Guidelines on Diagnosis and Treatment of Malignant Lymphomas

Treatment
Standard chemotherapy for DLBCL with 6-8 cycles of R-CHOP
can be used but is traditionally followed by involved field radiation
to the mediastinum. Recent experience with DA-R-EPOCH and
no radiotherapy is associated with an OS of 78% and EFS of
67%, which may be preferably as it avoids the need to irradiate
breast tissue in women and the myocardium in both sexes. If a
sub-optimal response is obtained from chemotherapy, the
decision to use radiotherapy versus peripheral blood stem cell
transplantation must be made with care, as the mortality risk of
transplant following radiotherapy is substantial.
Response Evaluation and Follow up
As outlined for DLBCL. PET scanning is recommended at the end
of treatment evaluation.
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