Early restaging positron emission tomography with <script type="math/tex">^{18}F</script>-fluorodeoxyglucose predicts outcome in patients with aggressive non-Hodgkin's lymphoma

Spaepen, K.; Stroobants, S.; Dupont, P.; Vandenberghe, P.; Thomas, J.; de Groot, T.; Balzarini, J.; De Wolf-Peeters, C.; Mortelmans, L.; Verhoef, G.

doi:10.1093/ANNONC/MDF256

Title

Early restaging positron emission tomography with $^{18}F$ -fluorodeoxyglucose predicts outcome in patients with aggressive non-Hodgkin's lymphoma

Author

Spaepen, K.

Stroobants, S.

Dupont, P.

Vandenberghe, P.

Thomas, J.

de Groot, T.

Balzarini, J.

De Wolf-Peeters, C.

Mortelmans, L.

Verhoef, G.

Abstract

Background: Less than half of all patients with aggressive non-Hodgkins lymphoma (NHL) are cured with standard chemotherapy. Therefore, it is important to distinguish between responders to standard treatment and non-responders who may benefit from an early change to a more effective therapy. This study was intended to assess the value of a midtreatment fluorine-18 fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) scan to predict clinical outcome in patients with aggressive NHL. Patients and methods: Seventy newly diagnosed patients with aggressive NHL, who were treated with doxorubicin-containing chemotherapy, underwent a [18F]FDG-PET scan at midtreatment. Presence or absence of abnormal [18F]FDG uptake was related to progression-free survival (PFS) and overall survival (OS) using KaplanMeier survival analysis. Multivariate analysis was performed to evaluate the effect of the International Prognostic Index (IPI) and early [18F]FDG-PET findings on PFS and OS. Results: At midtreatment, 33 patients showed persistent abnormal [18F]FDG uptake and none of these patients achieved a durable complete remission (CR), whereas 37 patients showed a negative scan; 31/37 remained in CR, with a median follow-up of 1107 days. Only 6/37 patients either achieved a partial response or relapsed. Comparison between groups indicated a statistically significant association between [18F]FDG-PET findings and PFS (P <1 × 105) and OS (P <1 × 105). In multivariate analysis, [18F]FDG-PET at midtreatment was a stronger prognostic factor for PFS (P <1 × 107) and OS (P <9 × 106) than the IPI (P <0.11 and P <0.03, respectively). Conclusions: Early restaging [18F]FDG-PET may be used to tailor induction chemotherapy in patients with aggressive NHL.

Language

English

Source (journal)

Annals of oncology / European Society for Medical Oncology. - Amsterdam

Publication

Amsterdam : 2002

ISSN

0923-7534

DOI

10.1093/ANNONC/MDF256

Volume/pages

13 :9 (2002) , p. 1356-1363