Evidence map›Paper›PMID 36420208›Full record

ArticleAdvances in radiation oncology

Radiation Therapy for Relapsed or Refractory Diffuse Large B-Cell Lymphoma: What Is the Right Regimen for Palliation?

Christopher M Wright, Alexandra D Dreyfuss, Jonathan A Baron, Russell Maxwell, Amberly Mendes, Andrew R Barsky, Abigail Doucette, Jakub Svoboda, Elise A Chong, Joshua A Jones and 3 more

Open access · goldAbstract read
In one paragraph

Article in Advances in radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Efficacy and toxicity of hypofractionated radiation therapy for patients with hematologic malignancies: A COVID-era ILROG collaborative report.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2025
    Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Christopher M WrightDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Alexandra D DreyfussDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Jonathan A BaronDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Russell MaxwellDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Amberly MendesDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Andrew R BarskyDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Abigail DoucetteDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Jakub SvobodaDepartment of Medicine, Hematology/Oncology Division, University of Pennsylvania, Philadelphia, Pennsylvania.
Elise A ChongDepartment of Medicine, Hematology/Oncology Division, University of Pennsylvania, Philadelphia, Pennsylvania.
Joshua A JonesDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Amit MaityDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
John P PlastarasDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
Ima PaydarDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
University of Pennsylvania · USMemorial Sloan Kettering Cancer Center · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

Purpose: To report objective response rates (ORR), time to local failure (TTLF), and overall survival (OS) among patients with relapsed or refractory diffuse large B-cell lymphoma after salvage- or palliative-intent radiation therapy (RT) and to investigate whether outcomes differed with conventional versus hypofractionated (≥2.5 Gy/fraction) RT. Methods and Materials: A single-institution observational cohort study was performed for patients who completed a course of RT for relapsed or refractory diffuse large B-cell lymphoma between January 1, 2008, and April 1, 2020. Predictors of ORR, TTLF, and OS were calculated using univariable and multivariable regression models. The Kaplan-Meier method was used to estimate TTLF and OS, and log-rank analysis was used to compare outcomes. Equivalent dose in 2 Gy fractions (EQD2) was calculated using an α/β of 10. Results: One-hundred and sixty-nine patients were treated with 205 RT courses (73 [36%] salvage, 132 [64%] palliative), and hypofractionated RT was used in 100 RT courses (49%). Median RT dose was 30 Gy (range, 8-60 Gy). ORR was 60% for the total cohort (53% and 69% for palliative and salvage cohorts, respectively). Over a median follow-up time of 4 months, median OS in all patients was 5 months (3 and 22 months for palliative and salvage cohorts, respectively). No statistically significant differences in ORR, TTLF, and OS were observed with hypofractionation compared with conventional fractionation. EQD2 ≥35 Gy was associated with improved ORR (odds ratio, 3.79 [1.19-12.03]; Conclusions: Hypofractionation is not associated with differences in disease outcomes for patients with relapsed or refractory diffuse large B-cell lymphoma, while higher RT dose (EQD2 ≥35 Gy) may improve ORR and TTLF. Future work is warranted to elucidate the ideal dose and fractionation schema for such patients who will likely also undergo novel systemic agents and cellular therapies.

Identifiers

PMID36420208
PMCPMC9677220
OpenAlexW4283785607

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.