Mouheb Mehdi, Pierre-Jean Morgane, Devillers Anne, Fermé Christophe, Benchalal Mohamed, Manson Guillaume, Le Jeune Florence, Houot Roch, Palard-Novello Xavier
From the Univ Rennes, CLCC Eugène Marquis.
Univ Rennes, CHU de Rennes, INSERM, LTSI-UMR 1099, Rennes.
Clin Nucl Med. 2024 Jan 1;49(1):e1-e5. doi: 10.1097/RLU.0000000000004930. Epub 2023 Nov 24.
We aimed to assess the prognostic value of baseline tumor burden and dissemination parameters extracted from 18 F-FDG PET/CT in patients with early or advanced Hodgkin lymphoma (HL) treated with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) or escalated BEACOPP (increased bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone).
Patients aged ≥18 years with classical Hodgkin lymphoma were retrospectively included. Progression-free survival (PFS) analysis of dichotomized clinicobiological and PET/CT parameters (SUV max , TMTV, TLG, D max , and D bulk ) was performed. Optimal cutoff values for quantitative metrics were defined as the values maximizing the Youden index from receiver operating characteristic analysis. PFS rates were estimated with Kaplan-Meier curves, and the log-rank test was used to assess statistical significance. Hazard ratios were calculated using Cox proportional hazards models.
With a median age of 32 years, 166 patients were enrolled. A total of 111 patients had ABVD or ABVD-like treatment with or without radiotherapy and 55 patients with escalated BEACOPP treatment. The median follow-up was 55 months. Only International Prognostic Score (IPS >1), TMTV >107 cm 3 , and TLG >1628 were found to be significant prognostic factors for PFS on univariate analysis. Multivariate analysis revealed that IPS and TLG were independently prognostic and, combined, identified 4 risk groups ( P < 0.001): low (low TLG and low IPS; 4-year PFS, 95%), intermediate-low (high IPS and low TLG; 4-year PFS, 79%), intermediate-high (low IPS and high TLG; 4-year PFS, 78%), and high (high TLG and high IPS; 4-year PFS, 71%).
Combining baseline TLG with IPS could improve PFS prediction.
我们旨在评估从18F-FDG PET/CT中提取的基线肿瘤负荷和播散参数对接受ABVD（阿霉素、博来霉素、长春花碱和达卡巴嗪）或强化BEACOPP（增加博来霉素、依托泊苷、阿霉素、环磷酰胺、长春新碱、丙卡巴肼和泼尼松）治疗的早期或晚期霍奇金淋巴瘤（HL）患者的预后价值。
回顾性纳入年龄≥18岁的经典霍奇金淋巴瘤患者。对二分的临床生物学和PET/CT参数（SUV最大值、TMTV、TLG、D最大值和D体积）进行无进展生存期（PFS）分析。定量指标的最佳截断值定义为通过受试者操作特征分析使约登指数最大化的值。用Kaplan-Meier曲线估计PFS率，并用对数秩检验评估统计学显著性。使用Cox比例风险模型计算风险比。
中位年龄为32岁，共纳入166例患者。111例患者接受了ABVD或类似ABVD的治疗，有或没有放疗，55例患者接受了强化BEACOPP治疗。中位随访时间为55个月。单因素分析发现，只有国际预后评分（IPS>1）、TMTV>107 cm³和TLG>1628是PFS的显著预后因素。多因素分析显示，IPS和TLG是独立的预后因素，两者结合可确定4个风险组（P<0.001）：低风险组（低TLG和低IPS；4年PFS，95%）、中低风险组（高IPS和低TLG；4年PFS，79%）、中高风险组（低IPS和高TLG；4年PFS，78%）和高风险组（高TLG和高IPS；4年PFS，71%）。
将基线TLG与IPS相结合可改善PFS预测。
