Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification
Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification
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DOI：
10.1200/jco.2013.54.8800
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发表时间：
2014-09-20
影响因子：
45.3
通讯作者：
Lister, T. Andrew
中科院分区：
文献类型：
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作者：
Cheson, Bruce D.;Fisher, Richard I.;Lister, T. Andrew
这项工作的目的是对霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL）患者的评估、分期和疗效评估建议进行更新。2011年6月在瑞士卢加诺举行的第11届恶性淋巴瘤国际会议上召开了一次研讨会，参会人员包括顶尖的血液学家、肿瘤学家、放射肿瘤学家、病理学家、放射科医生和核医学医生，他们代表了主要的国际淋巴瘤临床试验小组和癌症中心。临床和影像小组委员会在第12届恶性淋巴瘤国际会议的后续研讨会上展示了他们的结论，从而导致分期标准的修订以及2007年国际工作组疗效评估指南的修订。结果，氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET） - 计算机断层扫描（CT）被正式纳入FDG高亲和性淋巴瘤的标准分期。将对安阿伯描述性术语进行修改以用于疾病范围的解剖学分布，但症状后缀A或B仅用于HL。骨髓活检不再用于HL和大多数弥漫性大B细胞淋巴瘤的常规分期。然而，无论分期如何，一般的做法是根据局限性（I期和II期，非肿块型）或进展性（III期或IV期）疾病来治疗患者，II期肿块型疾病根据组织学和一些预后因素被视为局限性或进展性疾病。PET - CT将使用5分制来评估FDG高亲和性组织学类型的疗效。单个淋巴结垂直直径的乘积可用于确定疾病进展。不鼓励进行常规监测扫描。这些建议应能改进对淋巴瘤患者的评估，并提高比较临床试验结果的能力。（C）2014年美国临床肿瘤学会
The purpose of this work was to modernize recommendations for evaluation, staging, and response assessment of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). A workshop was held at the 11th International Conference on Malignant Lymphoma in Lugano, Switzerland, in June 2011, that included leading hematologists, oncologists, radiation oncologists, pathologists, radiologists, and nuclear medicine physicians, representing major international lymphoma clinical trials groups and cancer centers. Clinical and imaging subcommittees presented their conclusions at a subsequent workshop at the 12th International Conference on Malignant Lymphoma, leading to revised criteria for staging and of the International Working Group Guidelines of 2007 for response. As a result, fluorodeoxyglucose (FDG) positron emission tomography (PET)-computed tomography (CT) was formally incorporated into standard staging for FDG-avid lymphomas. A modification of the Ann Arbor descriptive terminology will be used for anatomic distribution of disease extent, but the suffixes A or B for symptoms will only be included for HL. A bone marrow biopsy is no longer indicated for the routine staging of HL and most diffuse large B-cell lymphomas. However, regardless of stage, general practice is to treat patients based on limited (stages I and II, nonbulky) or advanced (stage III or IV) disease, with stage II bulky disease considered as limited or advanced disease based on histology and a number of prognostic factors. PET-CT will be used to assess response in FDG-avid histologies using the 5-point scale. The product of the perpendicular diameters of a single node can be used to identify progressive disease. Routine surveillance scans are discouraged. These recommendations should improve evaluation of patients with lymphoma and enhance the ability to compare outcomes of clinical trials. (C) 2014 by American Society of Clinical Oncology