FDG‐PET after 1 cycle of therapy predicts outcome in diffuse large cell lymphoma and classic Hodgkin disease
Open Access
- 24 October 2006
- Vol. 107 (11), 2678-2687
- https://doi.org/10.1002/cncr.22276
Abstract
BACKGROUND. Early prediction of response to therapy may offer the potential to identify patients who will benefit from standard conventional therapy. The objective of this study was to determine the predictive value of FDG-PET as an early response indicator after 1 cycle of chemotherapy for progression-free survival (PFS) in diffuse large cell lymphoma (DLCL) and classic Hodgkin disease (HD). METHODS. FDG-PET was performed before, after 1 cycle, and after completion of chemotherapy in 47 patients. The patients were followed with a median follow-up of 21 months (range, 3–47 months). PFS was compared between PET-positive and PET-negative patients after 1 cycle and after completion of therapy. RESULTS. All PET-negative patients after 1 cycle (n = 31) had sustained complete remission with a median follow-up of 28 months. Fourteen of 16 PET-positive patients after 1 cycle had refractory disease or relapsed (median PFS, 5.5 months). There were 2 false-positive results, 1 with an active infection at the biopsy site and the other in a patient who had been in remission after radiation therapy. There was good agreement between the results obtained after 1 cycle and at completion of therapy (kappa, 0.80); however, the negative predictive value was higher for FDG-PET after 1 cycle than after completion of chemotherapy (100% vs 91.4%), although not statistically different (P = .40). CONCLUSIONS. FDG-PET had a high prognostic value after 1 cycle of chemotherapy, thus it can be a valid alternative for posttreatment evaluation of DLCL and HD and may offer the potential for change in treatment paradigms. Cancer 2006. © 2006 American Cancer Society.This publication has 24 references indexed in Scilit:
- Early 18F‐labeled fluoro‐2‐deoxy‐D‐glucose positron emission tomography scanning in the lymphomasCancer, 2006
- FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphomaBlood, 2006
- FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphomaAnnals of Oncology, 2005
- [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcomeBlood, 2005
- Response Assessment of Aggressive Non-Hodgkin’s Lymphoma by Integrated International Workshop Criteria and Fluorine-18–Fluorodeoxyglucose Positron Emission TomographyJournal of Clinical Oncology, 2005
- Factors predicting long-term survival in low-risk diffuse large B-cell lymphomaAmerican Journal of Hematology, 2003
- Prognostic value of positron emission tomography in the evaluation of post‐treatment residual mass in patients with Hodgkin's disease and non‐Hodgkin's lymphomaBritish Journal of Haematology, 2001
- Thoracic positron emission tomography using18F-fluorodeoxyglucose for the evaluation of residual mediastinal Hodgkin diseaseBlood, 2001
- A Prognostic Score for Advanced Hodgkin's DiseaseThe New England Journal of Medicine, 1998
- Chemotherapy Alone Compared with Chemotherapy plus Radiotherapy for Localized Intermediate- and High-Grade Non-Hodgkin's LymphomaThe New England Journal of Medicine, 1998