How would you treat an elderly fit patient with stage IE DLBCL (single skin lesion)?
Would you give 3 cycles of RCHOP followed by consolidative IFRT or 6 cycles of R-mini CHOP? Is there a role for 3 cycles of R-mini CHOP followed by IFRT? Is R-CVP a reasonable option with chances of long term remission?
Answer from: Medical Oncologist at Community Practice
Is this a primary cutaneous large B-cell lymphoma, leg type? I suspect so. This is a rare and aggressive disease. I would carefully stage the patient ( to include bone marrow ) and treat as per any localised DLBCL with 3-4 cycles R-CHOP and XRT. Even with this regimen 50% of patients relapse so I'd ...
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Answer from: Medical Oncologist at Community Practice
Localized Leg type DLBCL typically treated aggressively with RCHOPx 6, CNS prophylaxis, and consolidative radiation to cutaneous lesion. Longer discussion if unable to tolerate doxorubicin, poor tolerance of chemo, etc. Elderly in itself not a reason to hold treatment.
Answer from: Medical Oncologist at Academic Institution
Assuming DLBCL, leg type there is also precedent for local XRT after thorough staging with close follow up. It is imperative to have the pathology reviewed by an expert hematopathologist in cutaneous lymphomas.