How to manage early-stage follicular lymphoma.
Expert Rev Hematol
; 13(10): 1093-1105, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-740141
ABSTRACT
INTRODUCTION:
Early-stage follicular lymphoma (FL) is characterized by good prognosis and can be cured with involved-field radiotherapy (IF-RT) in most cases. PET scan is a milestone of diagnostic work-up, with the aim of identifying a truly localized disease; however, staging in most of the studies was without PET. AREAS COVERED We have searched in MEDLINE (inclusive dates 1994-2020) data about localized FL management. While high-quality evidence is lacking, current guidelines recommend IFRT or involved-site RT as first-line treatment in limited stages FL. Since a significant proportion of disease relapse occurred in non-irradiated areas, it has been hypothesized that occult disease could be present at diagnosis and could persist after RT, contributing to relapse. Available treatment options include watch-and-wait, chemotherapy, RT plus chemo- or chemo-immunotherapy, and RT combined with rituximab (R). EXPERT OPINION RT combined with chemotherapy could increase PFS, but a clear OS benefit is lacking and toxic effects could be unacceptable. A promising strategy is represented by R combined with IF-RT, with low relapse rate outside the radiation fields and without the toxicity reported with chemotherapy. The study of prognostic factors in PET-staged patients, the reduction of RT fields and doses, and a response-adapted strategy represent new perspectives to investigate.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Lymphoma, Follicular
Type of study:
Diagnostic study
/
Prognostic study
/
Reviews
Topics:
Long Covid
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Expert Rev Hematol
Journal subject:
Hematology
Year:
2020
Document Type:
Article
Affiliation country:
17474086.2020.1818226
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