End-of-treatment but not interim PET scan predicts outcome in nonbulky limited-stage Hodgkin's lymphoma
End-of-treatment but not interim PET scan predicts outcome in nonbulky limited-stage Hodgkin's lymphoma
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DOI：
10.1093/annonc/mdq549
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发表时间：
2011-04-01
影响因子：
50.5
通讯作者：
Abramson, J. S.
中科院分区：
文献类型：
--
作者：
Barnes, J. A.;LaCasce, A. S.;Abramson, J. S.
背景：早期中期正电子发射断层扫描(PET)对霍奇金淋巴瘤(HL)的预后有很强的预测作用，特别是在晚期疾病中，它已经得到了主要的研究。中期PET在局限性非肿块性疾病患者中的预后价值尚未得到很好的确定。患者和方法：96例非肿块性局限性HL患者进行了中期和治疗结束的PET扫描。结果：全组4年无进展生存率和无进展生存率分别为88%和97%。中期PET不能预测结果，阳性患者和阴性患者的PFS分别为87%和91%(P=0.57)。治疗结束后的正电子发射计算机断层扫描结果可以预测结果，在正电子发射计算机断层扫描阴性患者中，PFS为94%，而在正电子发射计算机断层扫描阳性患者中为54%(P<；0.0001)。终末期PET阴性患者的4年OS为100%，终末期PET阳性患者的4年OS为84%(P<；0.0001)。结论：与治疗结束时进行的扫描相比，中期PET扫描并不能预测结果。不管中期的PET结果如何，治疗结束时的PET对PFS和OS有很高的预测性。在这一低风险患者群体中，即使是PET扫描临时阳性的患者也显示出良好的预后。
Background: Early interim positron emission tomography (PET) scans appear powerfully predictive of outcome in Hodgkin's lymphoma (HL), particularly in advanced-stage disease where it has been predominantly studied. The prognostic value of interim PET in limited-stage patients with nonbulky disease has not been well established.Patients and methods: Ninety-six patients with nonbulky limited-stage HL were identified who had interim and end-of-treatment PET scans. Response rate, overall survival (OS), and progression-free survival (PFS) were calculated.Results: Four-year PFS and OS for the entire cohort were 88% and 97%, respectively. Interim PET did not predict outcome, with PFS in positive and negative patients 87% versus 91% (P = 0.57), respectively. End-of-treatment PET result was predictive of outcome, with PFS of 94% in end PET-negative patients versus 54% in end PET-positive patients (P < 0.0001). Four-year OS was 100% in end PET-negative patients and 84% in end PET-positive patients (P < 0.0001).Conclusions: Interim PET scans were not predictive of outcome, compared with scans carried out at completion of therapy. End-of-treatment PET was highly predictive of PFS and OS, regardless of interim PET result. In this low-risk patient population, even patients with interim positive PET scans show a favorable prognosis.