapy in the Management of Aggressive Non-Hodgkin’s Lymphomas

Rübe¹,

Nguyen²,

Brinkmann³

2002

Oncol Res Treat

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Even though chemotherapy plays a major role in the treatment of aggressive non-Hodgkin’s lymphomas, the high radiosensitivity of the lymphatic lesions has established radiotherapy as an important component in the management of the disease in localized stages. Nevertheless, the treatment strategies with regard to the stage-adopted indications for radiotherapy, the treatment volume, and the dose remain controversial. This article reviews the available data concerning combined-modality treatment in localized stages and treatment of bulky lesions and residual lymphomas after chemotherapy with emphasis on the role of radiation therapy.

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Section: Toxicitymentioning

confidence: 78%

Section: Bulky Diseasementioning

confidence: 99%

The Value of Radiation Therapy in the Management of Aggressive Non-Hodgkin’s Lymphomas

Rübe¹,

Nguyen²,

Brinkmann³

2002

Oncol Res Treat

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“…In the PR arm, although 31% converted to CR after high-dose RT, the relapse rate was nearly identical between those who did (46%) and those who did not (47%) convert to PR. 52 However, not every study has confirmed this finding, 53 and it remains unclear which cutoff in tumor measurement should be used to define bulkiness. 50 This compared favorably with the SWOG 8736 cohort treated with 3 cycles of CHOP plus IFRT, but nonetheless showed a pattern of seeming continuous relapse.…”

Section: Localized Diseasementioning

confidence: 99%

Treatment of Diffuse Large B-cell Lymphoma

Thirukonda¹,

Petrich²

2012

Pathology Case Reviews

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“…Other studies of consolidative radiotherapy have been non-randomised or retrospective, with all their attendant limitations. An analysis of a German study NHLB-94, demonstrated that patients with bulky disease had a poorer RFS than patients with non-bulky disease (53 vs. 66%, p ¼ 0.0001), but that the addition of radiotherapy appeared to negate this impact [89]. A study from the MDACC included 59 patients with stage III -IV intermediate grade NHL, 28 of whom received IFRT.…”

Section: Bulky Diseasementioning

confidence: 99%

The rationale and role of radiation therapy in the treatment of patients with diffuse large B-cell lymphoma in the Rituximab era

Wirth

2007

Leukemia & Lymphoma

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Developments in the evaluation and systemic management of diffuse large B-cell lymphoma (DLBCL) require ongoing assessment of the role of external beam radiotherapy in management. This review assesses data regarding the use of radiotherapy in the initial management of early stage and advanced DLBCL, and considers the implications of bulky and residual disease, and the contribution of PET scanning, to decisions regarding the use of radiotherapy after chemotherapy. Limited R-CHOP plus radiotherapy, or full dose R-CHOP alone, are both likely to cure approximately 90% of patients with low risk early stage disease. The choice of therapy will depend on considerations of acute and late toxicity of the two approaches, taking into account individual patient risk profiles and preferences. Unfavorable early-stage and advanced-stage disease require treatment with full dose R-CHOP. The presence of bulky disease predicts for a higher risk of relapse, which may be partly ameliorated by the addition of radiotherapy. The rapidity of response on PET scanning, the presence of a posttherapy residual mass, the potential toxicity of radiotherapy and the available salvage options all need to be considered on a patient by patient basis, when considering the use of radiotherapy for advanced disease.

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Consolidation radiotherapy to bulky disease in aggressive NHL. results of the NHL B-94 trial of the German high grade NHL study group(DSHNHL)

Cited by 4 publications

References 0 publications

The Value of Radiation Therapy in the Management of Aggressive Non-Hodgkin’s Lymphomas

The Value of Radiation Therapy in the Management of Aggressive Non-Hodgkin’s Lymphomas

Treatment of Diffuse Large B-cell Lymphoma

The rationale and role of radiation therapy in the treatment of patients with diffuse large B-cell lymphoma in the Rituximab era

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