Flipping Book - Hema
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Cover |
1 |
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ESTRO Course Book |
1 |
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Hematological Malignancies |
1 |
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3 – 5 September 2015 |
1 |
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London, United Kingdom |
1 |
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L01 The Role of the Radiation Oncologist - Specht |
7 |
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L02 Radiotherapy - Specht |
27 |
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L03 Chemotherapy - Engert |
55 |
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Slide Number 1 |
55 |
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Current approaches and emerging therapies in the treatment of malignant lymphoma |
56 |
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Slide Number 3 |
57 |
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Slide Number 4 |
58 |
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Slide Number 5 |
59 |
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Slide Number 6 |
60 |
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Slide Number 7 |
61 |
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Slide Number 8 |
62 |
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Slide Number 9 |
63 |
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Slide Number 10 |
64 |
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Slide Number 11 |
65 |
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Slide Number 12 |
66 |
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Slide Number 13 |
67 |
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Slide Number 14 |
68 |
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Slide Number 15 |
69 |
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Slide Number 16 |
70 |
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Slide Number 17 |
71 |
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Slide Number 18 |
72 |
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HL treated with MOPP and ABVD Patients in advanced stages |
73 |
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US Intergroup Trial E2496 ABVD vs Stanford V in Advanced Stages |
74 |
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Slide Number 21 |
75 |
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Slide Number 22 |
76 |
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GHSG HD9 trial FFTF by treatment arm |
77 |
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GHSG HD9 trial OS by treatment arm |
78 |
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Slide Number 25 |
79 |
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How can we improve BEACOPPescalated? |
80 |
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Slide Number 27 |
81 |
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Non Hodgkin lymphoma Subtypes |
82 |
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Slide Number 29 |
83 |
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Slide Number 30 |
84 |
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GELA LNH-98.5: Trial design |
85 |
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GELA LNH-98.5 10-year follow-upOverall survival |
86 |
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Standard Regimen for DLBCL Patients |
87 |
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Aggressive NHL: Prognostic factors - aaIPI |
88 |
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Results with R-CHOP in DLBCL |
89 |
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How to further improve DLBCL |
90 |
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DLBCL: Higher dose regimen |
91 |
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DLBCL: Salvage therapy |
92 |
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DLBCL: Conclusions |
93 |
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Slide Number 40 |
94 |
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Slide Number 41 |
95 |
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Slide Number 42 |
96 |
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Slide Number 43 |
97 |
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Slide Number 44 |
98 |
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Slide Number 45 |
99 |
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Slide Number 46 |
100 |
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Slide Number 47 |
101 |
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L04 Immunotherapy - Engert |
102 |
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Slide Number 1 |
102 |
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Immunotherapy of malignant lymphoma |
103 |
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Rationale for immunotherapy of malignant lymphoma |
104 |
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Slide Number 4 |
105 |
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Slide Number 5 |
106 |
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DLBCL in Gela trails: OS |
107 |
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R-CHOP + X |
108 |
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Maintenance in DLBCL |
109 |
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Event Free Survival by Treatment Arm(ITT population; N=683) |
110 |
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Nivolumab in clinical trialsAll B-Cell Lymphoma Patient Responses |
111 |
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Slide Number 11 |
112 |
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Slide Number 12 |
113 |
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Rituximab maintenance vs observation in relapsed FL (EORTC 20981): PFS |
114 |
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Rituximab maintenance vs observation in relapsed FL (EORTC 20981): Overall survival |
115 |
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PRIMA: Progression-free survival |
116 |
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Slide Number 16 |
117 |
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Bendamustine-Rituximab (B-R) vs CHOP-R |
118 |
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Slide Number 18 |
119 |
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Slide Number 19 |
120 |
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Slide Number 20 |
121 |
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Slide Number 21 |
122 |
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Slide Number 22 |
123 |
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Brentuximab Vedotin (SGN-35) Mechanism of action |
124 |
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Slide Number 24 |
125 |
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Phase II Pivotal Study of BV Safety (AEs in ≥20% of pts) |
126 |
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Random. Phase III (AETHERA)BV in HL pts after auto-TX |
127 |
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Slide Number 27 |
128 |
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Slide Number 28 |
129 |
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Slide Number 29 |
130 |
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Slide Number 30 |
131 |
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Slide Number 31 |
132 |
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Slide Number 32 |
133 |
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L05 Radioimmunotherapy - Illidge |
134 |
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Slide Number 1 |
134 |
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Slide Number 2 |
135 |
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Radioimmunotherapy – a unique tool targeting radiosensitivity |
136 |
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B-cell lymphomas express several antigens that can be targeted |
137 |
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Choice of radioisotope |
138 |
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Penetration of Particulate and Electromagnetic Radiation |
139 |
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Radiation delivery profile of conventional radiotherapy versus targeted radiotherapy |
140 |
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Yttrium-90 Ibritumomab tiuxetan (ZevalinTM) |
141 |
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90Y Ibritumomab Tiuxetan treatment is completed in 7 days |
142 |
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131I Tositumomab (Anti-B1):Mechanism Of Action |
143 |
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Treatment Regimen for131I Tositumomab (Licensed in USA – no longer available) |
144 |
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Results of a phase 1 study of 177Lu-DOTA-HH1 anti body radionuclide (Betalutin) conjugate for patients with relapsed CD37+ non-Hodgkin lymphomas – Lugano 2015 |
