“…Singleinstitution or multiinstitution studies, mainly retrospective, showed that the combination of chemotherapy with CHOP (Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) or CHOP-like regimens and radiation therapy (RT) is highly effective, given the peculiarity of the disease presentation and the tendency to recurrence in the primary site of origin 3, 4, 5 and 6. In the rituximab era, current standard therapy is represented by a combination of chemotherapy (CHOP, CHOP-like, EPOCH -Etoposide, Prednisone, Vincristine, Cyclophosphamide, Doxorubicin, M/VACOP-B -Methotrexate/Etoposide, Doxorubicin, Cyclophosphamide, Vincristine, Prednisone and Bleomicine) and rituximab followed by RT, with a higher response rate to rituximab chemotherapy (R-CT) when in comparison with chemotherapy alone 7, 8 and 9. Inasmuch as the outcomes are still unsatisfactory in a limited number of patients, with global overall survival rates of approximately 80%, more aggressive programs have been investigated, including strategies evaluating high-dose chemotherapy and autologous stem cells transplantation upfront (10). The need of consolidation RT has also been questioned in patients in complete remission after R-CT (11).…”