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Introduction: For indolent non-Hodgkin lymphomas (iNHL), ultra-low-dose radiation therapy (ULDRT) with 4 Gy (2 Gy × 2 or “boom-boom”) has demonstrated durable local control (70%), though distal relapses may occur. Concurrent systemic chemotherapy with RT extends PFS but is often avoided due to toxicity. We hypothesize that the combination of adaptive ULDRT and single-agent rituximab results in excellent local and systemic control with minimal toxicity.
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