145 |
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Slide Number 13 |
146 |
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Thorium-227 anti-CD22 |
147 |
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Defining features of RIT in relapsed Follicular Lymphoma |
148 |
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Pivotal Study of 131I Tositumomab Kaminski MS, et al. J Clin Oncol. 2001;19:3918–3928 |
149 |
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Progression Free Survival of 131I Rituximab vs Last qualifying chemotherapy. Illidge et al Blood 2009 |
150 |
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Duration of Responsein 90Y Ibritumomab Tiuxetan Trials |
151 |
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Slide Number 19 |
152 |
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Slide Number 20 |
153 |
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Multivariate analysis of prognostic factors correlated with response to Zevalin for NHL |
154 |
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Rituximab-Refractory Trial:Patient Response to Zevalin |
155 |
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Bendamustine in Rituximab refractory FL |
156 |
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Slide Number 24 |
157 |
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Slide Number 25 |
158 |
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Slide Number 26 |
159 |
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Slide Number 27 |
160 |
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Slide Number 28 |
161 |
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Slide Number 29 |
162 |
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Responses rates of Zevalin monotherapy versus R-chemo in first line therapy of Follicular NHL |
163 |
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Conclusions – Role of RIT in Follicular lymphoma |
164 |
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Slide Number 32 |
165 |
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Slide Number 33 |
166 |
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Slide Number 34 |
167 |
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Slide Number 35 |
168 |
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Slide Number 36 |
169 |
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Slide Number 37 |
170 |
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Questions |
171 |
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L06 - L07 |
172 |
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L06 Combined Modality Treatments - Engert |
172 |
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Slide Number 1 |
172 |
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Combined Modality Treatment of Hodgkin Lymphoma |
173 |
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Slide Number 3 |
174 |
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Hodgkin LymphomaCumulative relative survival of HL pts in Sweden |
175 |
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Slide Number 5 |
176 |
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Slide Number 6 |
177 |
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Slide Number 7 |
178 |
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Slide Number 8 |
179 |
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Hodgkin Lymphoma Evolution of Radiotherapy |
180 |
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Slide Number 10 |
181 |
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Slide Number 11 |
182 |
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Slide Number 12 |
183 |
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Slide Number 13 |
184 |
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Slide Number 14 |
185 |
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Slide Number 15 |
186 |
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HD13: Progression-free survivalAll patients (ITT) |
187 |
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HD13: Overall survivalAll patients (ITT) |
188 |
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Slide Number 18 |
189 |
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Slide Number 19 |
190 |
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Slide Number 20 |
191 |
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UK NCRI RAPID trialEarly stage HL |
192 |
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H10 (#20051): study design |
193 |
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H10 (#20051): study design |
194 |
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UK RAPID; EORTC/LYSA H10 RT or no RT in PET-negative early stage HL |
195 |
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Slide Number 25 |
196 |
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H10 (#20051): study design |
197 |
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EORTC/GELA/IIL H10 StudyAccrual 2006 - 2011 |
198 |
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Slide Number 28 |
199 |
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Slide Number 29 |
200 |
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Slide Number 30 |
201 |
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New Antibodies and Moleculesin Hodgkin Lymphoma |
202 |
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Brentuximab Vedotin (SGN-35) Mechanism of action |
203 |
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Slide Number 33 |
204 |
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Slide Number 34 |
205 |
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Slide Number 35 |
206 |
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Slide Number 36 |
207 |
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PD-1 Blockade in HLBackground |
208 |
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Slide Number 38 |
209 |
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Slide Number 39 |
210 |
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Slide Number 40 |
211 |
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Slide Number 41 |
212 |
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L07 Long Term Toxicity - Aleman New |
213 |
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Slide Number 1 |
213 |
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Long term toxicityLate effects after Hodgkin lymphoma: incidence and clinical implications |
214 |
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Content |
215 |
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Slide Number 4 |
216 |
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Survival after Hodgkin lymphoma |
217 |
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HL treatment changes since 1965 |
218 |
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HL treatment changes since 1965 |
219 |
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Slide Number 8 |
220 |
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Causes of second cancers |
221 |
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Causes of second cancers in relation to age |
222 |
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Slide Number 11 |
223 |
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Slide Number 12 |
224 |
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Risks of Second Malignancy following HL combined results from 3 large studies* (n=9618) |
225 |
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Survival outcome after a second malignancyn=1319 ; treatment period: 1969 and 1997; median fup 12 years. |
226 |
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Survival outcome after a second malignancyn=1319 ; treatment period: 1969 and 1997; median fup 12 years. |
227 |
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Relative risks of SMN by age at HL diagnosis |
228 |
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Slide Number 17 |
229 |
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From mantle field to IFRT |
230 |
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Slide Number 19 |
231 |
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Slide Number 20 |
232 |
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Slide Number 21 |
233 |
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Slide Number 22 |
234 |
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Literature on CRC risk after HL or childhood cancer and in A-bomb survivors |
235 |
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Slide Number 24 |
236 |
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SIR & AER of CRC in 2,820 5-year Dutch HL survivors, diagnosed<51 years, treated1965-1995; median fup 21.5 years |
237 |
|
Risk of CRC by HL treatment |
238 |
|
Clinical implications |
239 |
|
Slide Number 28 |
240 |
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Slide Number 29 |
