This protocol addresses initial management of primary hepatic lymphoma when histology confirms an indolent subtype: marginal zone lymphoma (MZL), Grade 1–2 follicular lymphoma (FL), or low-grade B-cell lymphoma (BCL), not otherwise specified.
The patient has a confirmed diagnosis of indolent primary hepatic lymphoma. Eligible histological subtypes are marginal zone lymphoma (MZL), Grade 1–2 follicular lymphoma (FL), and low-grade B-cell lymphoma (BCL), NOS.
Appropriate patients with indolent primary hepatic lymphoma are treated with a low-dose radiotherapy approach directed to the liver upfront. The full protocol — including eligibility criteria, fractionation, and adaptive decision points — is detailed in the structured regimen below.
The primary aim is complete response of the primary hepatic lymphoma, evaluated by PET-guided response assessment at 3 months following radiotherapy.
DOI: 10.3389/fonc.2025.1475118
Subgroup analysis was performed for diffuse large B-cell lymphoma (DLBCL) and indolent lymphomas, which included marginal zone lymphoma (MZL), Grade 1-2 follicular lymphoma (FL), and low-grade B-cell lymphoma (BCL), NOS.
Appropriate patients are treated with low dose radiotherapy upfront of 4Gy.
Our results are encouraging for the use of RT for appropriate patients with indolent PHL, using the adaptive approach of 400 cGy in 1-2 fractions, with the option to receive an additional 20Gy based on PET-guided response assessment 3 months post-RT.
The option to receive additional radiation is based on PET-guided response assessment 3 months post-RT.
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