A Study of Reduced Dose Radiation Therapy for People With B-Cell Lymphomas

Launched by MEMORIAL SLOAN KETTERING CANCER CENTER · Jun 17, 2025

Keywords

ClinConnect Summary

This clinical trial is studying whether a very low dose of radiation therapy (called VLDRT) can effectively treat people with certain types of slow-growing blood cancers called follicular lymphoma or marginal zone lymphoma. The goal is to see if this lower dose works as well as the standard, higher dose of radiation in controlling cancer in the affected areas and preventing new cancer spots from developing. Researchers are also looking to find out if using a lower dose might cause fewer side effects than the usual treatment.

People who may be eligible to join are adults diagnosed with early-stage follicular or marginal zone lymphoma (meaning the cancer is limited to one or two areas on the same side of the body), who have not yet had any treatment for lymphoma. Participants will receive either the very low dose or the standard dose of radiation and will be closely monitored to see how well their cancer responds and whether side effects occur. This study may offer a chance to get effective treatment with potentially fewer side effects, but it does require starting radiation within two months after joining the study.

Gender

ALL

Eligibility criteria

• • Inclusion Criteria: (Arms 1\&2)
• * Patients must be diagnosed with a follicular lymphoma or marginal zone lymphoma. Of note, there are now two widely-utilized pathology classification criteria used for mature B-cell lymphomas, the World Health Organization (WHO) 5th Edition Classification of Lymphoid Neoplasms and the International Consensus Classification (ICC) of Mature Lymphoid Neoplasms. Either criteria is acceptable and for the purposes of this protocol, the following diagnoses are included:
• • Follicular lymphoma
• • WHO 5th Edition
• • Classic follicular lymphoma (cFL)
• • Follicular lymphoma with uncommon features (uFL)
• • Pediatric type follicular lymphoma
• • Duodenal type follicular lymphoma
• • ICC
• • Follicular lymphoma, grades 1-2 or 3A
• • BCL2 rearrangement negative, CD23 positive follicle center lymphoma
• • Pediatric type follicular lymphoma
• • Duodenal type follicular lymphoma
• • Marginal zone lymphoma
• • WHO 5th Edition and ICC
• • Nodal marginal zone lymphoma
• • Pediatric nodal marginal zone lymphoma
• • Extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT)
• • Patients must have stage I or II disease (with stage I defined as involvement of one nodal region and stage II as two or more nodal regions involved on the same side of the diaphragm)
• • Patients should be newly diagnosed or previously observed with no prior lymphoma-directed therapy
• • If the patient is referred for localized gastric MALT lymphoma, there should be documented negative H. Pylori testing within 6 months prior to proposed radiotherapy
• • Age at the time of enrollment of ≥18 years
• • Patients must be able to start radiation within 2 months from time of randomization
• Exclusion Criteria:
• • Prior radiation to site(s) needing treatment
• • Follicular lymphoma, grade 3B (ICC) or Follicular large B cell lymphoma (FLBL by WHO 5th edition criteria)
• • Patients planned to receive concurrent systemic therapy (including oral steroids) for their lymphoma
• • Patient has cutaneous only iNHL defined as primary cutaneous B-cell lymphoma, primary cutaneous follicle center lymphoma, cutaneous marginal zone lymphoma or unspecified indolent lymphoma of the skin
• • Gross total resection of all disease
• • Tumor size measuring ≥5 cm in maximum diameter on any modality diagnostic imaging
• • Patients with any concurrent medical or psychiatric condition or disease which, in the investigator's judgment, would make them inappropriate candidates for entry into this study