241 |
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Slide Number 30 |
242 |
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Slide Number 31 |
243 |
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Slide Number 32 |
244 |
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Solid tumor risk by follow up intervalDutch 5 year HL survivors treated 1965-2000 at age 15-51 years (n=3,905) |
245 |
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Cumulative incidence any SMN by period |
246 |
|
Cumulative incidence of solid tumors by treatment period |
247 |
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Cumulative incidence of leukemia (excluding MDS) |
248 |
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Trend in cumulative incidence* of lung cancer by period of treatment and sex in 5 year HL survivors (n=3,905) and the general population |
249 |
|
Conclusions |
250 |
|
Summary SMN |
251 |
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Causes cardiovascular damage |
252 |
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Slide Number 41 |
253 |
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Cardiovascular toxicity Differences in mechanisms |
254 |
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Literature cardiovascular disease after HL |
255 |
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Morbidity of cardiovascular disease (all events in 2524 5-year survivors of HL treated before age 51 between 1965-1995) |
256 |
|
HL treatment |
257 |
|
Nested case-control studies |
258 |
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Nested case-control studies |
259 |
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Valvular heart disease after HL89 cases and 200 controls nested in cohort of 1852 Dutch five-year survivors of HL treated between 1965 and 1995 |
260 |
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Valvular heart disease after HL89 cases and 200 controls nested in cohort of 1,852 Dutch five-year survivors of HL treated between 1965 and 1995 |
261 |
|
Coronary heart disease after HL; 325 cases and 1,204 controls nested in a cohort of 2,617 Dutch 5‐year HL survivors treated between 1965 and 1995 |
262 |
|
Dose-response by tertiles of age at HL treatment |
263 |
|
Dose-associated cumulative incidence |
264 |
|
Estimated cumulative incidence by age at treatment |
265 |
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Estimated cumulative incidence by age at treatment |
266 |
|
Established CVD Risk factors |
267 |
|
Established CVD Risk factors |
268 |
|
Conclusions ischemic heart disease after HL |
269 |
|
Conclusions CVD after HL(literature and Dutch HL cohort) |
270 |
|
Anthracyclines |
271 |
|
Cardiovascular disease after therapy for HL: A detailed analysis of 9 collaborative EORTC-LYSA trials |
272 |
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CVD after therapy for HL: A detailed analysis of 9 collaborative EORTC-LYSA trials |
273 |
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Cardiovascular disease after therapy for HL: A detailed analysis of 9 collaborative EORTC-LYSA trials |
274 |
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Cardiovascular disease after therapy for HL: A detailed analysis of 9 collaborative EORTC-LYSA trials |
275 |
|
Cardiovascular disease after therapy for HL: A detailed analysis of 9 collaborative EORTC-LYSA trials |
276 |
|
Optimize treatment ? |
277 |
|
Treatment optimization: |
278 |
|
Slide Number 67 |
279 |
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Limit risk of (treatment -related) side effectsPatient |
280 |
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Slide Number 69 |
281 |
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Future |
282 |
|
Acknowledgements |
283 |
|
Slide Number 72 |
284 |
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Risk of second malignancy, Dutch HL cohort; 3370 5-yr survivors, 15-50 yr at dx, 1965 - 2000 |
285 |
|
SIRs and AERs of second malignancy, Dutch HL cohort; 3370 5-yr survivors, 15-50 yr at dx, 1965-2000 |
286 |
|
SIR of Second Malignancy following HL combined results from 3 large studies* (n=9618) |
287 |
|
Literature cardiovascular disease after HL, II |
288 |
|
Changes in RT fields over time |
289 |
|
Slide Number 78 |
290 |
|
Slide Number 79 |
291 |
|
Survival outcome after a second malignancyn=1319 ; treatment period: 1969 and 1997; median fup 12 years. |
292 |
|
Slide Number 81 |
293 |
|
Slide Number 82 |
294 |
|
Trend in cumulative incidence* of lung cancer by period of treatment and sex in 5 year HL survivors (n=3,905) and the general population |
295 |
|
Changes radiation techniques |
296 |
|
Screening for second cancers |
297 |
|
Future research SMN after HL |
298 |
|
Acknowledgements |
299 |
|
Slide Number 88 |
300 |
|
Spare slides |
301 |
|
Changes in radiation fields |
302 |
|
Statistical analyses |
303 |
|
Cardiovascular disease after treatment for HL |
304 |
|
Risk factors for CRC after HL treatmentMultivariable regression analysis |
305 |
|
Cumulative incidence of CRC by attained age |
306 |
|
Trends in SIRs of hematological malignancies after HL |
307 |
|
Trends in SIRs of solid SCs |
308 |
|
L08 Hodgkin Lymphoma; Lymphotic Predominance - Mikhaeel |
309 |
|
Slide Number 1 |
309 |
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Nodular Lymphocyte Predominant HLRole of Radiotherapy |
310 |
|
Incidence |
311 |
|
Characteristics |
312 |
|
Slide Number 5 |
313 |
|
Characteristics (2) |
314 |
|
Characteristics (3) |
315 |
|
Slide Number 8 |
316 |
|
Slide Number 9 |
317 |
|
Slide Number 10 |
318 |
|
Diagnostic work up |
319 |
|
Management |
320 |
|
CMT / Chemo for early stage |
321 |
|
Slide Number 14 |
322 |
|
BCCCA study |
323 |
|
Surgical resection |
324 |
|
Outcome of RT in early stage |
325 |
|
Slide Number 18 |
326 |
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Slide Number 19 |
327 |
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Slide Number 20 |
328 |
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Slide Number 21 |
329 |
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Radiotherapy |
330 |
|
Slide Number 23 |
331 |
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Slide Number 24 |
332 |
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Slide Number 25 |
333 |
|
Radiotherapy (cont.) |
334 |
|
Key points |
335 |
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Thank you |
336 |
|
L09 Classic Hodgkin Lymphoma; Radiotherapy and Early Stage - Illidge |
337 |
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Slide Number 1 |
337 |
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The role of radiotherapy in Early stage stage HL |
338 |
|
Overview of talk |
339 |
|
Overall results of therapy for early disease |
340 |
|
Late effects to avoid as cures increase |
341 |
|
Slide Number 6 |
342 |
|
Objectives in Early stage Hodgkin Lymphoma |
343 |
|
Results from the trialsEarly stage disease |
344 |
|
Slide Number 9 |
345 |
|
Slide Number 10 |
346 |
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Slide Number 11 |
347 |
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Slide Number 12 |
348 |
|
NCIC CTG ECOG HD.6 TrialUnfavorable Cohort-Causes of Death |
349 |
|
NCIC CTG ECOG HD.6 TrialSmall numbers and unusual events |
350 |
|
What do we learn from NCIC/ECOG HD6 ? |
351 |
|
What don’t we learn from HD6 ? |
352 |
|
GHSG HD10, HD11 (CMT) Comparisonwith NCIC CTG HD.6 (ABVD alone) |
353 |
|
Slide Number 18 |
354 |
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Key questions in using Combined Modality Treatment in early stage HL |
355 |
|
Transformation of RT Volumes / Doses in HLISRT – Specht L et al IJROBP 2014 |
356 |
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The Challenge of 18FDG PET CT in HL : Converting large SUV numbers into Binary (Positive / Negative) and making sense of it |
357 |
|
Slide Number 22 |
358 |
|
UK NCRI RAPID in early HL study Demographics |
359 |
|
UK NCRI RAPID study PET scores after 3 cycles ABVD |
360 |
|
UK NCRI RAPID Trial |
361 |
|
UK NCRI RAPID TrialPer protocol analysis of randomised patients |
362 |
|
UK RAPID Deaths in IFRT arm that did not receive IFRT : Older patients tolerate ABVD badly |
363 |
|
UK NCRI RAPID TrialPFS in the randomised PET –ve population (per protocol analysis, n=392) |
364 |
|
Summary of UK NCRI RAPID study |
365 |
|
EORTC/ LYSA/ FIL H10 (#20051): study design |
366 |
|
EORTC/LYSA/FIL H10 Trial |
367 |
|
Slide Number 32 |
368 |
|
Conclusions for FDG PET in Early HL |
369 |
|
Slide Number 34 |
370 |
|
Which Patients with Stage I-II Hodgkin Lymphoma for Contemporary Combined Modality Therapy in PET era ? |
371 |
|
Conclusions |
372 |
|
L10 Classic Hodgkin Lymphoma; Advanced Stage - Engert |
373 |
|
Slide Number 1 |
373 |
|
Treatment of advanced stage Hodgkin lymphoma |
374 |
|
Slide Number 3 |
375 |
|
Hodgkin LymphomaCumulative relative survival of HL pts in Sweden |
376 |
|
Slide Number 5 |
377 |
|
Slide Number 6 |
378 |
|
