Limited role of interim PET/CT in patients with diffuse largeB-cell lymphoma treated with R-CHOP
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Changhoon Yoo & Dae Ho Lee & Jeong Eun Kim &Jungmin Jo & Dok Hyun Yoon & Byeong Seok Sohn & Sang-We Kim & Jung-Shin Lee & Cheolwon Suh
- چاپ و سال / کشور: 2010
Description
Positron emission tomography (PET) has been found useful in monitoring response to treatment of malignant lymphoma. We investigated the ability of interim PET to monitor response to standard dose R-CHOP chemotherapy in chemotherapy-naïve patients with diffuse large B-cell lymphoma (DLBCL). Between March 2004 and April 2009, 155 DLBCL patients treated with R-CHOP and available for interim and posttreatment PET/CT were identified and included in this analysis. Response, progression-free survival (PFS), and overall survival (OS) were compared between interim PET/CT-negative and positive group, and among three patient groups which were categorized based on their interim and post-treatment PET/CT: those with early metabolic complete response (mCR), delayed mCR, and never mCR. Interim PET/CT-negative patients (n=100) showed superior CR rates to interim PET/CT-positive patients (n=55; 93% vs 62%, P<0.001). However, there was no difference in PFS (P=0.07) and OS (P=0.24) between interim PET/CT-negative and positive group. We categorized patients into three groups, with 100 (64%) in the early mCR group, 35 (23%) in the delayed mCR group, and 20 (13%) in the never mCR group. Early mCR and delayed mCR group did not differ significantly in PFS (P=0.84) or OS (P=0.20). However, the survival outcome in the never mCR group was significantly inferior to the combined early and delayed mCR group. The result from this study suggests that interim PET/CT might be an inappropriate tool for designing risk-adaptive therapy in chemotherapy-naïve DLBCL patients treated with R-CHOP. Prospective trials should be performed to clearly determine the role of interim PET/CT.
Ann Hematol (2011) 90:797–802 DOI 10.1007/s00277-010-1135-6 Received: 29 August 2010 / Accepted: 30 November 2010 / Published online: 22 December 2010
