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计算机断层扫描和18F-FDG正电子发射断层扫描用于霍奇金淋巴瘤和非霍奇金淋巴瘤患者的治疗控制:我们何时真的需要FDG-PET?

Computed tomography and 18F-FDG positron emission tomography for therapy control of Hodgkin's and non-Hodgkin's lymphoma patients: when do we really need FDG-PET?

作者信息

Reinhardt M J, Herkel C, Altehoefer C, Finke J, Moser E

机构信息

Department of Nuclear Medicine, University Hospital Bonn, Germany.

出版信息

Ann Oncol. 2005 Sep;16(9):1524-9. doi: 10.1093/annonc/mdi271. Epub 2005 Jun 9.

Abstract

BACKGROUND

The aim of this study was to evaluate the accuracy of computed tomography (CT) and [(18)F]fluoro-deoxy-d-glucose positron emission tomography (FDG-PET) for prediction of progression-free survival of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) patients after completion of therapy.

PATIENTS AND METHODS

CT and FDG-PET were performed in 40 HD, 17 indolent NHL and 44 aggressive NHL patients (29 women, 72 men; aged 41+/-14 years) in a median of 2 months after therapy. Progression-free survival was evaluated using the Kaplan-Meier method. Independent prognostic factors were identified by means of Cox proportional hazards model.

RESULTS

CT imaging results were progressive disease (PD) in five, stable disease (SD) in 57, and partial response (PR) or complete remission (CR) in 39 patients. FDG-PET suggested residual lymphoma in 24 patients. Three-year progression-free survival rates after exclusion of five PD patients were: 100% (PET negative; CT: PR or CR), 81% (PET negative; CT: SD), 21% (PET positive; CT: SD) and 0% (PET positive; CT: PR). FDG-PET (P<0.0001) and bulky disease (P <0.05) were identified as independent prognostic variables.

CONCLUSIONS

Among lymphoma patients with PR and SD on CT, FDG-PET discriminated those destined to progress into a low risk of < or =20% and a high risk for recurrence of > or =80%.

摘要

背景

本研究旨在评估计算机断层扫描(CT)和[18F]氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)对预测霍奇金病(HD)和非霍奇金淋巴瘤(NHL)患者治疗结束后无进展生存期的准确性。

患者与方法

对40例HD、17例惰性NHL和44例侵袭性NHL患者(29例女性,72例男性;年龄41±14岁)在治疗后中位2个月时进行CT和FDG-PET检查。采用Kaplan-Meier法评估无进展生存期。通过Cox比例风险模型确定独立预后因素。

结果

CT成像结果显示5例为疾病进展(PD),57例为疾病稳定(SD),39例为部分缓解(PR)或完全缓解(CR)。FDG-PET提示24例患者存在残留淋巴瘤。排除5例PD患者后的三年无进展生存率为:100%(PET阴性;CT:PR或CR),81%(PET阴性;CT:SD),21%(PET阳性;CT:SD)和0%(PET阳性;CT:PR)。FDG-PET(P<0.0001)和大包块病变(P<0.05)被确定为独立预后变量。

结论

在CT显示PR和SD的淋巴瘤患者中,FDG-PET可区分出进展风险低(≤20%)和复发风险高(≥80%)的患者。

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