Long-term results of HL patients |
379 |
|
GHSG HD9 trial FFTF by treatment arm |
380 |
|
Slide Number 9 |
381 |
|
Slide Number 10 |
382 |
|
Slide Number 11 |
383 |
|
Slide Number 12 |
384 |
|
TRM of BEACOPP escalated* Multivariate model |
385 |
|
GHSG HD18 trial for advanced stages |
386 |
|
Slide Number 15 |
387 |
|
RATHL: Impact of BleomycinPFS for PET-negative patients (ITT) |
388 |
|
UK RATHL Trial PFS for PET-negative HL patients (IIT) |
389 |
|
Slide Number 18 |
390 |
|
Slide Number 19 |
391 |
|
Slide Number 20 |
392 |
|
HD12 pts with no bulk and no rest (PFS n=388) |
393 |
|
HD12 patients with bulk only (PFS; n=402) |
394 |
|
HD12 pts with bulk and rest (PFS n=613) |
395 |
|
Slide Number 24 |
396 |
|
Slide Number 25 |
397 |
|
Slide Number 26 |
398 |
|
Slide Number 27 |
399 |
|
Slide Number 28 |
400 |
|
Slide Number 29 |
401 |
|
Advanced stage HLSummary |
402 |
|
Slide Number 31 |
403 |
|
Slide Number 32 |
404 |
|
L11 Classic Hodgkin Lymphoma; Advanced Stage & Radiotherapy - Yahalom |
405 |
|
Slide Number 1 |
405 |
|
Is There Still A Role of RT in Advanced-stage HL?(…and the background for questioning it…) |
406 |
|
Who is an “advanced-stage” patient? |
407 |
|
FDG-PET assessment Deauville criteria or 5 point scale |
408 |
|
Type of Chemotherapy |
409 |
|
RT in Advanced-Stage HL |
410 |
|
Slide Number 7 |
411 |
|
Slide Number 8 |
412 |
|
Slide Number 9 |
413 |
|
Slide Number 10 |
414 |
|
Slide Number 11 |
415 |
|
Slide Number 12 |
416 |
|
EORTC Study relevance concerns |
417 |
|
Slide Number 14 |
418 |
|
Slide Number 15 |
419 |
|
Slide Number 16 |
420 |
|
Slide Number 17 |
421 |
|
Slide Number 18 |
422 |
|
Randomized study of consolidation RT vs. Observation in bulky (>5cm) HL patients who became PET-negative after chemotherapy |
423 |
|
Slide Number 20 |
424 |
|
Slide Number 21 |
425 |
|
Intergroup Trial E2496: Response rates (%) |
426 |
|
Slide Number 23 |
427 |
|
Slide Number 24 |
428 |
|
CONCLUSIONS |
429 |
|
RT in GHSG BEACOPP Studies (1) |
430 |
|
RT in GHSG BEACOPP Studies (2) |
431 |
|
Slide Number 28 |
432 |
|
When RT should be considered in “advanced-stage”? |
433 |
|
RT in Salvage of Refractory or Relapsed patients |
434 |
|
L12 Classic Hodgkin Lymphoma; Relapsed, Refractory Disease - Yahalom |
435 |
|
RT for relapsed and refractory lymphoma |
435 |
|
Slide Number 2 |
436 |
|
Radiation Therapy for HDRecent Trends |
437 |
|
In the United States RT is less commonly used in the management HLthe consequences |
438 |
|
From medical oncology salvage leader: |
439 |
|
HL: the numbers |
440 |
|
High-Dose Therapy Salvage of Hodgkin Lymphoma Enhanced by RT: 30 Years of Experience |
441 |
|
MSKCC HL- Salvage with Transplantation Program |
442 |
|
MSKCC HL- Salvage with Transplantation Program |
443 |
|
Salvage Therapy of Hodgkin Lymphoma – Why RT? |
444 |
|
Integrating Radiotherapy - Rationale |
445 |
|
Integrating Radiotherapy- Concerns |
446 |
|
Integrating Radiotherapy - Options |
447 |
|
Integrating Radiotherapy - Preferred |
448 |
|
Phase I/II Trial of TLI vs High-Dose Chemotherapy Salvage Regimen |
449 |
|
Slide Number 16 |
450 |
|
Management of Relapsed HL @MSKCC |
451 |
|
Advantages of Integrated RT in High-Dose Therapy Regimen |
452 |
|
Boost Field (IFRT) |
453 |
|
TLI Field |
454 |
|
MSKCC Clinical Research Programof Salvage for Hodgkin Lymphoma1985-2015 |
455 |
|
Protocol Generation (1-85/86, 2-94, 3-98, 4-04/06) |
456 |
|
Protocol Generation (1-85/86, 2-94, 3-98, 4-04/06) |
457 |
|
Overall Survival |
458 |
|
Response to Salvage Therapy |
459 |
|
Primary Refractory vs Relapsed HL |
460 |
|
Extranodal Disease at Relapse |
461 |
|
Multivariate Analysis |
462 |
|
≥ Grade 3 Toxicity |
463 |
|
Second Malignancies |
464 |
|
Summary |
465 |
|
RECENT MSKCC STUDIES |
466 |
|
Lesson learned from our first 3 studies ASCT Studies in HL-1985-2004 |
467 |
|
Pre-ASCT Response |
468 |
|
MSKCC 11-142: Relapsed/refractory HL First TX following upfront therapy Moskowitz AJ et al Lancet Oncology 16, No 3, 284-292, March 2015 |
469 |
|
PET-adapted therapy with BV followed by augICE |
470 |
|
Post-salvage outcome |
471 |
|
Slide Number 39 |
472 |
|
EFS according to treatment and PET status |
473 |
|
ATHERA Study- Lancet 2015 |
474 |
|
BV post-ASCT |
475 |
|
Slide Number 43 |
476 |
|
Conclusions |
477 |
|
SUMMARY |
478 |
|
Thanks |
479 |
|
L13 Classic Hodgkin Lymphoma; Relapsed, Refractory Disease & Chemotherapy - Engert |
480 |
|
Slide Number 1 |
480 |
|
Relapsed and refractoryLymphoma |
481 |
|
Slide Number 3 |
482 |
|
Relapsed Hodgkin Lymphoma Selected conventional salvage regimen |
483 |
|
HDR2: European Intergroup TrialRelapsed Hodgkin Lymphoma* |
484 |
|
HDR2 Study for Relapsed HLPFS by Treatment Arm (Final Analysis) |
485 |
|
Slide Number 7 |
486 |
|
Slide Number 8 |
487 |
|
Slide Number 9 |
488 |
|
Slide Number 10 |
489 |
|
Slide Number 11 |
490 |
|
Slide Number 12 |
491 |
|
Relapsed and refractory lymphoma Summary |
492 |
|
More Informationwww.ghsg.orgThank you for your attention! |
493 |
|
International Hodgkin Symposium12.-15.10.2013, Köln, Gürzenich |
494 |
|
L14 Classic Hodgkin Lymphoma; Radiotherapy Volumes, Doses and Techniques - Ricardi |
495 |
|
Slide Number 1 |
495 |
|
Classical Hodgkin LymphomaRadiotherapy volumes, doses and techniques |
496 |
|
Slide Number 3 |
497 |
|
RT in classical Hodgkin Lymphoma |
498 |
|
RT in classical Hodgkin Lymphoma |
499 |
|
Slide Number 6 |
500 |
|
From IFRT to INRT |
501 |
|
RT in classical Hodgkin Lymphoma |
502 |
|
Slide Number 9 |
503 |
|
Slide Number 10 |
504 |
|
Slide Number 11 |
505 |
|
Treatment Volume Principles |
506 |
|
Slide Number 13 |
507 |
|
Slide Number 14 |
508 |
|
Slide Number 15 |
509 |
|
Slide Number 16 |
510 |
|
Slide Number 17 |
511 |
|
The concepts of INRT and ISRT |
512 |
|
Slide Number 19 |
513 |
|
INRT: guidelines 2008 |
514 |
|
Slide Number 21 |
515 |
|
Slide Number 22 |
516 |
|
Slide Number 23 |
517 |
|
Slide Number 24 |
518 |
|
Slide Number 25 |
519 |
|
Slide Number 26 |
520 |
|
Slide Number 27 |
521 |
|
Slide Number 28 |
522 |
|
Slide Number 29 |
523 |
|
Slide Number 30 |
524 |
|
Slide Number 31 |
525 |
|
Slide Number 32 |
526 |
|
Slide Number 33 |
527 |
|
Do we have clinical data on safety and efficacy of INRT/ISRT? |
528 |
|
Slide Number 35 |
529 |
|
Slide Number 36 |
530 |
|
Slide Number 37 |
531 |
|
Optimal radiation doses |
532 |
|
Slide Number 39 |
533 |
|
Slide Number 40 |
534 |
|
Slide Number 41 |
535 |
|
Slide Number 42 |
536 |
|
Dose constraints in lymphoma RT |
537 |
|
Slide Number 44 |
538 |
|
Slide Number 45 |
539 |
|
IMRT vs 3D-CRT in lymphoma |
540 |
|
IMRT in lymphoma RT |
541 |
|
Slide Number 48 |
542 |
|
Slide Number 49 |
543 |
|
Slide Number 50 |
544 |
|
Slide Number 51 |
545 |
|
Slide Number 52 |
546 |
|
Slide Number 53 |
547 |
|
Slide Number 54 |
548 |
|
Which technique is preferable? |
549 |
|
Which technique is preferable? |
550 |
|
Slide Number 57 |
551 |
|
Modern RT in HL |
552 |
|
Slide Number 59 |
553 |
|
L16 Indolent Nodal Non-Hodgkin Lymphoma; Early Stage - Illidge |
554 |
|
Slide Number 1 |
554 |
|
Slide Number 2 |
555 |
|
Slide Number 3 |
556 |
|
Slide Number 4 |
557 |
|
Slide Number 5 |
558 |
|
Hypothesis: Is more dose better? |
559 |
|
Reduced dose radiotherapy for NHL : A randomised phase III trialLowry L, Smith P, Qian W, Falk S, Benstead K, Illidge T, Linch D, Robinson M, Jack A, Hoskin P. Radiother Oncol. 2011 Jun 9. |
560 |
|
Indications for Radiotherapy |
561 |
|
Acute RT Toxicity |
562 |
|
Local Control at 1 month |
563 |
|
Slide Number 11 |
564 |
|
Slide Number 12 |
565 |
|
Slide Number 13 |
566 |
|
Slide Number 14 |
567 |
|
Slide Number 15 |
568 |
|
Radiotherapy alone for stage I-III low grade follicular lymphoma: long-term outcome and comparison of extended field and total nodal irradiation.Guckenberger M Radiat Oncol 2012 Jun 24;7:103. |
571 |
|
Radiotherapy alone for stage I-III low grade follicular lymphoma: long-term outcome and comparison of extended field and total nodal irradiation.Guckenberger M Radiat Oncol 2012 Jun 24;7:103. |
572 |
|
Slide Number 21 |
573 |
|
Is radiotherapy curative for stage I and II low-grade follicular lymphoma? Should RT alone remain standard of care ? |
574 |
|
Conclusions |
577 |
|
L17 Indolent Nodal Non-Hodgkin Lymphoma; New Agents - Illidge |
578 |
|
Slide Number 1 |
578 |
|
Slide Number 2 |
579 |
|
Decision making in Follicular Lymphoma |
580 |
|
Goals of therapy versus toxicity / tolerability in Follicular Lymphoma |
581 |
|
Follicular Lymphoma International Prognostic Index (FLIPI and F2) – |
582 |
|
Decision making in Initial treatment of Follicular Lymphoma |
583 |
|
Established definitions of when treatment required |
584 |
|
Treatments approaches for those requiring treatment (high tumour burden) |
585 |
|
Rituximab: An engineered murine/human chimeric monoclonal antibody – granted US FDA approval for treatment of cancer 1997 |
586 |
|
Rituximab-Chemotherapy in Untreated Advanced Follicular NHL |
587 |
|
Progression-Free Survival Dependson First-Line Treatment |
588 |
|
StiL R-Benda vs R-CHOPRummel MJ et al : Lancet Feb 20, 2013 |
