Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography for Interim Response Assessment of Advanced-Stage Hodgkin's Lymphoma and Diffuse Large B-Cell Lymphoma: A Systematic Review
Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography for Interim Response Assessment of Advanced-Stage Hodgkin's Lymphoma and Diffuse Large B-Cell Lymphoma: A Systematic Review
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DOI：
10.1200/jco.2008.16.0861
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发表时间：
2009-04-10
影响因子：
45.3
通讯作者：
Nagai, Hirokazu
中科院分区：
文献类型：
--
作者：
Terasawa, Teruhiko;Lau, Joseph;Nagai, Hirokazu
目的系统评价氟-18-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）对未经治疗的晚期霍奇金淋巴瘤（HL）或弥漫性大B细胞淋巴瘤（DLBCL）患者中期疗效评估的预后准确性。两名评估员独立审查了研究的入选和提取数据。如果无法从出版物中获得相关未发表数据，则向研究者索取。一个荟萃分析的预后准确性performed.Results13项研究，涉及360例晚期HL患者和311 DLBCL患者符合我们的纳入标准。晚期HL研究包括少数不可排除风险的患者。DLBCL研究具有异质性。FDG-PET对晚期HL的总体敏感性为0.81（95% CI，0.72 - 0.89），特异性为0.97（95% CI，0.94 - 0.99），对DLBCL的敏感性为0.78（95% CI，0.64 - 0.87），特异性为0.87（95% CI，0.75 - 0.93）。荟萃回归和亚组分析并没有确定影响预后accuracy.ConclusionFor低到中等风险的晚期HL，FDG-PET进行了几个周期的标准化疗后，似乎是一个可靠的预后测试，以确定不良反应者，排除前瞻性研究，以评估PET为基础的治疗策略。对于DLBCL，由于异质性，无法得出可靠的结论。中期PET仍然是一种未经证实的常规临床实践测试。它的使用应保留给治疗方案和成像条件标准化的研究环境。
PurposeTo systematically review the prognostic accuracy of fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) for interim response assessment of patients with untreated advanced-stage Hodgkin's lymphoma (HL) or diffuse large B-cell lymphoma (DLBCL).MethodsMEDLINE, EMBASE, SCOPUS, and Biologic Abstracts were searched for relevant studies. Two assessors independently reviewed studies for inclusion and extracted data. Relevant unpublished data were requested from the investigators if unavailable from publications. A meta-analysis of the prognostic accuracy was performed.ResultsThirteen studies involving 360 advanced-stage HL patients and 311 DLBCL patients met our inclusion criteria. Advanced-stage HL studies included few unfavorable-risk patients. DLBCL studies were heterogeneous. FDG-PET had an overall sensitivity of 0.81 (95% CI, 0.72 to 0.89) and a specificity of 0.97 (95% CI, 0.94 to 0.99) for advanced-stage HL, and a sensitivity of 0.78 (95% CI, 0.64 to 0.87) and a specificity of 0.87 (95% CI, 0.75 to 0.93) for DLBCL. Meta-regression and subgroup analyses did not identify factors that affect prognostic accuracy.ConclusionFor low-to intermediate-risk advanced-stage HL, FDG-PET performed after a few cycles of standard chemotherapy seems to be a reliable prognostic test to identify poor responders, warranting prospective studies to assess PET-based treatment strategies. For DLBCL, no reliable conclusions can be drawn due to heterogeneity. Interim PET remains an unproven test for routine clinical practice. Its use should be reserved for research settings where treatment regimens and imaging conditions are standardized.