FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma
FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma
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DOI：
10.1093/annonc/mdi272
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发表时间：
2005-09-01
影响因子：
50.5
通讯作者：
Timothy, AR
中科院分区：
文献类型：
--
作者：
Mikhaeel, NG;Hutchings, M;Timothy, AR
背景：不到50%的高级别非霍奇金淋巴瘤（NHL）患者经历了持久的无病生存。适应风险的治疗策略需要更好的工具来预测结果。本研究旨在评估2-[18F]氟-2-脱氧-d -葡萄糖（FDG-PET）正电子发射断层扫描在2至3个化疗周期后对无进展生存期（PFS）和总生存期（OS）的预测价值。患者和方法：121例高级别NHL患者行FDG-PET治疗。采用Kaplan-Meier生存分析，FDG-PET治疗反应与PFS和OS相关。采用Cox回归分析检验已知预处理预后因素的独立性。结果：50例FDG-PET扫描呈阴性，19例显示MRU， 52例呈阳性。pet阴性组的估计5年PFS为88.8%，MRU组为59.3%，pet阳性组为16.2%。Kaplan-Meier分析显示FDG-PET结果与PFS （P < 0.0001）和OS （P < 0.01）有很强的相关性。早期中期FDG-PET与其他预后因素无关。结论：早期中期FDG-PET是PFS和OS准确、独立的预测指标。FDG-PET对化疗反应的早期评估可以为患者选择替代治疗策略提供依据。
Background: Less than 50% of all high-grade non-Hodgkin lymphoma (NHL) patients experience lasting disease-free survival. Risk-adapted treatment strategies require better tools for prediction of outcome. This investigation aimed to assess the value of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) after two to three cycles of chemotherapy for prediction of progression-free survival (PFS) and overall survival (OS).Patients and methods: One hundred and twenty-one patients with high-grade NHL underwent FDG-PET. The therapy response on FDG-PET was correlated to PFS and OS using Kaplan-Meier survival analysis. Cox regression analyses were employed to test for independence of known pretreatment prognostic factors.Results: Fifty FDG-PET scans were negative, 19 scans showed minimal residual uptake (MRU), and 52 scans were positive. The estimated 5 year PFS was 88.8% for the PET-negative group, 59.3% for the MRU group, and 16.2% for the PET-positive group. Kaplan-Meier analyses showed strong associations between FDG-PET results and PFS (P < 0.0001) and OS (P < 0.01). Early interim FDG-PET was independent of the other prognostic factors.Conclusions: Early interim FDG-PET is an accurate and independent predictor of PFS and OS. An early assessment of chemotherapy response with FDG-PET could provide the basis for selection of patients for alternative therapeutic strategies.