592 |
|
StiL R-Benda vs R-CHOPRummel MJ et al : Lancet Feb 20, 2013 |
593 |
|
Maintenance Rituximab after Induction immunochemotherapyPRIMA: study design |
594 |
|
Safety and activity of lenalidomide and rituximab in untreated indolent lymphoma: an open-label, phase 2 trialFowler et al Lancet Oncol. 2014 Nov;15(12):15.Can cytotoxic chemotherapy be avoided ? |
596 |
|
Safety and activity of lenalidomide and rituximab in untreated indolent lymphoma: an open-label, phase 2 trialFowler et al Lancet Oncol. 2014 Nov;15(12):15.Response Rates of R2 |
597 |
|
Can cytotoxic chemotherapy be avoided ? The "RELEVANCE" Trial (Rituximab and Lenalidomide Versus Any Chemotherapy) |
598 |
|
Novel agents to target Follicular lymphoma in relapsed and rituximab refractory disease ? |
599 |
|
Slide Number 23 |
600 |
|
Slide Number 24 |
601 |
|
BCR signalling in lymphoid malignancy |
602 |
|
Slide Number 26 |
603 |
|
Hairy Cell Leukaemia as example of molecule versus disease |
604 |
|
Novel agents in Follicular NHL |
605 |
|
Slide Number 29 |
606 |
|
Gopal AK et al. N Engl J Med 2014;370:1008-1018. |
607 |
|
Other novel inhibitors in indolent lymphomas |
608 |
|
Slide Number 32 |
609 |
|
Conclusions therapy in advanced stage FL |
610 |
|
L18 Indolent Nodal Non-Hodgkin Lymphoma; Advanced Stage & Radiotherapy - Mikhaeel |
611 |
|
Slide Number 1 |
611 |
|
Indolent NHL-Comments on RT for advanced stage |
612 |
|
Outline |
613 |
|
Role of RT in advanced disease |
614 |
|
Low dose RT in advanced disease |
615 |
|
Patient selection |
616 |
|
Rapid excellent response with virtually no side effects |
617 |
|
Slide Number 8 |
618 |
|
Evidence for choice of dose |
619 |
|
Slide Number 10 |
620 |
|
Slide Number 11 |
621 |
|
Slide Number 12 |
622 |
|
Key points |
623 |
|
L19 Indolent Nodal Non-Hodgkin Lymphoma; Relapsed, Refactory Disease & Radiotherapy - Yahalom |
624 |
|
Slide Number 1 |
624 |
|
RT for relapsed indolent lymphomas |
625 |
|
General Treatment Options |
626 |
|
Field Design Concept |
627 |
|
RT Dose for Palliation |
628 |
|
Slide Number 6 |
629 |
|
STUDY DESIGN |
630 |
|
INDOLENT LYMPHOMAS: Local Control |
631 |
|
INDOLENT LYMPHOMAS: PFS |
632 |
|
INDOLENT LYMPHOMAS: Overall Survival |
633 |
|
Slide Number 11 |
634 |
|
Slide Number 12 |
635 |
|
Slide Number 13 |
636 |
|
Slide Number 14 |
637 |
|
Slide Number 15 |
638 |
|
Slide Number 16 |
639 |
|
FoRT: A phase III multi-centre randomised controlled trial of low dose radiotherapy for follicular and marginal zone lymphoma |
640 |
|
Slide Number 18 |
641 |
|
Slide Number 19 |
642 |
|
Slide Number 20 |
643 |
|
Slide Number 21 |
644 |
|
Slide Number 22 |
645 |
|
Slide Number 23 |
646 |
|
Slide Number 24 |
647 |
|
Slide Number 25 |
648 |
|
Whom to Boom-Boom? |
649 |
|
Slide Number 27 |
650 |
|
Slide Number 28 |
651 |
|
Slide Number 29 |
652 |
|
Response to very low dose RT is variable |
653 |
|
Slide Number 31 |
654 |
|
Database creation: Low grade lymphomas treated with 2 Gy x 2 |
655 |
|
Initial response predicts local progression free survival |
656 |
|
Slide Number 34 |
657 |
|
Slide Number 35 |
658 |
|
Whole transcriptome profiling with FFPE extracted RNA samples |
659 |
|
Whole transcriptome profiling with FFPE extracted RNA samples |
660 |
|
Increased expression in CR vs. PR/NR |
661 |
|
Decreased expression in CR vs. PR/NR |
662 |
|
Slide Number 40 |
663 |
|
Slide Number 41 |
664 |
|
CR vs. PR/NR Gene Pathways |
665 |
|
Slide Number 43 |
666 |
|
Conclusions |
667 |
|
Future Directions |
668 |
|
Thank you! |
669 |
|
L20 Indolent Nodal Non-Hodgkin Lymphoma; Volumes, Doses and Techniques - Ricardi |
670 |
|
Slide Number 1 |
670 |
|
Indolent Nodal non Hodgkin LymphomaVolumes, doses and techniques |
671 |
|
Modern RT in Indolent Lymphoma |
672 |
|
Slide Number 4 |
673 |
|
Slide Number 5 |
674 |
|
Slide Number 6 |
675 |
|
Slide Number 7 |
676 |
|
Treatment Volume Principles |
677 |
|
Slide Number 9 |
678 |
|
Slide Number 10 |
679 |
|
Radiation therapy as primary treatment |
680 |
|
Slide Number 12 |
681 |
|
Slide Number 13 |
682 |
|
Slide Number 14 |
683 |
|
Slide Number 15 |
684 |
|
Slide Number 16 |
685 |
|
Slide Number 17 |
686 |
|
Slide Number 18 |
687 |
|
Slide Number 19 |
688 |
|
Slide Number 20 |
689 |
|
Slide Number 21 |
690 |
|
Slide Number 22 |
691 |
|
Slide Number 23 |
692 |
|
Slide Number 24 |
693 |
|
Slide Number 25 |
694 |
|
Dose constraints in lymphoma RT |
695 |
|
IMRT vs 3D-CRT in lymphoma |
696 |
|
Slide Number 28 |
697 |
|
Which technique is preferable? |
698 |
|
Slide Number 30 |
699 |
|
Modern RT in lymphoma |
700 |
|
L21a Imaging for radiotherapy of lymphomas - Mikhaeel |
701 |
|
Slide Number 1 |
701 |
|
Imaging in Management of Lymphoma |
702 |
|
Outline |
703 |
|
Staging and Response Assessment |
704 |
|
The Lugano Classification - 2014 |
705 |
|
The Lugano Classification - 2014 |
706 |
|
What is new?(compared to 2007) |
707 |
|
PET/CT as standard imaging for staging |
708 |
|
Slide Number 9 |
709 |
|
Bone Marrow Assessment |
710 |
|
Slide Number 11 |
711 |
|
Slide Number 12 |
712 |
|
Slide Number 13 |
713 |
|
Interpretation of DIFFUSE marrow uptake |
714 |
|
Slide Number 15 |
715 |
|
Slide Number 16 |
716 |
|
Value of Initial Bulk |
717 |
|
Stage & Bulk in prognostic indices |
718 |
|
Recommendations for Bulk |
719 |
|
MTV-0 + DS |
720 |
|
Splenic Involvement |
721 |
|
Simplified Ann Arbor |
722 |
|
Response assessment |
723 |
|
Change from IHP to Deauville |
724 |
|
Escalation |
725 |
|
Slide Number 26 |
726 |
|
Score 3 |
727 |
|
Score 4 & 5 |
728 |
|
Slide Number 29 |
729 |
|
Slide Number 30 |
730 |
|
Challenges with quantitation |
731 |
|
Recommendation: Quantitation for Response |
732 |
|
Recommendation: Interim PET-CT |
733 |
|
Revised criteria for response assessment |
734 |
|
Slide Number 35 |
735 |
|
Slide Number 36 |
736 |
|
Slide Number 37 |
737 |
|
Slide Number 38 |
738 |
|
Slide Number 39 |
739 |
|
Slide Number 40 |
740 |
|
Slide Number 41 |
741 |
|
Slide Number 42 |
742 |
|
Recommendation: Residual metabolic activity |
743 |
|
HL |
744 |
|
6 ABVD |
745 |
|
3 months post chemo + IFRT |
746 |
|
Slide Number 47 |
747 |
|
Other staging & response systems |
748 |
|
Slide Number 49 |
749 |
|
Guy’s Campus |
750 |
|
Supplementary slides |
751 |
|
Studies comparing PET or PET-CT with CT for staging |
752 |
|
Contrast-enhanced CT? |
753 |
|
Recommendation: PET –ve Residual masses |
754 |
|
Changes to CT response from 2007 |
755 |
|
Follow up |
756 |
|
L21b Imaging for radiotherapy of lymphomas - Bethelsen |
757 |
|
Imaging for radiotherapy of lymphomas |
757 |
|
Staging and response criteria |
758 |
|
Staging PET/CT |
759 |
|
The Copenhagen Model |
760 |
|
Staging with CT |
761 |
|
PET/CT interpretation |
762 |
|
IV-Contrast |
763 |
|
with and without IV contrast |
764 |
|
CT scan without IV contrast |
765 |
|
CT scan with IV contrast |
766 |
|
Oral contrast |
767 |
|
Lymph node > 1.5 cm |
768 |
|
Chest X-ray is not required |
769 |
|
10 % have a normal chest x-ray |
770 |
|
Slide Number 15 |
771 |
|
Lungs, involvement of lymph nodes |
772 |
|
Lungs |
773 |
|
More diffuse infiltration, snow balls |
774 |
|
Spleen involvement |
775 |
|
Spleen – large solitary mass |
776 |
|
Spleen diffuse infiltration |
777 |
|
Spleen Focal nodula lesion |
778 |
|
Liver involvement also best detected with PET/CT |
779 |
|
Lymphoma in the stomach |
780 |
|
Colon |
781 |
|
Lymphoma infiltration of the kidneys |
782 |
|
Conclusion |
783 |
|
L22 Motion Management and Deep Inspiration Breath Hold DIBH Technique - Aznar |
784 |
|
Slide Number 1 |
784 |
|
Deep inspiration breath hold in thoracic tumours: imaging and treatmentMarianne C Aznar |
785 |
|
Lymphoma: a special case |
786 |
|
At Rigshospitalet |
787 |
|
Methods |
788 |
|
Fusing prechemo and planning images |
789 |
|
How to handle registration uncertainties ? |
790 |
|
Respiration monitoring |
791 |
|
CT + PET/CT |
792 |
|
Slide Number 10 |
793 |
|
Slide Number 11 |
794 |
|
Take home message (1) |
795 |
|
PET/CT acquisition in practice |
796 |
|
Methods: Image reconstruction |
797 |
|
Some problems at start-up !! |
798 |
|
Results: reduced respiration artifacts |
799 |
|
Registration for contouring |
800 |
|
Planning results |
801 |
|
Mean dose to lungs: 8.5Gy vs 12.8 Gy |
802 |
|
Benefit: inter-patient variation |
803 |
|
DIBH + VMAT/IMRT |
804 |
|
What to choose: IMRT? DIBH or both? |
805 |
|
Conclusions DIBH vs IMRT |
806 |
|
Take home message (2): treatment planning |
807 |
|
Position verification in DIBH |
808 |
|
Daily 2D images: fuse on spine, check sternum |
809 |
|
Can check heart position and lung inflation |
810 |
|
Some challenges with CBCT in DIBH |
811 |
|
Some possible compromises… |
812 |
|
A note about margins… |
813 |
|
Take home message (3): treatment delivery |
814 |
|
Conclusion |
815 |
|
Acknowledgments |
816 |
|
Keep breathing |
817 |
|
L23 Contouring Workshop - Specht |
818 |
|
Slide Number 1 |
818 |
|
Contouring Workshop |
819 |
|
Guidelines for radiotherapy of lymphomas, implemented by NCCN and most cooperative groups |
820 |
|
Pre-chemo PET/CT scan |
