Would you recommend ISRT for an initially bulky nodular lymphocyte predominant Hodgkin lymphoma with complete metabolic response after 4 cycles of R-CHOP?

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare subtype of Hodgkin lymphoma. Approximately 95% of Hodgkin lymphoma cases are classified as classic Hodgkin lymphoma, including the nodular sclerosis, mixed cellularity, lymphocyte-rich, and lymphocyte-depleted subtypes, all of which a...

NLPHL is an uncommon variety of HL. Its biology is not well understood, but the disease is generally CD20 positive and closely related to nodular NHL. For early-stage disease, NCCN guidelines recommend ISRT alone in most cases. Chemotherapy does not appear to improve outcome when added to RT for ear...

Yes, I would.

With the exception of early stage with no risk factors, nodular lymphocyte predominant HL should be treated according to what is known for "typical" HL.

Consolidative RT will lower the risk of recurrence in this patient.