Adams Hugo J A, Nievelstein Rutger A J, Kwee Thomas C
Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands.
Br J Haematol. 2015 Jul;170(2):185-91. doi: 10.1111/bjh.13420. Epub 2015 Apr 1.
This study systematically reviewed and meta-analysed the prognostic value of complete remission status at end-of-treatment (18) F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). The systematic PubMed/MEDLINE search yielded seven suitable studies comprising a total of 737 R-CHOP-treated DLBCL patients who were in complete remission at end-of-treatment FDG-PET. Overall, the methodological quality of included studies was reasonable. The disease relapse rate among all patients with complete remission status according to end-of-treatment FDG-PET ranged from 7·0% to 20·0%, with a weighted summary proportion of 13·7%. Five of seven studies reported progression-free survival (PFS) of these patients at various specific time points, i.e., 2-year PFS (n = 1), estimated 3-year PFS (n = 3) and 5-year PFS (n = 1), which was 83%, 85-86·4% and 75%, respectively. Three of seven studies reported overall survival (OS) of these patients at various specific time points, i.e., estimated 3-year OS (n = 2) and estimated 5-year OS (n = 1), which were 90%, 93·6% and 83%, respectively. In conclusion, a non-negligible proportion of R-CHOP-treated DLBCL patients who achieve complete remission according to end-of-treatment FDG-PET experiences disease relapse during follow-up.
本研究系统回顾并荟萃分析了接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松（R-CHOP）治疗的弥漫性大B细胞淋巴瘤（DLBCL）患者在治疗结束时（18）F-氟脱氧-D-葡萄糖正电子发射断层扫描（FDG-PET）完全缓解状态的预后价值。系统的PubMed/MEDLINE检索产生了7项合适的研究，共纳入737例接受R-CHOP治疗且在治疗结束时FDG-PET完全缓解的DLBCL患者。总体而言，纳入研究的方法学质量合理。根据治疗结束时FDG-PET处于完全缓解状态的所有患者的疾病复发率在7.0%至20.0%之间，加权汇总比例为13.7%。7项研究中有5项报告了这些患者在不同特定时间点的无进展生存期（PFS），即2年PFS（n = 1）、估计3年PFS（n = 3）和5年PFS（n = 1），分别为83%、85-86.4%和75%。7项研究中有3项报告了这些患者在不同特定时间点的总生存期（OS），即估计3年OS（n = 2）和估计5年OS（n = 1），分别为90%、93.6%和83%。总之，根据治疗结束时FDG-PET达到完全缓解的接受R-CHOP治疗的DLBCL患者中，有不可忽视比例的患者在随访期间出现疾病复发。