821 |
|
Post-chemo planning CT scan |
822 |
|
Breathing adaptation, technique |
823 |
|
Breathing adaptation, technique |
824 |
|
Slide Number 8 |
825 |
|
Slide Number 9 |
826 |
|
Slide Number 10 |
827 |
|
Slide Number 11 |
828 |
|
Slide Number 12 |
829 |
|
L24 Aggressive Nodal Non-Hodgkin Lymphoma; Early Stage - Ricardi |
830 |
|
Slide Number 1 |
830 |
|
AGGRESSIVE NODAL NON-HODGKIN LYMPHOMA, THE ROLE OF RADIOTHERAPYEarly Stage |
831 |
|
Is there (still) a role for Radiation Therapy in early stage DLCL? |
832 |
|
Slide Number 4 |
833 |
|
Slide Number 5 |
834 |
|
Slide Number 6 |
835 |
|
Slide Number 7 |
836 |
|
Slide Number 8 |
837 |
|
Slide Number 9 |
838 |
|
Slide Number 10 |
839 |
|
Slide Number 11 |
840 |
|
Slide Number 12 |
841 |
|
Slide Number 13 |
842 |
|
Slide Number 14 |
843 |
|
Slide Number 15 |
844 |
|
Slide Number 16 |
845 |
|
Slide Number 17 |
846 |
|
Slide Number 18 |
847 |
|
Slide Number 19 |
848 |
|
Slide Number 20 |
849 |
|
Slide Number 21 |
850 |
|
Slide Number 22 |
851 |
|
Slide Number 23 |
852 |
|
Slide Number 24 |
853 |
|
Which is the current Treatment Strategy? |
854 |
|
Slide Number 26 |
855 |
|
Slide Number 27 |
856 |
|
To irradiate or not to irradiate ? |
857 |
|
Slide Number 29 |
858 |
|
PET-oriented RT: BCCA experience |
859 |
|
DLCL 10 IPI = 0 bulk, 1 and/or bulk (7.5 cm) (less favourable according MInT) |
860 |
|
Slide Number 32 |
861 |
|
Background and open questions |
862 |
|
Slide Number 34 |
863 |
|
Slide Number 35 |
864 |
|
Slide Number 36 |
865 |
|
Slide Number 37 |
866 |
|
Slide Number 38 |
867 |
|
Slide Number 39 |
868 |
|
Cut-off value in the IELSG protocol |
869 |
|
Slide Number 41 |
870 |
|
Slide Number 42 |
871 |
|
Slide Number 43 |
872 |
|
Enrolled patients by sites (June, 2015) |
873 |
|
Slide Number 45 |
874 |
|
Slide Number 46 |
875 |
|
Slide Number 47 |
876 |
|
Slide Number 48 |
877 |
|
Slide Number 49 |
878 |
|
Slide Number 50 |
879 |
|
Slide Number 51 |
880 |
|
Slide Number 52 |
881 |
|
Slide Number 53 |
882 |
|
Slide Number 54 |
883 |
|
L25 Aggressive Nodal Non-Hodgkin Lymphoma; Advanced Stage - Aleman |
884 |
|
Slide Number 1 |
884 |
|
Aggressive nodal non Hodgkin lymphoma, the role of radiotherapy: Advanced stage – indicationsFocus on consolidation RT |
885 |
|
Slide Number 3 |
886 |
|
Slide Number 4 |
887 |
|
Aggressive nodal non Hodgkin lymphoma, the role of radiotherapy: Advanced stage - general |
888 |
|
Duke Experience |
889 |
|
Duke ExperienceKM curves infield control and EFS |
890 |
|
Duke ExperienceKM curve OS by consolidation RT |
891 |
|
Duke Experience |
892 |
|
University of Chicago Experience |
893 |
|
University of Chicago Experience |
894 |
|
University of Chicago Experience |
895 |
|
University of Chicago Experience |
896 |
|
MD Anderson Experience |
897 |
|
MD Anderson Experience |
898 |
|
MD Anderson ExperienceOS and PFS for patients in CR after 6-8 R-CHOP |
899 |
|
MD Anderson Experience |
900 |
|
U Modena Experience |
901 |
|
U Modena Experience |
902 |
|
U Modena Experience |
903 |
|
Role of Radiotherapy to Bulky Disease in Elderly Patients With Aggressive B-Cell Lymphoma (n=1,222) |
904 |
|
Role of Radiotherapy to Bulky Disease in Elderly Patients With Aggressive B-Cell Lymphoma (n=1,222) |
905 |
|
Role of Radiotherapy to Bulky Disease in Elderly Patients With Aggressive B-Cell LymphomaClinical characteristics |
906 |
|
Role of Radiotherapy to Bulky Disease in Elderly Patients With Aggressive B-Cell Lymphoma |
907 |
|
Role of Radiotherapy to Bulky Disease in Elderly Patients With Aggressive B-Cell Lymphoma |
908 |
|
Summary role of RT for advanced nodal aggressive NHL |
909 |
|
Slide Number 27 |
910 |
|
Spare |
911 |
|
Slide Number 29 |
912 |
|
Slide Number 30 |
913 |
|
Slide Number 31 |
914 |
|
Role of Radiotherapy to Bulky Disease in Elderly Patients With Aggressive B-Cell LymphomaClinical characteristics |
915 |
|
Slide Number 33 |
916 |
|
L26 Aggressive Nodal Non-Hodgkin Lymphoma; Relapsed, Refractory Disease - Mikhaeel |
917 |
|
Slide Number 1 |
917 |
|
Aggressive Nodal NHL-RT for Relapsed / Refractory Disease |
918 |
|
Outline |
919 |
|
(1) Persistent PET positivity after Primary Chemo |
920 |
|
Slide Number 5 |
921 |
|
Slide Number 6 |
922 |
|
Dorth et al |
923 |
|
Slide Number 8 |
924 |
|
Slide Number 9 |
925 |
|
Slide Number 10 |
926 |
|
Slide Number 11 |
927 |
|
Slide Number 12 |
928 |
|
Halasz et al |
929 |
|
Slide Number 14 |
930 |
|
Slide Number 15 |
931 |
|
Slide Number 16 |
932 |
|
Slide Number 17 |
933 |
|
Slide Number 18 |
934 |
|
PET +ve Post chemo |
935 |
|
Slide Number 20 |
936 |
|
(2) Peri-transplant RT |
937 |
|
2 Facts about ASCT salvage |
938 |
|
Slide Number 23 |
939 |
|
Slide Number 24 |
940 |
|
Role of Peri-transplant RT |
941 |
|
Slide Number 26 |
942 |
|
Slide Number 27 |
943 |
|
Slide Number 28 |
944 |
|
Timing of peri-transplant RT |
945 |
|
Choice |
946 |
|
(3) Relapse after transplant & transplant ineligible patients |
947 |
|
Non transplant eligible |
948 |
|
What can RT achieve in refractory HG-NHL? |
949 |
|
Salvage RT for relapsed / chemorefractory disease |
950 |
|
Slide Number 35 |
951 |
|
Slide Number 36 |
952 |
|
Slide Number 37 |
953 |
|
Implications |
954 |
|
Key points |
955 |
|
L27 Aggressive Nodal Non-Hodgkin Lymphoma; Volumes, Doses and Techniques - Aleman |
956 |
|
Slide Number 1 |
956 |
|
Aggressive nodal NHL, the role of RT: volume, dose and technique |
957 |
|
Aggressive nodal NHL, the role of radiotherapy: volume, dose and technique |
958 |
|
Aggressive nodal NHL – early stageTarget volume |
959 |
|
Aggressive nodal NHL – early stageTarget volume |
960 |
|
Aggressive nodal NHL – advanced stageTarget volume |
961 |
|
Aggressive nodal NHL – refractory diseaseTarget volume |
962 |
|
Slide Number 8 |
963 |
|
Slide Number 9 |
964 |
|
30 Gy vs 40-45 Gy |
965 |
|
Slide Number 11 |
966 |
|
Slide Number 12 |
967 |
|
Palliative radiotherapy |
968 |
|
Slide Number 14 |
969 |
|
Palliative radiotherapy |
970 |
|
Slide Number 16 |
971 |
|
RT technical isssues |
972 |
|
Aggressive nodal NHL- early stagePrinciples of ISRT for Nodal Sites |
973 |
|
Questions? |
974 |
|
L29 Other Indications; Myeloma - Solitary & Disseminated - Ricardi |
975 |
|
Slide Number 1 |
975 |
|
Myeloma: Solitary & Disseminated |
976 |
|
Multiple myeloma |
977 |
|
Multiple myeloma |
978 |
|
Slide Number 5 |
979 |
|
Slide Number 6 |
980 |
|
Slide Number 7 |
981 |
|
Slide Number 8 |
982 |
|
Clinical presentation, diagnosis and staging |
983 |
|
Clinical presentation, diagnosis and staging |
984 |
|
Slide Number 11 |
985 |
|
Slide Number 12 |
986 |
|
Slide Number 13 |
987 |
|
Slide Number 14 |
988 |
|
Slide Number 15 |
989 |
|
Slide Number 16 |
990 |
|
Treatment |
991 |
|
Slide Number 18 |
992 |
|
Treatment |
993 |
|
Slide Number 20 |
994 |
|
Radiotherapy in MM |
995 |
|
Role of Radiotherapy in MM |
996 |
|
Slide Number 23 |
997 |
|
Slide Number 24 |
998 |
|
Slide Number 25 |
999 |
|
Slide Number 26 |
1000 |
|
Palliative RT for Multiple Myeloma @ University of Torino |
1001 |
|
Slide Number 28 |
1002 |
|
Palliative RT for Multiple Myeloma @ University of Torino |
1003 |
|
Systemic radiotherapy in MM:TBI and HBI |
1004 |
|
Slide Number 31 |
1005 |
|
Continuous improvement in overall survival |
1006 |
|
Solitary plasmacytoma |
1007 |
|
Slide Number 34 |
1008 |
|
Slide Number 35 |
1009 |
|
Slide Number 36 |
1010 |
|
Slide Number 37 |
1011 |
|
Slide Number 38 |
1012 |
|
Solitary Plasmacytoma @ University of Torino |
1013 |
|
Slide Number 40 |
1014 |
|
Slide Number 41 |
1015 |
|
Slide Number 42 |
1016 |
|
Slide Number 43 |
1017 |
|
Slide Number 44 |
1018 |
|
Slide Number 45 |
1019 |
|
L30 Other Indications; Granuloctic Sarcoma (Chloroma) - Yahalom |
1020 |
|
Slide Number 1 |
1020 |
|
RT for Extramedullary Leukemias (“Granulocytic Sarcomas” –Chloromas) and Leukemia Cutis |
1021 |
|
Background |
1022 |
|
Slide Number 4 |
1023 |
|
Slide Number 5 |
1024 |
|
Incidence |
1025 |
|
Limited Literature |
1026 |
|
Slide Number 8 |
1027 |
|
Slide Number 9 |
1028 |
|
Slide Number 11 |
1029 |
|
Slide Number 12 |
1030 |
|
Slide Number 13 |
1031 |
|
Slide Number 14 |
1032 |
|
Slide Number 15 |
1033 |
|
Slide Number 16 |
1034 |
|
Slide Number 17 |
1035 |
|
Slide Number 18 |
1036 |
|
Slide Number 19 |
1037 |
|
L31 Other Indications; Total Body Irradiation as Part of the Conditioning Regimen for Transplant - Yahalom |
1038 |
|
Slide Number 1 |
1038 |
|
TBI and local RT in the conditioning regimen of BMT of Leukemia |
1039 |
|
Radiation therapy for leukemia |
1040 |
|
Total body irradiation as part of conditioning |
1041 |
|
Indications for HSCT |
1042 |
|
Biology of TBI |
1043 |
|
TBI effects on blood |
1044 |
|
Acute toxicity of TBI |
1045 |
|
Late toxicity of TBI and HSCT |
1046 |
|
Secondary Malignant Neoplasms after TBI and HSCT |
1047 |
|
TBI: Techniques |
1048 |
|
TBI: Simulation Films |
1049 |
|
TBI: Technique |
1050 |
|
TBI: MSKCC Standing AP/PA Technique |
1051 |
|
TBI: MSKCC Chest Wall Compensation |
1052 |
|
TBI: MSKCC Standing AP/PA Technique |
1053 |
|
TBI: Duke Pediatric Setup |
1054 |
|
TBI: MSKCC Techniques |
