Fruchart Christophe, Reman Oumedaly, Le Stang Nolwenn, Musafiri Dada, Cheze Stéphane, Macro Margaret, Switsers Odile, Aide Nicolas, Liegard Mélanie, Levaltier Xavier, Peny Anne-Marie, Leporrier Michel, Bardet Stéphane
Department of Haematology, François Baclesse Center, Caen, France.
Leuk Lymphoma. 2006 Dec;47(12):2547-57. doi: 10.1080/10428190600942959.
The prognostic value of fluorodeoxyglucose positron emission tomography (FDG-PET) and gallium-67 scan (GS) performed early after chemotherapy was assessed in 40 patients with newly diagnosed aggressive lymphoma. FDG-PET and GS were performed before and after three cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or two cycles of ACVBP (doxorubicin, cyclophosphamide, vindesine, bleomycin, prednisone), with or without rituximab. Thirty-five patients had diffuse large B-cell lymphoma (DLBCL), two had mantle-cell lymphoma and three had T-cell lymphoma. Four patients relapsed despite early negative FDG-PET and GS including all three patients with T-cell lymphoma. Nine patients stayed in remission despite positive FDG-PET and/or GS of whom five showed moderate intensity residual bone uptake. Seven of these nine early false positives had a negative exam at the end of treatment. In patients with DLBCL, the 2-year event-free survival was 85% for negative versus 30% for positive FDG-PET patients (P = 0.003) whereas it was 78% for negative versus 33% for positive GS patients (P = 0.018). Sensitivity, specificity and diagnostic accuracy of FDG-PET and GS were not significantly different: 90% versus 70%, 76 versus 80% and 80 versus 77%, respectively. We conclude that both FDG-PET and GS are valuable tools to early predict outcome in patients with DLBCL.
在40例新诊断的侵袭性淋巴瘤患者中，评估了化疗后早期进行的氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和镓-67扫描（GS）的预后价值。在接受CHOP（环磷酰胺、阿霉素、长春新碱、泼尼松）三个周期或ACVBP（阿霉素、环磷酰胺、长春地辛、博来霉素、泼尼松）两个周期治疗之前和之后，进行FDG-PET和GS检查，治疗中使用或不使用利妥昔单抗。35例患者患有弥漫性大B细胞淋巴瘤（DLBCL），2例患有套细胞淋巴瘤，3例患有T细胞淋巴瘤。尽管早期FDG-PET和GS检查结果为阴性，但仍有4例患者复发，其中包括所有3例T细胞淋巴瘤患者。尽管FDG-PET和/或GS检查结果为阳性，但仍有9例患者处于缓解期，其中5例显示中度强度的残留骨摄取。这9例早期假阳性患者中有7例在治疗结束时检查结果为阴性。在DLBCL患者中，FDG-PET检查结果为阴性的患者2年无事件生存率为85%，而检查结果为阳性的患者为30%（P = 0.003）；GS检查结果为阴性的患者2年无事件生存率为78%，而检查结果为阳性的患者为33%（P = 0.018）。FDG-PET和GS的敏感性、特异性和诊断准确性无显著差异：分别为90%对70%、76%对80%和80%对77%。我们得出结论，FDG-PET和GS都是早期预测DLBCL患者预后的有价值工具。
