Gallamini Andrea, Rigacci Luigi, Merli Francesco, Nassi Luca, Bosi Alberto, Capodanno Isabella, Luminari Stefano, Vitolo Umberto, Sancetta Rosaria, Iannitto Emilio, Trentin Livio, Stelitano Caterina, Tavera Silvia, Biggi Alberto, Castagnoli Antonio, Versari Annibale, Gregianin Michele, Pelosi Ettore, Torchio Pierfederico, Levis Alessandro
SC Ematologia Azienda, Ospedaliera S Croce e Carle, Cuneo, Italy.
Haematologica. 2006 Apr;91(4):475-81.
We explored the predictive value on therapy outcome of an early evaluation of treatment response by 18F-fluorodeoxyglucose position emission tomography (18F-FDG-PET) scan performed after two courses of conventional standard-dose chemotherapy in advanced-stage Hodgkin's disease.
One hundred and eight patients with newly-diagnosed Hodgkin's disease in stage IIA with adverse prognostic factors, or in stage IIB through IVB, were re-staged with FDG-PET after two cycles of ABVD (PET-2). The end-point of the study was the predictive value of PET-2 on 2-year progression-free survival and 2-year failure-free survival. No treatment variation based only on PET-2 results was allowed.
Eighty-eight patients attained complete remission (CR) while 20 showed disease progression during therapy or within 6 months after having reached CR; one patient relapsed. PET-2 was positive in 20 patients: 17 progressed during therapy, one relapsed and two remained in CR. By contrast, 85/88 (97%) patients with a negative PET-2 remained in CR; three progressed or relapsed early after the end of the chemotherapy. Thus, the positive predictive value of a PET-2 was 90% and the negative predictive value was 97%. The sensitivity, specificity and overall accuracy of PET-2 were 86%, 98% and 95%, respectively. The 2-year probability of failure-free survival for PET-2 negative and for PET-2 positive patients was 96% and 6%, respectively (log rank test = 116.7, p < 0.01).
18F-FDG-PET scan performed after two courses of conventional standard-dose chemotherapy in advanced-stage Hodgkin's disease was able to predict treatment outcome in 103/108 (95%) of the patients.
我们探讨了在晚期霍奇金淋巴瘤患者接受两个疗程的传统标准剂量化疗后，通过18F-氟脱氧葡萄糖正电子发射断层扫描（18F-FDG-PET）对治疗反应进行早期评估，其对治疗结果的预测价值。
108例新诊断的霍奇金淋巴瘤患者，IIA期伴有不良预后因素，或IIB期至IVB期，在接受两个周期的ABVD化疗后（PET-2），用FDG-PET进行重新分期。研究的终点是PET-2对2年无进展生存期和2年无失败生存期的预测价值。不允许仅基于PET-2结果进行治疗调整。
88例患者达到完全缓解（CR），20例在治疗期间或达到CR后6个月内出现疾病进展；1例复发。PET-2阳性的20例患者中：17例在治疗期间进展，1例复发，2例仍处于CR状态。相比之下，PET-2阴性的88例患者中有85例（97%）仍处于CR状态；3例在化疗结束后早期进展或复发。因此，PET-2的阳性预测值为90%，阴性预测值为97%。PET-2的敏感性、特异性和总体准确率分别为86%、98%和95%。PET-2阴性和阳性患者的2年无失败生存期概率分别为96%和6%（对数秩检验=116.7，p<0.01）。
在晚期霍奇金淋巴瘤患者接受两个疗程的传统标准剂量化疗后进行的18F-FDG-PET扫描，能够在108例患者中的103例（95%）预测治疗结果。