1055 |
|
TBI: Prescription |
1056 |
|
TBI is associated with better survival |
1057 |
|
TBI associated with less veno-occlusive disease (liver complications) |
1058 |
|
TBI associated with better outcomes in ALL & AML, but not MM |
1059 |
|
TBI used in non-myeloablative regimens for various diseases |
1060 |
|
L32 Other Indications; Splenomegaly, Hypersplenism - Specht |
1061 |
|
Slide Number 1 |
1061 |
|
Hypersplenism, splenomegaly |
1062 |
|
Splenomegaly |
1063 |
|
Splenic irradiation |
1064 |
|
Splenic irradiation |
1065 |
|
Splenic irradiation |
1066 |
|
L33 Pathology WHO Classification (morphology, immunophenotype, genetics) - Wilkins |
1067 |
|
Slide Number 1 |
1067 |
|
WHO Classification of Lymphomas:how pathology reflects biology to inform treatment |
1068 |
|
Lymph node structure reflects function |
1069 |
|
Reactive lymph node |
1070 |
|
Lymphoid follicles: factories for B-cell production |
1071 |
|
B-cell proliferation and apoptosis are essential in germinal centres |
1072 |
|
Paracortical T-cell zone andT-cells in follicles |
1073 |
|
Principles of WHO lymphoma classification |
1074 |
|
What does histology tell us? |
1075 |
|
Nodular/Follicular Architecture |
1076 |
|
‘Classical’ Morphology in Burkitt Lymphoma |
1077 |
|
What does immunophenotype tell us? |
1078 |
|
Defining Immunophenotypes |
1079 |
|
What does genetic information add? |
1080 |
|
When do we use PCR and when FISH? |
1081 |
|
Slide Number 16 |
1082 |
|
Slide Number 17 |
1083 |
|
Slide Number 18 |
1084 |
|
Slide Number 19 |
1085 |
|
FISH for t(8;14) - MYC-IGH Translocation |
1086 |
|
Slide Number 21 |
1087 |
|
Slide Number 22 |
1088 |
|
Slide Number 23 |
1089 |
|
Lymphomas mainly involving lymph nodes |
1090 |
|
Follicular lymphoma |
1091 |
|
Morphology in DLBCL |
1092 |
|
Ki67 Expression in Burkitt and DLBCL |
1093 |
|
Immunophenotype in Burkitt Lymphoma |
1094 |
|
Angio-immunoblastic T-cell Lymphoma |
1095 |
|
Angio-immunoblastic T-cell Lymphoma |
1096 |
|
Angio-immunoblastic T-cell Lymphoma |
1097 |
|
Anaplastic Large Cell Lymphoma |
1098 |
|
Anaplastic Large Cell Lymphoma, ALK+ve |
1099 |
|
Anaplastic Large Cell Lymphoma, ALK-ve |
1100 |
|
Classical Hodgkin Lymphoma -nodular sclerosis subtype |
1101 |
|
Classical Hodgkin Lymphoma –nodular sclerosis subtype |
1102 |
|
Classical Hodgkin Lymphoma –nodular sclerosis subtype |
1103 |
|
Nodular Lymphocyte Predominant HL |
1104 |
|
Lymphomas that like to circulate -‘leukaemic’ lymphomas |
1105 |
|
Splenic Marginal Zone Lymphoma |
1106 |
|
Classical Mantle Cell Lymphoma |
1107 |
|
Blastoid Mantle Cell Lymphoma |
1108 |
|
Extranodal Lymphomas of Mucosa-associated Lymphoid Tissue |
1109 |
|
Other Extranodal Sites |
1110 |
|
‘Never Events’ in Lymphoma Pathology |
1111 |
|
Histiocytic Necrotising Lymphadenitis |
1112 |
|
What’s on the Horizon in WHO 2016? |
1113 |
|
L35 Extranodal Lymphomas; Head and Neck - Specht |
1114 |
|
Slide Number 1 |
1114 |
|
Extranodal lymphomas: Head and neck |
1115 |
|
Extranodal (not necessarily extralymphatic) sites in the upper aerodigestive tract |
1116 |
|
Head & neck lymphomas, general principles |
1117 |
|
Head & neck lymphomas, general principles |
1118 |
|
Head & neck lymphomas, indolent |
1119 |
|
MALT lymphoma in left parotid glandPost-op images |
1120 |
|
PTV |
1121 |
|
Treatment plan (RapidArc) |
1122 |
|
Head & neck lymphomas, aggressive |
1123 |
|
DLBCL in tonsil |
1124 |
|
Pre-chemo images |
1125 |
|
Post-chemo planning CT |
1126 |
|
Treatment plan (RapidArc) |
1127 |
|
NK/T-cell lymphomas, nasal type |
1128 |
|
NK/T-cell lymphomas, nasal type |
1129 |
|
NK/T-cell lymphomas, nasal type |
1130 |
|
NK/T-cell lymphoma, nasal typeCourtesy of Dr. Shunan Qi, Memorial Sloan Kettering Cancer Center, New York, and Chinese Academy of Medical Sciences, Beijing |
1131 |
|
Extranodal NK/T cell lymphoma, nasal type, CS IEA, involving left nasal cavity, IPI: 0 |
1132 |
|
Nasal cavity and adjacent structures |
1133 |
|
Slide Number 21 |
1134 |
|
Slide Number 22 |
1135 |
|
Slide Number 23 |
1136 |
|
Key points |
1137 |
|
L36 Extranodal Lymphomas; Thyroid - Mikhaeel |
1138 |
|
Slide Number 1 |
1138 |
|
Thyroid Lymphoma |
1139 |
|
Incidence |
1140 |
|
Pathogenesis |
1141 |
|
Histological types |
1142 |
|
Clinical Presentation |
1143 |
|
Staging |
1144 |
|
Imaging |
1145 |
|
Slide Number 9 |
1146 |
|
Biopsy |
1147 |
|
FNAC |
1148 |
|
Role of Surgery |
1149 |
|
Treatment |
1150 |
|
Slide Number 14 |
1151 |
|
QUESTIONS? |
1152 |
|
L37 Extranodal Lymphomas; Orbital - Ricardi |
1153 |
|
Slide Number 1 |
1153 |
|
Extranodal lymphomas: characteristics, the role of RT, volumes, doses and techniquesOrbital (ocular adnexal) Lymphoma |
1154 |
|
Slide Number 3 |
1155 |
|
Slide Number 4 |
1156 |
|
Slide Number 5 |
1157 |
|
Slide Number 6 |
1158 |
|
Slide Number 7 |
1159 |
|
Slide Number 8 |
1160 |
|
Slide Number 9 |
1161 |
|
Slide Number 10 |
1162 |
|
Slide Number 11 |
1163 |
|
Slide Number 12 |
1164 |
|
Slide Number 13 |
1165 |
|
Slide Number 14 |
1166 |
|
Slide Number 15 |
1167 |
|
Slide Number 16 |
1168 |
|
Slide Number 17 |
1169 |
|
Slide Number 18 |
1170 |
|
Slide Number 19 |
1171 |
|
Slide Number 20 |
1172 |
|
Slide Number 21 |
1173 |
|
Slide Number 22 |
1174 |
|
Slide Number 23 |
1175 |
|
Slide Number 24 |
1176 |
|
Slide Number 25 |
1177 |
|
Slide Number 26 |
1178 |
|
Slide Number 27 |
1179 |
|
Slide Number 28 |
1180 |
|
Slide Number 29 |
1181 |
|
Slide Number 30 |
1182 |
|
Slide Number 31 |
1183 |
|
Slide Number 32 |
1184 |
|
Slide Number 33 |
1185 |
|
Slide Number 34 |
1186 |
|
Slide Number 35 |
1187 |
|
Slide Number 36 |
1188 |
|
Slide Number 37 |
1189 |
|
Slide Number 38 |
1190 |
|
Slide Number 39 |
1191 |
|
Slide Number 40 |
1192 |
|
Slide Number 41 |
1193 |
|
Slide Number 42 |
1194 |
|
Slide Number 43 |
1195 |
|
L38 Extranodal Lymphomas; Gastric - Yahalom |
1196 |
|
Slide Number 1 |
1196 |
|
Gastric Marginal Zone Lymphoma:Role of RT |
1197 |
|
Slide Number 3 |
1198 |
|
Slide Number 4 |
1199 |
|
Slide Number 5 |
1200 |
|
RT of Gastric Lymphomas |
1201 |
|
Involved-field Radiotherapy for H. pylori-independent Gastric Marginal Zone (MALT) Lymphoma: 23 years of experience with 131 patients1991-2012 at MSKCC |
1202 |
|
Patient Characteristics |
1203 |
|
Diagnostic/Staging Workup |
1204 |
|
H. Pylori |
1205 |
|
Chemotherapy |
1206 |
|
Radiotherapy |
1207 |
|
Response to RT |
1208 |
|
Stomach relapse after RT |
1209 |
|
Slide Number 15 |
1210 |
|
Slide Number 16 |
1211 |
|
Slide Number 17 |
1212 |
|
Slide Number 18 |
1213 |
|
Principles of RT of Stomach |
1214 |
|
Principles of Gastric Lymphoma RT (1) |
1215 |
|
Principles of Gastric Lymphoma RT (2) |
1216 |
|
Gastric Anatomy |
1217 |
|
Slide Number 23 |
1218 |
|
RT of Stomach: Pre Planning Studies |
1219 |
|
RT of Stomach: simulation |
1220 |
|
RT of Stomach: volumes |
1221 |
|
Treatment Planning |
1222 |
|
3D-CRT vs. IMRT |
1223 |
|
Treatment Planning Goals |
1224 |
|
DVH: 3D-CRT vs. IMRT |
1225 |
|
Respiratory Motion |
1226 |
|
Respiratory Motion |
1227 |
|
Respiratory Motion |
1228 |
|
Respiratory Motion |
1229 |
|
Conclusions |
1230 |
|
L39 Extranodal Lymphomas; Skin - Specht |
1231 |
|
Slide Number 1 |
1231 |
|
Extranodal lymphomas: Skin |
1232 |
|
Primary cutaneous lymphomas |
1233 |
|
Slide Number 4 |
1234 |
|
Slide Number 5 |
1235 |
|
Marginal zone lymfom |
1236 |
|
Primary cutaneous follicle center lymphoma PCFCL |
1237 |
|
Primary cutaneous diffuse large B-cell lymphoma, leg type |
1238 |
|
Slide Number 9 |
1239 |
|
Slide Number 10 |
1240 |
|
Slide Number 11 |
1241 |
|
Primary Cutaneous CD30+ neoplasms(lymphomatoid papulosis, ALCL) |
1242 |
|
Localized skin lymphomas: ISRT |
1243 |
|
Mycosis fungoides |
1244 |
|
Slide Number 15 |
1245 |
|
Slide Number 16 |
1246 |
|
X-ray vs. electron depth-dose-curves |
1247 |
|
Total skin electron beam therapy (TSEBT) |
1248 |
|
Slide Number 19 |
1249 |
|
TSEBT |
1250 |
|
Additional treatment of ”shadowed areas” |
1251 |
|
TSEBT, pt. with generalized plaques, before and 1 month after and 1 year after |
1252 |
|
TSEBT, pt. with tumors, before and 6 months after |
1253 |
|
TSEBT, pt. with tumors, before and 6 months after |
1254 |
|
TSEBT, pt. with plaques and small tumors, before and 7 years after |
1255 |
|
TSEBT outcome |
1256 |
|
L40 Extranodal Lymphomas; Testicular - Aleman |
1257 |
|
Slide Number 1 |
1257 |
|
Extranodal lymphomas: Characteristics, the role of radiotherapy, volumes doses and techniques:Testicular lymphoma |
1258 |
|
Testicular lymphoma |
1259 |
|
Testicular lymphoma |
1260 |
|
Risk of recurrence in contralateral testis |
1261 |
|
Slide Number 6 |
1262 |
|
Prognostic factors for PFS in PTL |
1263 |
|
Slide Number 8 |
1264 |
|
First-Line Treatment for Primary Testicular DLBCL With R-CHOP, CNS Prophylaxis, and Contralateral Testis RT: an International Phase II Trial (n=53, stage I-II) |
1265 |
|
Testicular lymphoma |
1266 |
|
Testicular lymphomaProphylactic RT contralateral testicle |
1267 |
|
Setup radiotherapy testicle |
1268 |
|
Testicular lymphoma |
1269 |
|
Testicular lymphoma |
1270 |
|
