Blood: PET-CT guidance consolidates the effects of radiotherapy on long-term prognostication in patients with advanced DLBCL.

The consolidation of radiotherapy (RT) for advanced diffuse large B-cell lymphoma (DLBCL) remains controversial, and clinical routine treatment still uses RT in patients with large initial tumor volume or residual lumps.
PET-CT is a sensitive way to detect the presence of residual lesions at the end of treatment (EOT).
has been using PET-guided methods to selectively manage RT in BC since 2005.
study analyzed EOT-PET data from patients with advanced DLBCL who received at least six courses of treatment with R-CHOP between January 2005 and March 2017.
have been observed in patients with complete metabolic remission (PET-NEG) and, where feasible, in patients with PET-POS positives.
723 patients were followed in the middle for 4.3 years: 517 (72%) were PET-NEG and 206 (28%) were PET-ROS.
3-year progress time (TTP) was 83% vs 56% for PET-NEG and PET-ROS patients, and 87% vs 64% for 3-year overall survival (OS) respectively.
non-progressive PET-POS patients who received solid radiotherapy (109/206,53%) had a prognostic close proximity to PET-NEG patients, with 3-year TTP and OS estimates of 76% and 80%, respectively.
of PET-NEG patients with a tumor diameter of 10 cm at the time of diagnosis was no different from that of patients with smaller tumor size, even if RT was not performed.
, this study shows that patients with advanced DLBCL who have PET-NEG at EOT and who are not treated with RT have good prognostication.
FDG-PET can reliably guide patients on whether they need solid radiotherapy.
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