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治疗中期及治疗结束时[(18)F] - 氟脱氧葡萄糖正电子发射断层扫描 - 计算机断层扫描在弥漫性大B细胞淋巴瘤患者一线治疗中的应用

Utility of interim and end-of-treatment [(18)F]-fluorodeoxyglucose positron emission tomography-computed tomography in frontline therapy of patients with diffuse large B-cell lymphoma.

作者信息

Huntington Scott F, Nasta Sunita D, Schuster Stephen J, Doshi Jalpa A, Svoboda Jakub

机构信息

a Abramson Cancer Center.

b Division of Hematology-Oncology.

出版信息

Leuk Lymphoma. 2015;56(9):2579-84. doi: 10.3109/10428194.2015.1007506. Epub 2015 Feb 11.

Abstract

[(18)F]-fluorodeoxyglucose positron emission tomography-computed tomography (PET/CT) is part of standard pretreatment staging and post-treatment assessment in patients undergoing first-line therapy for diffuse large B-cell lymphoma (DLBCL). While many providers obtain interim PET/CT (I-PET) for DLBCL, the clinical utility of these scans is unclear. We conducted a retrospective study of patients with DLBCL undergoing I-PET during first-line therapy (n = 94). The majority (61%) of patients had at least one negative I-PET and all patients with negative I-PET remained in remission at the end of treatment. I-PET was strongly associated with progression-free survival and remained independent on multivariable modeling (non-complete remission [CR]:CR I-PET, hazard ratio 2.7, p = 0.01). All patients with negative I-PET were in remission at the end of frontline therapy, and end-of-treatment PET/CT offered little clinical utility in this subset. Therefore, I-PET may offer an approach of early clinical predication and obviate the need for end-of-treatment imaging in the majority of patients with DLBCL.

摘要

[18F]氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描(PET/CT)是弥漫性大B细胞淋巴瘤(DLBCL)一线治疗患者标准治疗前分期和治疗后评估的一部分。虽然许多医疗服务提供者会为DLBCL患者进行中期PET/CT(I-PET)检查,但这些扫描的临床实用性尚不清楚。我们对一线治疗期间接受I-PET检查的DLBCL患者进行了一项回顾性研究(n = 94)。大多数(61%)患者至少有一次I-PET检查结果为阴性,所有I-PET检查结果为阴性的患者在治疗结束时仍处于缓解状态。I-PET与无进展生存期密切相关,并且在多变量模型中仍具有独立性(非完全缓解[CR]:CR I-PET,风险比2.7,p = 0.01)。所有I-PET检查结果为阴性的患者在一线治疗结束时均处于缓解状态,治疗结束时的PET/CT对这一亚组患者的临床实用性不大。因此,I-PET可能提供一种早期临床预测方法,并且在大多数DLBCL患者中无需进行治疗结束时的影像学检查。

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