L41 Extranodal Lymphomas; Breast - Aleman |
1271 |
|
Slide Number 1 |
1271 |
|
Extranodal lymphomas: Characteristics, the role of radiotherapy, volumes doses and techniques:Primary breast lymphoma |
1272 |
|
Breast lymphoma |
1273 |
|
Primary diffuse large B-cell lymphoma of the breast:a study by the International Extranodal Lymphoma Study Group |
1274 |
|
Primary diffuse large B-cell lymphoma of the breast:a study by the International Extranodal Lymphoma Study Group |
1275 |
|
Primary diffuse large B-cell lymphoma of the breast:a study by the International Extranodal Lymphoma Study Group |
1276 |
|
Primary diffuse large B-cell lymphoma of the breast:a study by the International Extranodal Lymphoma Study Group;cause specific survival, overall survival and progression free survival |
1277 |
|
Primary diffuse large B-cell lymphoma of the breast:a study by the International Extranodal Lymphoma Study Group |
1278 |
|
Primary diffuse large B-cell lymphoma of the breast:a study by the International Extranodal Lymphoma Study Group |
1279 |
|
Suggested algorithm for newly diagnosed PB-DLBCL |
1280 |
|
Suggested algorithm for newly diagnosed PB-DLBCL |
1281 |
|
Follicular and marginal zone primary breast lymphoma (PBL): results from International Extranodal Lymphoma Study Group |
1282 |
|
Follicular and marginal zone primary breast lymphoma (PBL): results from International Extranodal Lymphoma Study Group |
1283 |
|
15-year PFS and OS in follicular and marginal zone primary breast lymphoma |
1284 |
|
15-year cause specific survival in follicular and marginal zone primary breast lymphoma |
1285 |
|
Follicular and marginal zone primary breast lymphoma (PBL): results from International Extranodal Lymphoma Study Group |
1286 |
|
Radiotherapy |
1287 |
|
Breast lymphoma |
1288 |
|
Breast lymphoma |
1289 |
|
49-year old woman with DLBCL right breast in CR after chemo |
1290 |
|
Breast lymphoma |
1291 |
|
Questions? |
1292 |
|
Slide Number 23 |
1293 |
|
Treatment specification IELSG series. |
1294 |
|
L42 Extradonal Lymphoma; Lung - Ricardi |
1295 |
|
Slide Number 1 |
1295 |
|
Lung Lymphoma |
1296 |
|
Background |
1297 |
|
Background |
1298 |
|
Histology |
1299 |
|
Cytogenetics |
1300 |
|
Slide Number 7 |
1301 |
|
Clinical presentation |
1302 |
|
Diagnosis |
1303 |
|
StagingAnn Arbor system modified by Ferraro |
1304 |
|
Treatment |
1305 |
|
Slide Number 12 |
1306 |
|
Slide Number 13 |
1307 |
|
Slide Number 14 |
1308 |
|
Slide Number 15 |
1309 |
|
Slide Number 16 |
1310 |
|
Slide Number 17 |
1311 |
|
Slide Number 18 |
1312 |
|
Slide Number 19 |
1313 |
|
Slide Number 20 |
1314 |
|
Surgical approach |
1315 |
|
Surgical approach |
1316 |
|
Radiotherapy |
1317 |
|
Slide Number 24 |
1318 |
|
Slide Number 25 |
1319 |
|
Slide Number 26 |
1320 |
|
Slide Number 27 |
1321 |
|
Slide Number 28 |
1322 |
|
Slide Number 29 |
1323 |
|
Conclusions |
1324 |
|
Conclusions |
1325 |
|
Slide Number 32 |
1326 |
|
Slide Number 33 |
1327 |
|
Modern RT for lung lymphoma |
1328 |
|
RECOMMENDATIONS |
1329 |
|
L43 Systemic approaches to early and advanced marginal zone lymphoma - Davies |
1330 |
|
Slide Number 1 |
1330 |
|
Systemic approaches to early and advanced marginal zone lymphoma |
1331 |
|
The faces of MZL |
1332 |
|
Splenic Marginal Zone Lymphoma |
1333 |
|
Slide Number 5 |
1334 |
|
Slide Number 6 |
1335 |
|
Slide Number 7 |
1336 |
|
Slide Number 8 |
1337 |
|
Rituximab |
1338 |
|
Outcomes in patients with splenic marginal zone lymphoma and marginal zone lymphoma treated with rituximab with or without chemotherapy or chemotherapy alone |
1339 |
|
Slide Number 11 |
1340 |
|
RESORT trial |
1341 |
|
Slide Number 13 |
1342 |
|
Slide Number 14 |
1343 |
|
Slide Number 15 |
1344 |
|
Nodal MZL |
1345 |
|
BR vs. R-CHOP as First Line Treatment in Patients with Indolent and Mantle Cell Lymphomas (MCL): Updated Results from the StiL NHL1 Study |
1346 |
|
Slide Number 18 |
1347 |
|
Slide Number 19 |
1348 |
|
Slide Number 20 |
1349 |
|
Slide Number 21 |
1350 |
|
Slide Number 22 |
1351 |
|
Slide Number 23 |
1352 |
|
Extranodal MZL |
1353 |
|
Slide Number 25 |
1354 |
|
Slide Number 26 |
1355 |
|
Slide Number 27 |
1356 |
|
Slide Number 28 |
1357 |
|
IELSG 19 |
1358 |
|
IELSG 19 |
1359 |
|
Slide Number 31 |
1360 |
|
Slide Number 32 |
1361 |
|
Lenalidomide |
1362 |
|
The R2 regimen (Fowler at al. Lancet Oncol 2014) |
1363 |
|
Slide Number 35 |
1364 |
|
Slide Number 36 |
1365 |
|
Toxicity of R2 |
1366 |
|
Exhausted T-cells |
1367 |
|
Slide Number 39 |
1368 |
|
Slide Number 40 |
1369 |
|
Idelalisib is highly selective for PI3Kδ isoform |
1370 |
|
Overall response rate: 09 study |
1371 |
|
Overall response rate by disease subgroups* |
1372 |
|
Duration of response by disease group |
1373 |
|
PFS: On study vs. last prior therapy |
1374 |
|
Adverse events occurring in >12% of patients |
1375 |
|
Slide Number 47 |
1376 |
|
B-cell receptor signalling. ..Inhibit and spare the chemotherapy |
1377 |
|
Slide Number 49 |
1378 |
|
Ibrutinib in B-cell lymphoma |
1379 |
|
Toxicity |
1380 |
|
Ibrutininb in Mantle cell |
1381 |
|
Other inhibitors of PI3K |
1382 |
|
Slide Number 54 |
1383 |
|
Slide Number 55 |
1384 |
|
Slide Number 56 |
1385 |
|
Slide Number 57 |
1386 |
|
Slide Number 58 |
1387 |
|
What about the other targets? |
1388 |
|
Targeted chemotherapy in clinical development |
1389 |
|
In summary… |
1390 |
|
L44 Extradonal Lymphoma; Bone - Ricardi |
1391 |
|
Slide Number 1 |
1391 |
|
Extranodal lymphomas: characteristics, the role of RT, volumes, doses and techniques Bone |
1392 |
|
Slide Number 3 |
1393 |
|
Slide Number 4 |
1394 |
|
Slide Number 5 |
1395 |
|
Slide Number 6 |
1396 |
|
Slide Number 7 |
1397 |
|
Slide Number 8 |
1398 |
|
Slide Number 9 |
1399 |
|
Slide Number 10 |
1400 |
|
Slide Number 11 |
1401 |
|
Slide Number 12 |
1402 |
|
Slide Number 13 |
1403 |
|
Slide Number 14 |
1404 |
|
Slide Number 15 |
1405 |
|
Slide Number 16 |
1406 |
|
Slide Number 17 |
1407 |
|
Slide Number 18 |
1408 |
|
Slide Number 19 |
1409 |
|
Slide Number 20 |
1410 |
|
Slide Number 21 |
1411 |
|
Slide Number 22 |
1412 |
|
Slide Number 23 |
1413 |
|
Slide Number 24 |
1414 |
|
Slide Number 25 |
1415 |
|
Slide Number 26 |
1416 |
|
Slide Number 27 |
1417 |
|
Slide Number 28 |
1418 |
|
Slide Number 29 |
1419 |
|
Slide Number 30 |
1420 |
|
Slide Number 31 |
1421 |
|
Slide Number 32 |
1422 |
|
Slide Number 33 |
1423 |
|
Slide Number 34 |
1424 |
|
Slide Number 35 |
1425 |
|
Slide Number 36 |
1426 |
|
Slide Number 37 |
1427 |
|
Slide Number 38 |
1428 |
|
L45 Extradonal Lymphoma; CNS - Yahalom |
1429 |
|
Slide Number 1 |
1429 |
|
Primary CNS Lymphoma (PCNSL) |
1430 |
|
Definitions |
1431 |
|
Primary CNS Lymphoma (PCNSL) |
1432 |
|
Primary CNS Lymphoma:A unique lymphoma entity |
1433 |
|
PCNSLEpidemiology |
1434 |
|
PCNSLEpidemiology |
1435 |
|
PCNSL in “immunocompetent” hosts |
1436 |
|
Primary CNS Lymphoma |
1437 |
|
PCNSLSymptoms |
1438 |
|
Slide Number 11 |
1439 |
|
Slide Number 12 |
1440 |
|
Slide Number 13 |
1441 |
|
PCNSLExtent of Disease |
1442 |
|
Primary CNS Lymphoma |
1443 |
|
PCNSL: A unique treatment challenge |
1444 |
|
PCNSL Baseline Evaluation |
1445 |
|
PCNSLCT Appearance |
1446 |
|
PCNSLMRI Appearance |
1447 |
|
The debated role of RT consolidation |
1448 |
|
RTOG 83-15 WBRT alone |
1449 |
|
Slide Number 22 |
1450 |
|
MSKCC (1986): MTX-WBRT-ARAc |
1451 |
|
Slide Number 24 |
1452 |
|
Slide Number 25 |
1453 |
|
Slide Number 26 |
1454 |
|
Neurotoxicity by Age |
1455 |
|
Sites of PCNSL |
1456 |
|
Slide Number 29 |
1457 |
|
PCNSL - Neurotoxicity |
1458 |
|
PCNSL- Neurotoxicity |
1459 |
|
Slide Number 32 |
1460 |
|
Slide Number 33 |
1461 |
|
Slide Number 34 |
1462 |
|
Slide Number 35 |
1463 |
|
Hypothesis |
1464 |
|
Chemotherapy Schedule |
1465 |
|
RT Schedule |
1466 |
|
Slide Number 39 |
1467 |
|
Slide Number 40 |
1468 |
|
Slide Number 41 |
1469 |
|
Slide Number 42 |
1470 |
|
70 year old lady with severe headachesStereotactic biopsy- Diffuse large B-Cell Lymphoma |
1471 |
|
Randomized on RTOG-MSKCC protocol to receive low-dose RT after CR to R-MPV |
1472 |
|
RT Dose- 23.4 Gy (1.8 Gy X13) |
1473 |
|
Role of RT in PCNSL |
1474 |
|
Salvage of chemotherapy alone failures (MSKCC) |
1475 |
|
Salvage of chemotherapy alone failures (MGH) |
1476 |
|
RT in PCNSL: Field design |
1477 |
|
Slide Number 50 |
1478 |
|
RT in PCNSL: Dose |
1479 |
|
Slide Number 52 |
1480 |
|
RT in PCNSL – Take home |
1481 |
|
L46 Extradonal Lymphoma; Other Sites - Mikhaeel |
1482 |
|
Slide Number 1 |
1482 |
|
Extra-nodal LymphomaRare sites |
1483 |
|
Rare sites |
1484 |
|
Histologies |
1485 |
|
General principles of management |
1486 |
|
Slide Number 6 |
1487 |
|
Slide Number 7 |
1488 |
|
Slide Number 8 |
1489 |
|
RICOVER-60: RT to extra-lymphatic tissue |
1490 |
|
Slide Number 10 |
1491 |
|
Slide Number 11 |
1492 |
|
Abdominal lymphoma |
1493 |
|
Abdominal lymphoma |
1494 |
|
Pelvic Lymphoma |
1495 |
|
Female patients with DLBCL and involvement of the reproductive organs have poor outcomes and markedly increased risk of CNS relapse with R-CHOP(-like) therapy |
1496 |
|
OS |
1497 |
|
CNS relapse |
1498 |