Abstract：
Diffuse large B‑cell lymphoma (DLBCL) is an aggressive lymphoma subtype treated successfully with immunochemotherapy. However, there are conflicting data on the role and impact of consolidative radiation therapy (RT). The publication of the national evidence-based guideline on DLBCL prompted us to review relevant passages on radiation oncology.
The following article reviews the evidence and recommendations given in the current German evidence-based guideline on DLBCL regarding RT and summarizes pivotal aspects. Additional literature is presented to provide a comprehensive background for the published recommendations.
RT shall be administered to all patients with localized positron emission tomography(PET)-positive residues after completion of immunochemotherapy and should use a dose of 30-40 Gray in normofractionation. For RT planning, PET information before and after immunochemotherapy shall be used, with either a PET-CT in the RT treatment position or an image fusion to the planning CT. Conformal techniques shall be used for target volume coverage, with a risk-benefit evaluation for the individual patient. Additionally, RT may be used in the treatment context of various subtypes of DLBCL as well as in the recurrent or refractory treatment situation.
RT remains an integral part of the treatment repertoire of DLBCL. With the use of PET-guided treatment, RT is indicated for patients with metabolically active tumors. In the context of the ongoing development of targeted therapies, new RT indications may evolve.
The following article reviews the evidence and recommendations given in the current German evidence-based guideline on DLBCL regarding RT and summarizes pivotal aspects. Additional literature is presented to provide a comprehensive background for the published recommendations.
RT shall be administered to all patients with localized positron emission tomography(PET)-positive residues after completion of immunochemotherapy and should use a dose of 30-40 Gray in normofractionation. For RT planning, PET information before and after immunochemotherapy shall be used, with either a PET-CT in the RT treatment position or an image fusion to the planning CT. Conformal techniques shall be used for target volume coverage, with a risk-benefit evaluation for the individual patient. Additionally, RT may be used in the treatment context of various subtypes of DLBCL as well as in the recurrent or refractory treatment situation.
RT remains an integral part of the treatment repertoire of DLBCL. With the use of PET-guided treatment, RT is indicated for patients with metabolically active tumors. In the context of the ongoing development of targeted therapies, new RT indications may evolve.
摘要：
目的：弥漫性大B细胞淋巴瘤（DLBCL）是一种通过免疫化疗成功治疗的侵袭性淋巴瘤亚型。然而,关于巩固放射治疗（RT）的作用和影响的数据相互矛盾。DLBCL国家循证指南的发表促使我们回顾放射肿瘤学的相关段落。
方法：以下文章回顾了当前德国关于DLBCL的循证指南中关于RT的证据和建议，并总结了关键方面。提供了其他文献，以为已发布的建议提供全面的背景。
结果：应在完成免疫化疗后对所有具有局部正电子发射断层扫描（PET）阳性残留物的患者进行RT，并应使用30-40格雷的剂量。对于RT计划，应使用免疫化疗前后的PET信息，在RT治疗位置使用PET-CT或与计划CT进行图像融合。目标体积覆盖应使用共形技术，对个体患者进行风险收益评估。此外,RT可用于DLBCL的各种亚型的治疗背景以及复发或难治性治疗情况。
结论：RT仍然是DLBCL治疗库的组成部分。随着PET引导治疗的使用，RT适用于代谢活跃肿瘤患者。在靶向治疗不断发展的背景下，新的RT适应症可能会发展。
方法：以下文章回顾了当前德国关于DLBCL的循证指南中关于RT的证据和建议，并总结了关键方面。提供了其他文献，以为已发布的建议提供全面的背景。
结果：应在完成免疫化疗后对所有具有局部正电子发射断层扫描（PET）阳性残留物的患者进行RT，并应使用30-40格雷的剂量。对于RT计划，应使用免疫化疗前后的PET信息，在RT治疗位置使用PET-CT或与计划CT进行图像融合。目标体积覆盖应使用共形技术，对个体患者进行风险收益评估。此外,RT可用于DLBCL的各种亚型的治疗背景以及复发或难治性治疗情况。
结论：RT仍然是DLBCL治疗库的组成部分。随着PET引导治疗的使用，RT适用于代谢活跃肿瘤患者。在靶向治疗不断发展的背景下，新的RT适应症可能会发展。
