Consolidation radiotherapy to bulky disease in aggressive NHL. First results of the NHL B-94 trial of the DSHNHL

The impact of radiotherapy in aggressive NHL is not well defined. In the NH L B-94 trial of the DSHNHL, an irradiation of bulky disease areas was done after completing 6 cycles of CHOP/CHOEP chemotherapy. In the entire patient group, including those patients with extranodal disease and those who did not receive the complete chemotherapy, bulky disease was a significant inde pendent prognostic factor concerning recurrence-free survival (66.1% (no bu lk) vs. 53.3% (bulk), p=0.0001). Out of 366 patients with nodal disease onl y and 6 cycles of chemotherapy according to the protocol, 84 of 91 patients with bulky disease were irradiated with 36 Gy. In this group of patients t he prognostic impact of bulky disease could not be shown any longer (recurr ence-free survival 77.3% (no bulk) vs. 74.1% (bulk). Localized radiotherapy of bulky disease areas may therefore have contributed to an improvement in outcome in this high-risk group.