Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, South Korea.
Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea.
Eur J Nucl Med Mol Imaging. 2018 Dec;45(13):2274-2284. doi: 10.1007/s00259-018-4093-1. Epub 2018 Jul 28.
The aim of this study was to establish a risk-stratification model integrating posttreatment metabolic response using the Deauville score and the pretreatment National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) in nodal PTCLs.
We retrospectively analysed 326 patients with newly diagnosed nodal PTCLs between January 2005 and June 2016 and both baseline and posttreatment PET/CT data. The final model was validated using an independent prospective cohort of 79 patients.
Posttreatment Deauville score (1/2, 3, and 4/5) and the NCCN-IPI (low, low-intermediate, high-intermediate, and high) were independently associated with progression-free survival: for the Deauville score, the hazard ratios (HRs) were 1.00 vs. 2.16 (95% CI 1.47-3.18) vs. 7.86 (5.66-10.92), P < 0.001; and for the NCCN-IPI, the HRs were 1.00 vs. 2.31 (95% CI 1.20-4.41) vs. 4.42 (2.36-8.26) vs. 7.09 (3.57-14.06), P < 0.001. Based on these results, we developed a simplified three-group risk model comprising a low-risk group (low or low-intermediate NCCN-IPI with a posttreatment Deauville score of 1 or 2, or low NCCN-IPI with a Deauville score of 3), a high-risk group (high or high-intermediate NCCN-IPI with a Deauville score of 1/2 or 3, or low-intermediate NCCN-IPI with a Deauville score of 3), and a treatment failure group (Deauville score 4 or 5). This model was significantly associated with progression-free survival (5-year, 70.3%, 31.4%, and 4.7%; P < 0.001) and overall survival (5-year, 82.1%, 45.5%, and 14.7%; P < 0.001). Similar associations were also observed in the independent validation cohort.
The risk-stratification model integrating posttreatment Deauville score and pretreatment NCCN-IPI is a powerful tool for predicting treatment failure in patients with nodal PTCLs.
本研究旨在建立一种风险分层模型，该模型整合了治疗后代谢反应的 Deauville 评分和治疗前的美国国家综合癌症网络-国际预后指数（NCCN-IPI），用于结外 T 细胞淋巴瘤（PTCLs）。
我们回顾性分析了 2005 年 1 月至 2016 年 6 月期间 326 例新诊断为结外 PTCLs 的患者，同时分析了基线和治疗后 PET/CT 数据。最终模型使用 79 例独立前瞻性队列进行验证。
治疗后 Deauville 评分（1/2、3 和 4/5）和 NCCN-IPI（低、低-中、中-高和高）与无进展生存独立相关：对于 Deauville 评分，风险比（HRs）分别为 1.00 比 2.16（95%CI 1.47-3.18）比 7.86（5.66-10.92），P<0.001；对于 NCCN-IPI，HRs 分别为 1.00 比 2.31（95%CI 1.20-4.41）比 4.42（2.36-8.26）比 7.09（3.57-14.06），P<0.001。基于这些结果，我们开发了一种简化的三分组风险模型，包括低危组（低或低-中 NCCN-IPI 伴治疗后 Deauville 评分 1 或 2，或低 NCCN-IPI 伴 Deauville 评分 3）、高危组（高或中-高 NCCN-IPI 伴 Deauville 评分 1/2 或 3，或低-中 NCCN-IPI 伴 Deauville 评分 3）和治疗失败组（Deauville 评分 4 或 5）。该模型与无进展生存（5 年，70.3%、31.4%和 4.7%；P<0.001）和总生存（5 年，82.1%、45.5%和 14.7%；P<0.001）显著相关。在独立验证队列中也观察到了类似的关联。
整合治疗后 Deauville 评分和治疗前 NCCN-IPI 的风险分层模型是预测结外 PTCLs 患者治疗失败的有力工具。
