NCCN Guidelines for Patients® | Diffuse Large B-cell Lymphoma

39 NCCN Guidelines for Patients ® : Diffuse Large B-cell Lymphoma, 2017 if you are older than 80 years of age and have multiple health conditions. After 3 to 4 chemotherapy cycles, treatment results will be assessed. Testing should occur at least 8 weeks after treatment. Imaging tests are used. PET/CT has been found to be very useful for checking results. Tests results are used to advise the next steps in treatment. If the cancer appears to be gone or smaller, there is no need to change your treatment plan. Complete the 6 cycles of chemotherapy. If the cancer looks the same or larger, a biopsy may be done to confirm 4 Treatment guide First-line treatment Guide 4. First-line treatment for stages I & II Option 1 Immunochemotherapy Results Treatment 6 cycles of: • RCHOP or • RCEPP • RCDOP • DA-EPOCH + rituximab • RCEOP • RGCVP • R-mini-CHOP No signs of cancer • Radiation therapy Cancer looks smaller on scans and no cancer is found with biopsy • Radiation therapy Cancer looks smaller on scans; Cancer is found with biopsy or biopsy is not done • Higher-dose radiation therapy • Blood stem cell transplant ± radiation therapy • Clinical trial Cancer looks the same or larger • Second-line treatment ( Guide 8 ) • Radiation therapy in some cases. Option 2 Immunochemotherapy Results Treatment 3–4 cycles out of 6 planned cyles of: • RCHOP or • RCEPP • RCDOP • R-DA-EPOCH + rituximab • RCEOP • RGCVP • R-mini-CHOP No signs of cancer • Complete treatment Cancer looks smaller • Complete treatment Cancer looks the same or larger; No cancer is found with biopsy • Complete treatment Cancer looks the same or larger; Cancer is found with biopsy or biopsy is not done • Second-line treatment ( Guide 8 ) • Radiation therapy in some cases

RkJQdWJsaXNoZXIy MTE3MTE1