Utility of Routine Post-Therapy Surveillance Imaging in Diffuse Large B-Cell Lymphoma
Utility of Routine Post-Therapy Surveillance Imaging in Diffuse Large B-Cell Lymphoma
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DOI：
10.1200/jco.2014.55.7561
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发表时间：
2014-11-01
影响因子：
45.3
通讯作者：
Link, Brian K.
中科院分区：
文献类型：
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作者：
Thompson, Carrie A.;Ghesquieres, Herve;Link, Brian K.
目的我们在一个大型、前瞻性入组的美国弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者队列中检查了治疗后监测成像的效用，并在来自法国的独立患者队列中证实了我们的结果。方法从爱荷华大学/梅奥诊所淋巴瘤专业研究卓越计划和莱昂的分子流行病学资源 (MER) 中确定了新诊断的 DLBCL 并接受基于蒽环类药物的免疫化疗的患者。法国里昂贝拉德癌症中心。对于复发患者，从记录中提取复发和结果的详细信息。结果从 MER 中识别出 680 名 DLBCL 患者，其中 552 名 (81%) 在诱导后获得缓解。 552 名患者中有 112 名（20%）病情复发。大多数（64%）的复发是在预定的随访之前发现的。治疗后观察到的 552 名患者中，有 9 名 (1.6%) 患者在出现临床表现之前进行了监测成像检测，发现 DLBCL 复发。在里昂队列中，影像学检查发现 222 名患者中有 4 名无症状 DLBCL 复发（1.8%）。在 MER (P = .56) 和 Lyon 队列 (P = .25) 中，在计划随访时检测到的 DLBCL 复发后与在计划随访前检测到的患者的生存率没有差异。结论 大多数 DLBCL 复发是在计划随访之外检测到的，与计划随访之外检测到的 DLBCL 患者相比，在计划随访时检测到的 DLBCL 患者的结局没有差异。这些数据不支持使用常规监测影像来随访 DLBCL。 (C) 2014 年美国临床肿瘤学会
PurposeWe examined the utility of post-therapy surveillance imaging in a large, prospectively enrolled cohort of patients with diffuse large B-cell lymphoma (DLBCL) from the United States and confirmed our results in an independent cohort of patients from France.MethodsPatients with newly diagnosed DLBCL and treated with anthracycline-based immunochemo-therapy were identified from the Molecular Epidemiology Resource (MER) of the University of Iowa/Mayo Clinic Lymphoma Specialized Program of Research Excellence and the Leon Berard Cancer Center, Lyon, France. In those with relapse, details at relapse and outcomes were abstracted from records.Results680 individuals with DLBCL were identified from the MER, 552 (81%) of whom achieved remission after induction. 112 of the 552 patients (20%) suffered a relapse. The majority (64%) of relapses were identified before a scheduled follow-up visit. Surveillance imaging detected DLBCL relapse before clinical manifestations in nine out of 552 patients (1.6%) observed after therapy. In the Lyon cohort, imaging identified asymptomatic DLBCL relapse in four out of 222 patients (1.8%). There was no difference in survival after DLBCL relapse in patients detected at scheduled follow-up versus before scheduled follow-up in both the MER (P = .56) and Lyon cohorts (P = .25).ConclusionThe majority of DLBCL relapses are detected outside of planned follow-up, with no difference in outcome in patients with DLBCL detected at a scheduled visit compared with patients with relapse detected outside of planned follow-up. These data do not support the use of routine surveillance imaging for follow-up of DLBCL. (C) 2014 by American Society of Clinical Oncology