Tufts Medical Center, Boston, MA.
Seagen Inc., Bothell, WA.
JCO Oncol Pract. 2023 Jun;19(6):e867-e876. doi: 10.1200/OP.22.00811. Epub 2023 Mar 22.
We surveyed oncologists who treat classic Hodgkin lymphoma (cHL) as part of the CONNECT study to understand the treatment decision-making process, including the impact of positron emission tomography/computed tomography (PET/CT) imaging.
US physicians self-identifying as oncologists, hematologists, or hematologists/oncologists with ≥2 years of practice experience who treated ≥1 adult with stage III/IV cHL in the frontline setting in the last year were surveyed (October 19-November 16, 2020). Physician demographics, guideline adherence, and PET/CT utilization, interpretation, and access barriers were assessed.
In total, 301 physicians participated in the survey. Eighty-eight percent of physicians gave somewhat-to-significant consideration to NCCN guidelines. Most physicians (94%; n = 284) reported obtaining a PET/CT scan at diagnosis; of these physicians, 97% reported obtaining an interim PET/CT scan for stage III/IV cHL, with 65% typically obtaining an interim PET/CT scan after cycle 2. The Deauville 5-point scale (5PS) was the primary scoring system used to review PET/CT results by 62% of physicians, with a positive score defined as ≥3 by 44%, ≥4 by 37%, and ≥2 by 12% of physicians. Fifty-five percent of physicians reported difficulty in obtaining PET/CT scans.
Although most physicians considered NCCN guidelines when treating patients with stage III/IV cHL, interim PET/CT scans after cycle 2 were not universally obtained. When PET/CT scans were obtained, Deauville 5PS scores were not always provided, and variability existed on what defined a positive score. These findings suggest that opportunities exist for education and improved PET-adapted treatment approaches.
我们调查了参与 CONNECT 研究的治疗经典霍奇金淋巴瘤(cHL)的肿瘤学家,以了解治疗决策过程,包括正电子发射断层扫描/计算机断层扫描(PET/CT)成像的影响。
我们调查了自认为是肿瘤学家、血液学家或血液科/肿瘤学家的美国医生,这些医生的从业经验至少有 2 年,且在过去一年中曾在一线治疗过至少 1 例 III/IV 期 cHL 成人患者。评估了医生的人口统计学特征、指南遵循情况以及 PET/CT 的使用、解释和获取障碍。
共有 301 名医生参与了这项调查。88%的医生对 NCCN 指南给予了一定程度的关注。大多数医生(94%;n=284)报告在诊断时进行了 PET/CT 扫描;其中 97%的医生报告对 III/IV 期 cHL 进行了中期 PET/CT 扫描,65%的医生通常在第 2 个周期后进行中期 PET/CT 扫描。62%的医生主要使用 Deauville 5 分评分系统(5PS)来评估 PET/CT 结果,其中 44%的医生将阳性评分定义为≥3,37%的医生将阳性评分定义为≥4,12%的医生将阳性评分定义为≥2。55%的医生报告说难以获得 PET/CT 扫描。
尽管大多数医生在治疗 III/IV 期 cHL 患者时会考虑 NCCN 指南,但并非所有患者都在第 2 个周期后进行了中期 PET/CT 扫描。当进行 PET/CT 扫描时,并不总是提供 Deauville 5PS 评分,而且对阳性评分的定义也存在差异。这些发现表明,在教育和改进 PET 适应性治疗方法方面存在机会。