Lymphoma   

My experience has been that patients can be neurologically devastated years out from WBRT. In Medical Oncology practice at my institution, we do not r...

In a refractory DLBCL of entire circumference of leg below knee, how do you spare a tissue strip for lymph node drainage? 

If the patient cannot tolerate methotrexate or further chemotherapy, how effective is radiation therapy (e.g. WBRT) in rendering the patient disease-f...

If the patient has received RCHOPx3 and the post treatment PET is negative, what would your management be?

Would your recommendations change if the mass were significantly smaller, say 1-2 cm, and was completely excised with negative margins?  

In particular, for frail patients to avoid toxicity or for those that do not want chemotherapy

Would you offer refractory doses (40-50 Gy) to the RPnodes and send for splenectomy? Or would you offer refractory doses to both RP nodes and spleen?&...

Have the RAPID or CALGB 5064 studies changed your treatment approach?

For instance, if the tissue came back SLL, Waldenstrom's, follicular lymphoma, or even nodular lymphocyte-predominant Hodgkin lymphoma, would any or a...

NCCN recommends either ISRT with rituximab/chemotherapy or ISRT alone in this scenario.  What factors help your decision making?

What if it is a young patient?

Would your recommendation change if the patient was HIV positive?

Would you consider this refractory disease and go on to salvage regimen and auto-SCT, or is there a role for definitive XRT to the site of residual di...

At what age would you treat an early stage hodgkins lymphoma patient with ABVD + RT (adult treatment) vs OEPA x 2 or AV-PC x 3 (pediatric paradigm)?&n...

How do you decide between WBRT, maintenance chemotherapy, or stem cell transplantation? 

Do the potential late effects offset any benefit of mediastinal XRT in a young patient with bulky disease?

For a stage IAE DLBCL (in this case, of the oral cavity) that was completely excised, s/p R-CHOP, is the ISRT target volume just the preop volume plus...

Some specific questions: Would you recommend repeat biopsy to confirm residual disease? How would your recommendations vary if the patient had pre...

Would you follow an algorithm such as the one proposed by Hall et al? How do you decide between intrathecal chemotherapy vs systemic therapy with HD-...

If they are symptomatic do you relax that time interval? Do you ever consider partial brain radiation instead of whole brain to minimize neurotoxicity...

Would you use a similar dose and fractionation as gastric MALT (30Gy in 1.5 Gy fractions)?

Should prechemo PET positive disease from bowel or other structures be carved out? 

Would you consider observation following surgical resection with negative margins? Would you recommend WBRT and/or ISRT? What would be your preferred ...

Would you use 10 Gy in 1 Gy per fraction as mentioned in a litterature review in Pubmed?

What factors influence your choice to treat as well as dose and target?

In the case of an excised groin node with no residual disease and no chemotherapy in a young adult patient, how large should the fields be? Is it requ...

PET/CT/bone marrow biopsy negative for evidence of distant disease. Following 4 cycles of combination chemotherapy with no evidence of progressive dis...

Specifically, is there still a role for dd RCHOP followed by ICE, or do you recommend DA-R-EPOCH for all patients?

When treating with radiation therapy, what dose-fractionation do you typically utilize?

With the field moving more toward ISRT/ INRT, and conformal radiation, would you generate separate PTV for initial nodal involvements that are within ...

If so, what data should be presented to insurance companies to cover the cost?

When nodal regions not amenable to biopsy but are enlarged without significant SUV uptake, should they be treated as involed and recieve RT?

After ABVE-PC X4 and Ifos/vinorelbine x 2 per AHOD 0831 (and is unable to have these sites biopsied), what dose would you treat to and what volume wou...

When radiation therapy is utilized, what should the radiation therapy treatment fields include and what imaging studies should be completed to assist ...

If so, should involved site radiation thearpy (ISRT) or involved field radiation therapy (IFRT) be used for the radiation therapy treatment fields? Wo...

Are the results of AHOD0031 practice changing?

When the disease (in this case, lymphoma) involves almost all of the entire muscle compartment of the distal lower extremity, what is a safe dose? I'm...

If a patient with stage I, low grade follicular lymphoma achieves a complete response after rituxan and treanda is there any role for consolidative ra...

Specifically for marginal zone or follicle center?

Is it necessary to treat the whole orbit or is conformal treatment ok? 

After a nerve sparing parotidectomy, would you offer postoperative radiotherapy? If so, what volume and dose? Would it change your management if the p...

In a patient with Stage IE DLBCL, is your treatment volume postchemo ISRT or whole breast? Would you consolidate if a lumpectomy was performed prior t...

Would you prescribe to a higher dose? Treat with wider margins? Encourage the use of systemic therapy?

Hoskin et al (Lancet Oncology 2014) suggest 24Gy/12fx is more effect RT dose compared to 4Gy.

Is there a benefit to IMRT when we treat to relatively low doses (as compared to squamous cell cancers of the head and neck)?

Or is it more appropriate for certain sites/stages/histologies?

Specifically, for a diffuse large B cell lymphoma of the femur?

It seems that with the arms up, you get better lung blocking but with arms akimbo, you might have a lower dose to the humeral head.