Therapeutic evaluation and prognostic value of interim hybrid PET/CT with 18F-FDG after three to four cycles of chemotherapy in non-Hodgkin's lymphoma
Therapeutic evaluation and prognostic value of interim hybrid PET/CT with 18F-FDG after three to four cycles of chemotherapy in non-Hodgkin's lymphoma
复制标题
DOI：
10.1080/10245330701393840
复制
发表时间：
2007-01-01
期刊：
影响因子：
1.9
通讯作者：
Xing, Yan
中科院分区：
文献类型：
--
作者：
Zhao, Jinhua;Qiao, Wenli;Xing, Yan
现代风险适应性治疗需要准确评估患者的预后。本研究旨在评价非霍奇金淋巴瘤（NHL）患者化疗3-4个周期后行2-[18 F]氟-2-脱氧-D-葡萄糖（F-18-FDG）混合PET/ CT显像对早期评价疗效和预测无进展生存期（PFS）的价值。在化疗前（初始扫描）和化疗3-4个周期后（中期扫描）进行18 F-FDG混合PET/CT扫描。使用Kaplan-Meier分析将中期FDG结果与PFS相关。结果：化疗3-4周期后，28例患者18个病灶F-FDG阳性，8例病灶MRU阴性，25例病灶扫描阴性。FDG阳性组22例病情进展，3例死亡。18例F-FDG阴性患者中有9例复发，MRU组中有4例复发。生存分析显示早期中期FDG成像与PFS之间存在高度显著的相关性（P < 0.0005）。FDG阴性患者的2年PFS率为72.2%，FDG阳性患者为23.0%。回归模型显示，FDG显像阳性患者与阴性患者的风险比非常高（P < 0.001），故FDG显像对NHL的无进展生存有显著预测价值。利用FDG扫描对化疗反应进行早期评估可能会为选择患者采取替代治疗策略提供有用的信息。
Purpose: Modern risk-adapted treatment requires accurate assessment of the patient's prognosis. This study assessed the value of hybrid PET/ CT with 2-[18F] fluoro-2-deoxy-D-glucose (F-18-FDG) after 3-4 cycles of chemotherapy for early evaluation of response to therapy and prediction of progression-free survival (PFS) in non-Hodgkin's lymphoma (NHL).Methods: Sixty-one consecutive NHL patients (37 male and 24 female) were included. The 18 F-FDG hybrid PET/CT scans were performed prior to chemotherapy (initial scan) and after 3-4 cycles of chemotherapy (interim scan). Interim FDG findings were correlated to the PFS using Kaplan-Meier analysis. Regression analyses were employed to test for independence of established pretreatment prognostic factors.Results: After 3-4 cycles of chemotherapy, positive 18 F-FDG lesions were found in 28 patients, minimal residual uptake (MRU) in 8 and negative scans in 25 patients. In FDG-positive group, 22 patients showed progress and three died. Nine 18 F-FDG negative patients and 4 patients from the MRU group relapsed. Survival analyses showed highly significant associations between early interim FDG imaging and PFS (P < 0.0005). The 2-year PFS rate for FDG-negative patients was 72.2 and 23.0% for FDG positive patients. The regression model showed that the predictive value of FDG imaging owed its significance to the very high hazard ratio between patients with positive FDG imaging and patients with negative FDG imaging (P < 0.001).Conclusions: Early interim FDG imaging is an excellent and independent predictor of PFS in NHL. An early assessment of chemotherapy response with FDG scans may provide useful information for selection of patients for alternative therapeutic strategies.