Limited-stage DLBCL: it's patient selection.

In this issue of Blood, Lamy et al present the results of the LYSA/GOELAMS trial 02-03, where patients with limited-stage diffuse large B-cell lymphoma (DLBCL) received either 4 or 6 cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) based on risk stratification, and those achieving complete response (CR) by positron emission tomography (PET) after 4 cycles either received 40 Gy of radiation or were observed. The outcomes were excellent regardless of radiation administration, which was not surprising because the study enrolled a favorable-risk cohort of patients. The role of radiation therapy (RT) is hard to discern in this setting.