Nuclear Medicine Department, University Hospital S. Orsola-Malpighi, Via Massarenti, 9, CAP 40138 Bologna, Italy.
Eur J Nucl Med Mol Imaging. 2011 Sep;38(9):1620-7. doi: 10.1007/s00259-011-1836-7. Epub 2011 May 11.
To evaluate the role of postchemotherapy FDG PET and compare it with other predictive factors in paediatric Hodgkin's disease (HD).
In this retrospective study, 98 paediatric patients with HD (enrolled in eight Italian centres) were analysed. Their mean age was 13.8 years (range 5-19 years). A PET scan was performed at the end of chemotherapy and reported as positive or negative on the basis of visual and/or semiquantitative analysis. True outcome was defined as remission or disease on the basis of combined criteria (clinical, instrumental and/or histological) with a mean follow-up period of 25 months. Statistical analyses were performed for the postchemotherapy PET results and other potential predictive factors (age cut-off, stage, presence of bulky masses and therapeutic group) with respect to patient outcome and progression-free survival (PFS).
Overall the patients had a mean PFS of 23.5 months (range 4-46 months): 87 achieved remission (88.8%) and 11 showed disease. Of the 98 patients, 17 were positive on postchemotherapy PET . Seven patients (41%) showed disease during follow-up, and relapse occurred in only four out of the 81 patients who were negative on PET (p = 0.0001). Kaplan-Meier analysis demonstrated significant correlations between PFS and the postchemotherapy PET result (p = 0.0001) and a cut-off age at diagnosis of 13.3 years (p = 0.0337), whereas disease stage (p = 0.7404), therapeutic group (p = 0.5240) and presence of bulky masses (p = 0.2208) were not significantly correlated with PFS. Multivariate analysis confirmed a statistically significant correlation with PFS only for the postchemotherapy PET findings (p = 0.0009).
In paediatric HD, age at diagnosis and postchemotherapy PET results are the main predictors of patient outcome and PFS, with FDG PET being the only independent predictive factor for PFS.
评估化疗后氟代脱氧葡萄糖正电子发射断层扫描（FDG PET）的作用，并将其与儿科霍奇金病（HD）的其他预测因素进行比较。
在这项回顾性研究中，分析了 98 例儿科 HD 患者（来自意大利 8 个中心）。他们的平均年龄为 13.8 岁（范围为 5-19 岁）。在化疗结束时进行 PET 扫描，并根据视觉和/或半定量分析将其报告为阳性或阴性。根据联合标准（临床、仪器和/或组织学）确定真实结果为缓解或疾病，平均随访期为 25 个月。针对化疗后 PET 结果和其他潜在预测因素（年龄截止值、分期、大肿块的存在和治疗组）与患者结局和无进展生存期（PFS）进行统计学分析。
总体而言，患者的平均 PFS 为 23.5 个月（范围为 4-46 个月）：87 例患者达到缓解（88.8%），11 例患者出现疾病。98 例患者中，17 例化疗后 PET 阳性。7 例（41%）在随访期间出现疾病，而在 81 例 PET 阴性的患者中，只有 4 例出现复发（p=0.0001）。Kaplan-Meier 分析表明，PFS 与化疗后 PET 结果显著相关（p=0.0001），诊断时年龄为 13.3 岁（p=0.0337）的截止值也显著相关，而疾病分期（p=0.7404）、治疗组（p=0.5240）和大肿块的存在（p=0.2208）与 PFS 无显著相关性。多变量分析仅证实化疗后 PET 结果与 PFS 具有统计学显著相关性（p=0.0009）。
在儿科 HD 中，诊断时的年龄和化疗后 PET 结果是患者结局和 PFS 的主要预测因素，FDG PET 是 PFS 的唯一独立预测因素。
