The Role of Radiation Therapy in the Treatment of Stage I-II Diffuse Large B-Cell Lymphoma

The role of radiation therapy (RT) in the treatment of Stage I–II diffuse large B cell lymphoma (DLBCL) is controversial: consolidation RT improves local control, but does this translate into an overall survival benefit? The paucity of randomized clinical trials means that the debate surrounding the benefit of consolidation RT remains unresolved. To date, the published literature demonstrates that consolidation RT has dual advantages in patients stage I-II DLBCL: (1) to improve local control and progression-free survival, and (2) to spare additional cycles of chemotherapy in patient with favourable-risk disease. Critics of consolidation RT are often influenced by the profile of late toxicities that are associated with outdated RT techniques. In the current era of molecular-based targeted therapy and functional imaging, prospective randomized studies are required to answer this research question and to investigate risk-adapted treatment strategies for patients with stage I–II DLBCL.