Use of subsequent PET/CT in diffuse large B-cell lymphoma patients in complete remission following primary therapy / 癌症
Chinese Journal of Cancer
; (12): 70-78, 2015.
Article
in En
| WPRIM
| ID: wpr-349619
Responsible library:
WPRO
ABSTRACT
Interim 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (I-PET/CT) is a powerful tool for monitoring the response to therapy in diffuse large B-cell lymphoma (DLBCL). This retrospective study aimed to determine when and how to use I-PET/CT in DLBCL. A total of 197 patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) were enrolled between October 2005 and July 2011; PET/CT was performed at the time of diagnosis (PET/CT0), after 2 and 4 cycles of chemotherapy (PET/CT2 and PET/CT4, respectively), and at the end of treatment (F-PET/CT). According to the International Harmonization Project for Response Criteria in Lymphoma, 110 patients had negative PET/CT2 scans, and 87 had positive PET/CT2 scans. The PET/CT2-negative patients had significantly higher 3-year progression-free survival rate (75.8% vs. 38.2%) and 3-year overall survival rate (93.5% vs. 55.6%) than PET/CT2-positive patients. All PET/CT2-negative patients remained negative at PET/CT4, but 3 were positive at F-PET/CT. Among the 87 PET/CT2-positive patients, 57 remained positive at F-PET/CT, and 32 progressed during chemotherapy (15 at PET/CT4 and 17 at F-PET/CT). Comparing PET/CT4 with PET/CT0, 7 patients exhibited progression, and 8 achieved partial remission. Comparing F-PET/CT with PET/CT0, 10 patients exhibited progression, and 7 achieved partial remission. In conclusion, our results indicate that I-PET/CT should be performed after 2 rather than 4 cycles of immunochemotherapy in DLBCL patients. There is a limited role for subsequent PET/CT in the detection of relapse in PET/CT2-negative patients, but repeat PET/CT is required if the PET/CT2 findings are positive.
Full text:
1
Database:
WPRIM
Main subject:
Remission Induction
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Tomography, X-Ray Computed
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Retrospective Studies
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Mortality
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Lymphoma, Large B-Cell, Diffuse
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Positron-Emission Tomography
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Diagnosis
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Drug Therapy
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Multimodal Imaging
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Methods
Type of study:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limits:
Adolescent
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Adult
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Aged
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Aged80
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Humans
Language:
En
Journal:
Chinese Journal of Cancer
Year:
2015
Type:
Article