What are the NCCN and ESMO guidelines on the treatment of follicular lymphoma (FL)?

Updated: Feb 25, 2021
  • Author: Sanjay Vinjamaram, MD, MPH; Chief Editor: Emmanuel C Besa, MD  more...
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The NCCN and ESMO offer similar treatment recommendations, as follows [26, 72] :

  • Involved-site radiation therapy (ISRT), 24-30 Gy, is the preferred treatment option for stage I or II

  • If significant toxicity is expected from radiotherapy, initial observation may be more appropriate

  • Other first-line treatment options include rituximab, alone or in combination with other agents, and radioimmunotherapy

  • Combination treatment with involved-field radiation therapy (IFRT) and chemotherapy (see below) and/or radioimmunotherapy is recommended for more advanced stages

  • In asymptomatic patients with advanced-stage, low tumor burden disease, initiate treatment when the patients become symptomatic, as there is no survival advantage with immediate treatment versus a watch-and-wait approach

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