Department of Nuclear Medicine, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
J Nucl Med. 2010 Sep;51(9):1337-43. doi: 10.2967/jnumed.109.073197. Epub 2010 Aug 18.
Our objective was to assess the prognostic value of (18)F-FDG PET after 2 cycles of chemotherapy using doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in Hodgkin lymphoma (HL) patients overall and in subgroups of patients with early and advanced stages and with low and high risks according to the International Prognostic Score (IPS).
One hundred fifteen patients with newly diagnosed HL were prospectively included in the study. All underwent standard ABVD therapy followed by consolidation radiotherapy in cases of bulky disease. After 2 cycles of ABVD, the patients were evaluated with PET (PET2). Prognostic analysis compared the 3-y event-free survival (EFS) rate to the PET2 results, clinical data, and IPS.
Of the 104 evaluated patients, 93 achieved complete remission after first-line therapy. During a median follow-up of 36 mo, relapse or disease progression was seen in 22 patients. Treatment failure was seen in 16 of the 30 PET2-positive patients and in only 6 of the 74 PET2-negative patients. PET2 was the only significant prognostic factor. The 3-y EFS was 53.4% for PET2-positive patients and 90.5% for PET2-negative ones (P < 0.001). When patients were categorized according to low or high IPS risk and according to early or advanced stage of disease, PET2 was also significantly associated with treatment outcome.
PET2 is an accurate and independent predictor of EFS in HL. A negative interim (18)F-FDG PET result is highly predictive of treatment success in overall HL patients, as well as in subgroups with early or advanced-stage disease and with low or high IPS risk.
我们的目的是评估在霍奇金淋巴瘤（HL）患者中，使用多柔比星、博来霉素、长春碱和达卡巴嗪（ABVD）进行 2 个周期化疗后，（18）F-FDG PET 的预后价值，这些患者分为早期和晚期、低危和高危亚组，根据国际预后评分（IPS）。
115 例新诊断的 HL 患者前瞻性纳入研究。所有患者均接受标准 ABVD 治疗，然后在疾病体积较大的情况下进行巩固性放疗。在 ABVD 第 2 周期后，对患者进行 PET（PET2）评估。预后分析比较了 3 年无事件生存（EFS）率与 PET2 结果、临床数据和 IPS。
在 104 例可评估的患者中，93 例在一线治疗后达到完全缓解。在中位随访 36 个月期间，22 例患者出现复发或疾病进展。在 30 例 PET2 阳性患者中，有 16 例治疗失败，而在 74 例 PET2 阴性患者中只有 6 例治疗失败。PET2 是唯一的显著预后因素。PET2 阳性患者的 3 年 EFS 为 53.4%，PET2 阴性患者为 90.5%（P < 0.001）。当根据低危或高危 IPS 风险以及疾病的早期或晚期对患者进行分类时，PET2 也与治疗结果显著相关。
PET2 是 HL 患者 EFS 的准确和独立预测因子。在总体 HL 患者中，以及在早期或晚期疾病、低危或高危 IPS 风险亚组中，阴性中期（18）F-FDG PET 结果高度提示治疗成功。
