PET Unit, Nuclear Medicine Department, University Hospital S. Orsola-Malpighi, Bologna.
Department of Hematology, 'L. Seragnoli' Institution, University Hospital S. Orsola-Malpighi, Bologna.
Ann Oncol. 2010 Sep;21(9):1877-1883. doi: 10.1093/annonc/mdq024. Epub 2010 Feb 10.
The aim of this study is the 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) evaluation following radioimmunotherapy (RIT) with ibritumomab tiuxetan Y 90 in patients with non-Hodgkin's follicular lymphoma (FL).
We retrospectively analyzed data from 59 relapsed or refractory FL patients treated with ibritumomab tiuxetan Y 90 in four different PET centers who had a PET scan carried out before and after RIT. Possible predictive factors of progression-free survival (PFS) were studied through univariate and multivariate analysis.
The post-RIT PET documented 45.8% complete responders (CR), 25.4% partial responders (PR) and 28.8% nonresponders [stable disease + progressive disease], with an overall survival of 71.2% (range 59.5%-90.9%). With a median follow-up period of 23 months, the univariate analysis documented a statistically significant relation between disease extent before RIT and response to treatment with respect to PFS (P = 0.015), while all the other prognostic factors showed no significant correlation. When carrying out the multivariate analysis, post-RIT PET resulted as the lonely independent predictor of PFS (P < 0.00001).
RIT is an effective therapy in FL patients, as confirmed in our study too. Disease extension before treatment and response to RIT, as assessed by FDG-PET, result as main predictors of PFS, with the post-RIT PET result being the only independent predictive factor.
本研究的目的是评估氟-18 标记的 2-脱氧-2-氟-D-葡萄糖（FDG）正电子发射断层扫描（PET）在应用替伊莫单抗铼 90 进行放射免疫治疗（RIT）后对非霍奇金滤泡性淋巴瘤（FL）患者的疗效。
我们回顾性分析了在四个不同的 PET 中心接受替伊莫单抗铼 90 治疗的 59 例复发或难治性 FL 患者的数据，这些患者在 RIT 前后均进行了 PET 扫描。通过单因素和多因素分析研究了无进展生存（PFS）的可能预测因素。
RIT 后 PET 检查显示 45.8%的完全缓解（CR），25.4%的部分缓解（PR）和 28.8%的无缓解（疾病稳定+进展），总生存率为 71.2%（范围 59.5%-90.9%）。中位随访时间为 23 个月，单因素分析显示，RIT 前疾病范围与治疗反应与 PFS 之间存在统计学显著相关性（P = 0.015），而所有其他预后因素均无显著相关性。在进行多因素分析时，RIT 后 PET 是 PFS 的唯一独立预测因素（P < 0.00001）。
RIT 是 FL 患者的一种有效治疗方法，我们的研究也证实了这一点。治疗前疾病范围和 RIT 反应，通过 FDG-PET 评估，是 PFS 的主要预测因素，RIT 后 PET 结果是唯一的独立预测因素。
