The importance of radiotherapy on diffuse large B cell lymphoma treatment: a current review

Abstract

Diffuse large B cell lymphoma is recognized as a heterogeneous group of hematological malignancies; two main subtypes germinal center B and activated B cells are well defined although 15% of patients remain with unclassifiable disease. R-CHOP treatment has proven to provide very effective results in limited or advanced stage of the disease. However, treatment solely involving R-CHOP submits the patient to possible chemotherapy-induced toxicities, which may be avoided with the use of radiotherapy. Patients with early stage localized disease or who are particularly unresponsive to chemotherapy may be more suitable for mixed modality treatment with R-CHOP and consolidative radiotherapy. Although radiotherapy is being slowly phased out by other treatment strategies including chemotherapy and therapeutic drugs, it is still a highly important method of treatment. The different forms of radiotherapy can be used alongside these "new-age" treatment strategies to further improve prognostic outcomes and overall survival rates. The establishment of radiotherapy as a treatment strategy provides a highly beneficial prognostic advantage in early stage, localized disease.

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“…Different forms of RT, including involved-field RT, involved-node RT and involved-site RT, may be used alongside these ‘new-age’ treatment strategies to further improve prognostic outcomes and overall survival rates. Nevertheless, RT remains an important treatment method and may be used instead of certain treatments, including the treatment of patients who are unresponsive to or develop complications from the use of chemotherapy ( 23 ). A study by Held et al ( 24 ) provided strong support for adding RT in the treatment of large (≥7.5 cm in diameter) tumors in elderly patients (>60 years of age) with aggressive B-cell lymphoma.…”