Hutchings M, Mikhaeel N G, Fields P A, Nunan T, Timothy A R
Department of Clinical Oncology, Department of Haematology, The Clinical PET Centre, Guy's and St. Thomas' Hospital, London, UK.
Ann Oncol. 2005 Jul;16(7):1160-8. doi: 10.1093/annonc/mdi200. Epub 2005 Jun 6.
Long-term survival from Hodgkin lymphoma (HL) is 80-90%, but the treatment has serious late adverse effects. Modern risk-adapted treatment requires accurate assessment of the patient's prognosis. This investigation assessed the value of positron emission tomography (PET) with 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) after two or three cycles of chemotherapy for prediction of progression-free survival (PFS) and overall survival (OS).
A total of 85 patients with HL underwent FDG-PET after two or three cycles of chemotherapy. Median follow-up was 3.3 years. FDG-PET results were related to PFS and OS using Kaplan-Meier analysis. Regression analyses were employed to test for independence of established pretreatment prognostic factors.
After two or three cycles of chemotherapy, 63 patients had negative FDG-PET scans, nine patients had minimal residual uptake (MRU) and 13 patients had positive scans. Three PET-negative patients and one patient from the MRU group relapsed. In the PET-positive group, nine patients progressed and two died. Survival analyses showed highly significant associations between early interim FDG-PET and PFS (P <0.0001) and OS (P <0.03). All advanced-stage patients with positive interim FDG-PET relapsed within 2 years.
Early interim FDG-PET is an accurate and independent predictor of PFS and OS in HL. A positive interim FDG-PET is highly predictive of relapse in advanced-stage disease.
霍奇金淋巴瘤（HL）患者的长期生存率为80% - 90%，但其治疗会产生严重的晚期不良反应。现代风险适应性治疗需要准确评估患者的预后。本研究评估了在两或三个化疗周期后进行的2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描（PET，即FDG-PET）对无进展生存期（PFS）和总生存期（OS）的预测价值。
共有85例HL患者在两或三个化疗周期后接受了FDG-PET检查。中位随访时间为3.3年。使用Kaplan-Meier分析将FDG-PET结果与PFS和OS相关联。采用回归分析来检验既定的预处理预后因素的独立性。
在两或三个化疗周期后，63例患者的FDG-PET扫描结果为阴性，9例患者有最小残留摄取（MRU），13例患者扫描结果为阳性。3例PET阴性患者和MRU组中的1例患者复发。在PET阳性组中，9例患者病情进展，2例死亡。生存分析显示早期中期FDG-PET与PFS（P <0.0001）和OS（P <0.03）之间存在高度显著的关联。所有中期FDG-PET阳性的晚期患者均在2年内复发。
早期中期FDG-PET是HL患者PFS和OS的准确且独立的预测指标。中期FDG-PET阳性对晚期疾病的复发具有高度预测性。
