Long-term results of PET-guided radiation in patients with advanced-stage diffuse large B-cell lymphoma treated with R-CHOP

Abstract Consolidative radiation therapy (RT) for advanced-stage diffuse large B-cell lymphoma (DLBCL) remains controversial, with routine practice continuing to include RT in patients initial bulky disease or residual masses. Positron emission tomography (PET)-computed is a sensitive modality detecting the presence of at end treatment (EOT). A PET-guided approach selectively administering has been policy British Columbia since 2005. Patients DLBCL diagnosed from 1 January 2005 March 2017 and treated least 6 cycles R-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone plus rituximab), who underwent EOT PET, were included this analysis. Those complete metabolic response (PET-negative [PET-NEG]) observed; those PET-positive (PET-POS) scans offered consolidative RT, when feasible. Of patient records reviewed, 723 identified, median follow-up 4.3 years: 517 (72%) PET-NEG; 206 (28%) PET-POS. Time progression (TTP) overall survival (OS) 3 years 83% vs 56% 87% 64%, PET-NEG PET-POS scans, respectively. nonprogressing (109 206; 53%) had outcomes approaching patients, 3-year estimates 76% 80% TTP OS. (≥10 cm) diagnosis indistinguishable without bulk, despite omission RT. These data suggest that are receive no have excellent outcomes. 18F-fluorodeoxyglucose-PET can reliably guide selective administration even initially disease.