Radiation Therapy in Relapsed or Refractory Non-Hodgkin's Lymphoma Who Have Undergone Stem Cell Transplantation

Exclusion Criteria

• •No patients with stage IA or IIA disease at initial diagnosis who, at time of relapse or diagnosis of refractory disease prior to salvage therapy, remained in stage IA or IIA, with no new disease sites, without having received radiotherapy
• •Received up to 2 regimens and 4 courses of salvage chemotherapy
• •* Monoclonal antibodies (e.g., rituximab) are not considered salvage chemotherapy
• •* Achieved complete response (CR), unconfirmed CR, or partial response (PR) if bulky disease OR
• •* Achieved PR (but not CR) if non-bulky disease
• •No residual disease involving extranodal organs diffusely (e.g., liver, lung, bone, kidney, or leptomeningeal) after salvage chemotherapy
• •Planned autologous hematopoietic stem cell transplantation (ASCT)
• •* ASCT conditioning must be with high-dose BEAM (carmustine, etoposide, cytarabine, and melphalan) chemotherapy
• •No disease progression after ASCT
• •No major organ complication or poor hematologic recovery from ASCT that would preclude initiation of study radiotherapy within 14 weeks after ASCT
• •No more than 2 non-contiguous nodal or extranodal areas of bulky/residual disease requiring more than 2 separate involved-field radiotherapy volume arrangements (e.g., field arrangement covering up to 2 involved lymph node regions or extranodal sites, with or without 1 adjacent nodal/region or extranodal site)
• •No active CNS lymphoma (parenchymal brain and/or leptomeningeal)
• •PATIENT CHARACTERISTICS:
• •Age:
• •18 and over
• •Performance status:
• •ECOG 0-2
• •Life expectancy:
• •Not specified
• •Hematopoietic:
• •Not specified
• •Hepatic:
• •Not specified
• •Renal:
• •Not specified
• •Other:
• •Not pregnant or nursing
• •Fertile patients must use effective contraception
• •No other malignancy within the past 5 years except basal cell carcinoma of the skin
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •See Disease Characteristics
• •No prior radioimmunotherapy
• •Chemotherapy:
• •See Disease Characteristics
• •Endocrine therapy:
• •Not specified
• •Radiotherapy:
• •See Disease Characteristics
• •No prior total body irradiation
• •No prior radiotherapy to the site of bulky disease or residual tumor
• •Surgery:
• •Not specified
• •Other:
• •No other concurrent anti-cancer therapy unless documentation of disease progression