Zheng Serena, Gupta Kanika, Goyal Piyush, Nakajima Reiko, Michaud Laure, Batlevi Connie Lee, Hamlin Paul A, Horwitz Steven, Kumar Anita, Matasar Matthew J, Moskowitz Alison J, Moskowitz Craig H, Noy Ariela, Palomba M Lia, Straus David J, Von Keudell Gottfried, Falchi Lorenzo, Yahalom Joachim, Zelenetz Andrew D, Younes Anas, Salles Gilles, Schöder Heiko, Joffe Erel
Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
New York Medical College, Valhalla, NY 10595, USA.
Cancers (Basel). 2023 Mar 14;15(6):1760. doi: 10.3390/cancers15061760.
Recent prospective clinical trial data suggest that patients with Hodgkin's lymphoma who continue treatment with ABVD, despite failing to attain a complete metabolic response on interim PET (PET2+), may fare better than previously published. We describe the outcomes of PET2+ patients who continued ABVD and compare the performance of a quantitative measure based on the lesion-to-liver SUV ratio (LLS qPET2+) to that of the subjective Deauville criteria (dvPET2+). We analyzed all patients with newly diagnosed advanced-stage Hodgkin lymphoma treated with frontline ABVD at the Memorial Sloan Kettering Cancer Center between 2008 and 2017. Eligibility was set to correspond with the RATHL inclusion criteria. Images were reviewed by two nuclear medicine physicians and discordant cases were resolved with a third expert in consensus. qPET2+ was defined as LLS ≥ 1.3. We identified 227 patients of whom 25% (57) were qPET2+, but only 14% (31) were dvPET2+. Forty-eight patients (84%) continued ABVD with a 3-year PFS of 70% for qPET2+ and 64% for dvPET2+. In conclusion, interim PET interpretation in clinical practice may be associated with a higher rate of scans deemed positive. Irrespective of the criteria for PET2 positivity, a subset of patients may continue ABVD without a dismal outcome.
近期的前瞻性临床试验数据表明，患有霍奇金淋巴瘤的患者，尽管在中期PET检查（PET2+）时未达到完全代谢缓解，但继续接受ABVD治疗，其预后可能比先前发表的结果更好。我们描述了继续接受ABVD治疗的PET2+患者的预后情况，并比较了基于病灶与肝脏SUV比值的定量测量方法（LLS qPET2+）与主观的迪厄多内标准（dvPET2+）的性能。我们分析了2008年至2017年期间在纪念斯隆凯特琳癌症中心接受一线ABVD治疗的所有新诊断的晚期霍奇金淋巴瘤患者。入选标准与RATHL纳入标准一致。图像由两名核医学医师进行审查，不一致的病例由第三位专家达成共识解决。qPET2+定义为LLS≥1.3。我们确定了227例患者，其中25%（57例）为qPET2+，但只有14%（31例）为dvPET2+。48例患者（84%）继续接受ABVD治疗，qPET2+患者的3年无进展生存率为70%，dvPET2+患者为64%。总之，临床实践中的中期PET解读可能与更高比例的阳性扫描结果相关。无论PET2阳性的标准如何，一部分患者可以继续接受ABVD治疗而不会有不良预后。
