Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Cancer Sci. 2011 Feb;102(2):414-8. doi: 10.1111/j.1349-7006.2010.01802.x. Epub 2010 Dec 12.
The aim of the present study was to investigate the relevance of monitoring metabolic reduction evaluated by (18) F-fluorodeoxyglucose ((18) F-FDG) PET/CT in relapsed or refractory patients with follicular lymphoma (FL) and mantle cell lymphoma (MCL) who received bendamustine. We conducted a phantom study of 18F-FDG PET/CT to ensure quality control for performing a multicenter clinical study. We analyzed 49 patients with relapsed or refractory FL and MCL who received bendamustine (120 mg/m(2)) on days 1-2 of a 21-day cycle for up to six cycles as a licensing phase II study. 18F-FDG PET/CT scans were acquired before the first and after the last cycle. In a total of 175 target lesions, the maximum perpendicular diameter (Max PD), minimum PD (Min PD), sum of the products of the Max PD (SPD), maximum standardized uptake value (SUVmax), and the percentage reduction rates of Max PD (%Max PD), SPD (%SPD) and SUVmax (%SUVmax) were evaluated for the response to treatment. The therapeutic response was assessed after the last cycle of treatment according to the revised response criteria for malignant lymphoma (revised RC). We evaluated 134 lesions in 39 patients (76%) achieving complete response (CR) and 41 lesions in 10 patients (24%) not achieving CR. The Max PD, Min PD, SPD and SUVmax of the lesions after the last cycle were significantly higher in patients with non-CR than in patients with CR. The %MPD, %SPD and %SUVmax of the lesions were significantly greater in patients with CR than in patients with non-CR (P < 0.0001). Metabolic reduction was observed in all target lesions of relapsed or refractory patients with FL and MCL who achieved CR after bendamustine therapy.
本研究旨在探讨监测代谢缓解在复发或难治性滤泡淋巴瘤（FL）和套细胞淋巴瘤（MCL）患者接受苯达莫司汀治疗中的相关性。我们进行了 18F-氟脱氧葡萄糖（18F-FDG）PET/CT 体模研究，以确保执行多中心临床研究的质量控制。我们分析了 49 例接受苯达莫司汀（120mg/m2）治疗的复发或难治性 FL 和 MCL 患者，每 21 天为一个周期，共 6 个周期，作为许可阶段 II 研究。在第 1 个周期前和最后 1 个周期后采集 18F-FDG PET/CT 扫描。在总共 175 个靶病灶中，评估了最大垂直直径（Max PD）、最小 PD（Min PD）、Max PD 乘积的总和（SPD）、最大标准化摄取值（SUVmax）以及 Max PD（%Max PD）、SPD（%SPD）和 SUVmax（%SUVmax）的降低率，以评估对治疗的反应。根据恶性淋巴瘤修订后的反应标准（修订后的 RC），在最后 1 个周期治疗后评估治疗反应。我们评估了 39 例患者中的 134 个病灶（76%）达到完全缓解（CR），10 例患者中的 41 个病灶（24%）未达到 CR。最后 1 个周期后，非 CR 患者的病灶 Max PD、Min PD、SPD 和 SUVmax 显著高于 CR 患者。CR 患者的病灶%MPD、%SPD 和%SUVmax 显著高于非 CR 患者（P<0.0001）。在接受苯达莫司汀治疗后达到 CR 的复发或难治性 FL 和 MCL 患者的所有靶病灶中均观察到代谢缓解。
