淋巴瘤中的F-FDG PET/CT：影像引导的个性化医疗成为现实了吗？
F-FDG PET/CT in Lymphoma: Has Imaging-Directed Personalized Medicine Become a Reality?
作者信息
Barrington Sally F, Johnson Peter W M
机构信息
King's College London and Guy's and St. Thomas' PET Centre, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom; and
Cancer Research U.K. Centre, University of Southampton, Southhampton, United Kingdom.
出版信息
J Nucl Med. 2017 Oct;58(10):1539-1544. doi: 10.2967/jnumed.116.181347. Epub 2017 Aug 10.
Abstract
PET/CT using F-FDG is an essential part of the management of patients with lymphoma. Efforts to standardize PET acquisition and reporting, including the 5-point Deauville scale, have enabled PET to become a surrogate for treatment success or failure in common lymphoma subtypes. This review summarizes the key clinical-trial evidence that supports PET-directed personalized approaches in lymphoma. PET-guided therapy has improved outcomes in Hodgkin lymphoma, using less chemotherapy and more selective radiotherapy. Attempts to intensify chemotherapy in aggressive non-Hodgkin lymphomas have, however, proved ineffective in patients treated with rituximab and chemotherapy. Trials are under way to determine whether PET can obviate consolidation radiotherapy in patients with diffuse large B-cell lymphoma and primary mediastinal B-cell lymphoma. More recently, PET has been reported to be a reliable predictor of outcome in follicular lymphoma requiring treatment, and prospective trials to test PET-guided therapy in this disease are anticipated.
摘要
使用氟代脱氧葡萄糖（F-FDG）的正电子发射断层扫描/计算机断层扫描（PET/CT）是淋巴瘤患者管理的重要组成部分。包括五点迪厄多内量表在内的标准化PET采集和报告的努力，使PET成为常见淋巴瘤亚型治疗成败的替代指标。本综述总结了支持淋巴瘤中PET导向个体化治疗方法的关键临床试验证据。PET引导的治疗改善了霍奇金淋巴瘤的治疗效果，减少了化疗用量，增加了选择性放疗。然而，在接受利妥昔单抗和化疗的侵袭性非霍奇金淋巴瘤患者中，强化化疗的尝试已被证明无效。正在进行试验以确定PET是否可以避免弥漫性大B细胞淋巴瘤和原发性纵隔B细胞淋巴瘤患者的巩固放疗。最近，有报道称PET是需要治疗的滤泡性淋巴瘤预后的可靠预测指标，预计将开展前瞻性试验以测试该疾病中PET引导的治疗。
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