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Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

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Radiation Therapy Dose Response in Bulky Relapsed/Refractory Large B-Cell Lymphoma.

Jonathan A Baron¹, Christopher M Wright², Alexandra D Dreyfuss³

¹Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.

Practical Radiation Oncology

|July 6, 2024

Summary

Higher radiation therapy (RT) doses (over 30 Gy) improve tumor control for bulky diffuse large B-cell lymphoma (DLBCL). This is crucial for achieving durable local control in relapsed/refractory cases.

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Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Published on: June 7, 2015

Area of Science:

Oncology
Radiation Oncology
Hematology

Background:

Relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL) presents treatment challenges.
Bulky tumors (≥7.5 cm) in r/r DLBCL often have poorer prognoses.
Radiation therapy (RT) is used in palliative and salvage settings for r/r DLBCL.

Purpose of the Study:

To determine if radiation therapy (RT) dose influences response in bulky tumors within relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL).

Main Methods:

Retrospective analysis of 151 patients with r/r DLBCL treated with RT (2008-2020).
Calculated equivalent doses in 2-Gy fractions (EQD2) for conventional and hypofractionated RT schemes.
Compared objective response rates (ORRs) and freedom from local progression (FFLP) based on tumor size and RT dose.

Main Results:

Bulky tumors showed a trend towards worse ORR (50% vs. 65%) compared to non-bulky tumors.
For bulky tumors, RT with EQD2 >30 Gy significantly improved ORR (64% vs. 27%, P=.0073).
Higher EQD2 (>30 Gy) was associated with better FFLP in bulky tumors (unreached vs. 4.0 months, P=.0047).

Conclusions:

Bulky r/r DLBCL tumors have less favorable local control outcomes.
Higher RT doses (EQD2 >30 Gy) are recommended for durable local control in bulky r/r DLBCL.
Dose escalation should be considered for bulky tumors to improve treatment efficacy.