The Deauville 5-Point Scale Improves the Prognostic Value of Interim FDG PET/CT in Extranodal Natural Killer/T-Cell Lymphoma
The Deauville 5-Point Scale Improves the Prognostic Value of Interim FDG PET/CT in Extranodal Natural Killer/T-Cell Lymphoma
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Deauville 5 点量表提高了临时 FDG PET/CT 在结外自然杀伤/T 细胞淋巴瘤中的预后价值
DOI：
10.1097/rlu.0000000000000892
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发表时间：
2015-10-01
影响因子：
10.6
通讯作者：
Tian, Rong
中科院分区：
文献类型：
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作者：
Jiang, Chong;Su, Minggang;Tian, Rong
目的FDGPET/CT对结源性自然杀伤/T细胞淋巴瘤（ENKTL）的预后价值仍存在争议。此外，多维尔5点量表（DS）在ENKTL中的效用是不确定的。因此，我们设计了一项前瞻性研究，以检查3种PET/CT分析方法（国际协调项目[IHP]标准、DS和基于SUV的评估）的预后价值。患者和方法60例初诊的未经治疗的ENKTL患者入组。在初始治疗（治疗前）和治疗中期（中期）进行PET/CT评价。根据IHP标准、DS和FDG摄取变化（SUVmax）确定中期PET/CT缓解。然后检查国际协调项目标准、DS和SUVmax预测无进展生存期（PFS）和总生存期（OS）的能力。结果中位随访23.5个月，基于DS和SUVmax的中期PET/CT是PFS和OS的显著预测因素，多因素分析后，DS是PFS（P < 0.001）和OS（P < 0.001）的独立预测因素。&Dgr;SUVmax是OS的独立预测因子（P = 0.013），但不是PFS的独立预测因子（P = 0.054），其准确性和阳性预测值低于DS。结论DS的PET/CT中期分析预测ENKTL患者的不良治疗结局，而基于IHP标准和SUV评估的PET/CT中期分析的预后价值有限。
Purpose The prognostic value of FDG PET/CT in extranodal natural killer/T-cell lymphoma (ENKTL) is still controversial. Furthermore, the utility of the Deauville 5-point scale (DS) in ENKTL is uncertain. Therefore, we designed a prospective study to examine the prognostic value of 3 methods of PET/CT analysis (International Harmonization Project [IHP] criteria, DS, and SUV-based assessment). Patients and Methods Sixty patients with newly diagnosed untreated ENKTL were enrolled. PET/CT evaluation was performed before initial treatment (pretreatment) and midtreatment (interim). Interim PET/CT response was determined based on IHP criteria, DS, and change in FDG uptake (&Dgr;SUVmax). International Harmonization Project criteria, DS, and &Dgr;SUVmax were then examined for the ability to predict progression-free survival (PFS) and overall survival (OS). Results Over a median follow-up of 23.5 months, interim PET/CT based on DS and &Dgr;SUVmax were significant predictors of PFS and OS. After multivariate analysis, DS was an independent predictor of PFS (P < 0.001) and OS (P < 0.001). &Dgr;SUVmax was an independent predictor of OS (P = 0.013) but not PFS (P = 0.054) and with a lower accuracy and positive predictive value than DS. Conclusions Interim PET/CT analysis with DS predicts unfavorable treatment outcomes of ENKTL patients, whereas interim PET/CT analysis based on IHP criteria and SUV-based assessment have limited prognostic value.