Therapy for stage I aggressive non-Hodgkin's lymphoma

Although radiotherapy was considered sufficient for stage I and limited stage II aggressive non-Hodgkin's lymphoma in the past, new data from randomized studies have shown that intensified chemotherapy or combined modality therapy (multiagent chemotherapy followed by involved field radiotherapy) can result in complete remission in 75-90% of the cases, with 5-year overall survival ranging between 82% and 89%. However, not all patients benefit from this management. Patients above 60 years of age, with high lactate dehydrogenase concentration, poor performance, or extranodal disease localized in the testis or central nervous system have a much worse outcome. Therefore, typical extranodal character of this disease (40-57% of the patients show a primary extranodal localization) needs to be recognized and therapy adapted to these subcategories.