18F-FDG PET After 2 Cycles of ABVD Predicts Event-Free Survival in Early and Advanced Hodgkin Lymphoma
18F-FDG PET After 2 Cycles of ABVD Predicts Event-Free Survival in Early and Advanced Hodgkin Lymphoma
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DOI：
10.2967/jnumed.109.073197
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发表时间：
2010-09-01
影响因子：
9.3
通讯作者：
Meneghetti, Jose C.
中科院分区：
文献类型：
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作者：
Cerci, Juliano J.;Pracchia, Luis F.;Meneghetti, Jose C.
我们的目的是评估F-18-FDG PET在使用阿霉素、博来霉素、长春花碱和达卡巴胺（ABVD）化疗2个周期后对霍奇金淋巴瘤（HL）患者的预后价值，以及根据国际预后评分（IPS）对早期和晚期、低风险和高风险患者进行亚组的预后价值。方法：115例新诊断的HL患者前瞻性纳入研究。所有患者均接受了标准的ABVD治疗，对体积较大的疾病进行了巩固放疗。ABVD 2个周期后，进行PET （PET2）评估。预后分析将3年无事件生存率（EFS）与PET2结果、临床数据和IPS进行比较。结果：在104例接受评估的患者中，93例在一线治疗后完全缓解。在中位随访36个月期间，22例患者出现复发或疾病进展。30例pet2阳性患者中有16例治疗失败，74例pet2阴性患者中只有6例治疗失败。PET2是唯一重要的预后因素。pet2阳性患者3-y EFS为53.4%，pet2阴性患者为90.5% （P < 0.001）。当患者根据低或高IPS风险以及根据疾病的早期或晚期进行分类时，PET2也与治疗结果显着相关。结论：PET2是HL患者EFS准确、独立的预测指标。中期F-18-FDG PET阴性结果可高度预测整体HL患者的治疗成功，以及早期或晚期疾病和低或高IPS风险的亚组。
Our objective was to assess the prognostic value of F-18-FDG PET after 2 cycles of chemotherapy using doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in Hodgkin lymphoma (HL) patients overall and in subgroups of patients with early and advanced stages and with low and high risks according to the International Prognostic Score (IPS). Methods: One hundred fifteen patients with newly diagnosed HL were prospectively included in the study. All underwent standard ABVD therapy followed by consolidation radiotherapy in cases of bulky disease. After 2 cycles of ABVD, the patients were evaluated with PET (PET2). Prognostic analysis compared the 3-y event-free survival (EFS) rate to the PET2 results, clinical data, and IPS. Results: Of the 104 evaluated patients, 93 achieved complete remission after first-line therapy. During a median follow-up of 36 mo, relapse or disease progression was seen in 22 patients. Treatment failure was seen in 16 of the 30 PET2-positive patients and in only 6 of the 74 PET2-negative patients. PET2 was the only significant prognostic factor. The 3-y EFS was 53.4% for PET2-positive patients and 90.5% for PET2-negative ones (P < 0.001). When patients were categorized according to low or high IPS risk and according to early or advanced stage of disease, PET2 was also significantly associated with treatment outcome. Conclusion: PET2 is an accurate and independent predictor of EFS in HL. A negative interim F-18-FDG PET result is highly predictive of treatment success in overall HL patients, as well as in subgroups with early or advanced-stage disease and with low or high IPS risk.