Reed Janet Denise, Masenge Andries, Buchner Ane, Omar Fareed, Reynders David, Vorster Mariza, Van de Wiele Christophe, Sathekge Mike
Department of Nuclear Medicine, University of Pretoria, Pretoria 0002, South Africa.
Steve Biko Academic Hospital, Pretoria 0002, South Africa.
J Clin Med. 2021 Dec 20;10(24):5979. doi: 10.3390/jcm10245979.
Lymphoma is the third most common paediatric cancer. Early detection of high-risk patients is necessary to anticipate those who require intensive therapy and follow-up. Current literature shows that residual tumor avidity on PET (Positron Emission Tomography) following chemotherapy corresponds with decreased survival. However, the value of metabolic parameters has not been adequately investigated. In this retrospective study, we aimed to evaluate the prognostic value of metabolic and other parameters in paediatric and adolescent Hodgkin lymphoma. We recorded tMTV (total Metabolic Tumor Volume), TLG (Total Lesion Glycolysis), and SUVmax (maximum Standard Uptake Value) on baseline PET, as well the presence of bone marrow or visceral involvement. HIV (human immunodeficiency virus) status and baseline biochemistry from clinical records were noted. All patients received stage-specific standard of care therapy. Response assessment on end-of-treatment PET was evaluated according to the Deauville criteria. We found that bone marrow involvement ( = 0.028), effusion ( < 0.001), and treatment response ( < 0.001) on baseline PET, as well as HIV status ( = 0.036) and baseline haemoglobin ( = 0.039), were significantly related to progression-free survival (PFS), whereas only effusion ( = 0.017) and treatment response ( = 0.050) were predictive of overall survival (OS). Only baseline tMTV predicted treatment response ( = 0.017). This confirms the value of F-18 FDG PET/CT (Fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography) in prognostication in paediatric and adolescent Hodgkin lymphoma; however, further studies are required to define the significance of metabolic parameters.
淋巴瘤是第三大常见的儿童癌症。早期发现高危患者对于预判哪些患者需要强化治疗和随访至关重要。当前文献表明，化疗后正电子发射断层扫描（PET）上残留肿瘤的摄取与生存率降低相关。然而，代谢参数的价值尚未得到充分研究。在这项回顾性研究中，我们旨在评估代谢及其他参数在儿童和青少年霍奇金淋巴瘤中的预后价值。我们记录了基线PET上的总代谢肿瘤体积（tMTV）、总病变糖酵解（TLG）和最大标准摄取值（SUVmax），以及骨髓或内脏受累情况。记录了临床记录中的人类免疫缺陷病毒（HIV）状态和基线生化指标。所有患者均接受了特定分期的标准治疗。根据多维尔标准评估治疗结束时PET的反应评估。我们发现，基线PET上的骨髓受累（P = 0.028）、积液（P < 0.001）和治疗反应（P < 0.001），以及HIV状态（P = 0.036）和基线血红蛋白（P = 0.039）与无进展生存期（PFS）显著相关，而只有积液（P = 0.017）和治疗反应（P = 0.050）可预测总生存期（OS）。只有基线tMTV可预测治疗反应（P = 0.017）。这证实了F-18氟脱氧葡萄糖PET/CT（氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描）在儿童和青少年霍奇金淋巴瘤预后评估中的价值；然而，需要进一步研究来确定代谢参数的意义。
