Fonseca João M, Zloic Sanda K, Ayogu Chukwudi I, Marole Karabo K, Ingold Gianluca C, Moreira Sarah V, Soato Ratti Marco A
Radiology, Hospital Geral de Salvador, Salvador, BRA.
Radiology, Special Hospital Agram, Zagreb, HRV.
Cureus. 2024 Dec 5;16(12):e75169. doi: 10.7759/cureus.75169. eCollection 2024 Dec.
Follicular lymphoma (FL) is an indolent non-Hodgkin lymphoma subtype, posing challenges in prognostication. While interim PET/CT is a recognized response assessment tool in other lymphoma subtypes, its prognostic value for FL remains uncertain. This study aims to evaluate the significance of interim PET results, which were assessed using the Deauville Score. A systematic review and meta-analysis were conducted across several databases, including studies that evaluated interim PET during frontline chemoimmunotherapy, with outcomes adjusted for other prognostic factors. Data extraction and risk of bias were performed independently by two authors. Hazard ratios (HR) and 95% confidence intervals (CI) were pooled using random-effects models, with leave-one-out sensitivity analyses to further assess the results. Four studies involving 427 patients were included. The pooled HR for Progression-Free Survival (PFS) was 2.88 (95% CI: 1.83-4.52; I² = 55.5%; <0.0001), indicating a significant association between positive PET results and poorer PFS. The pooled HR for overall survival (OS) was 3.32 (95% CI: 1.34-8.23; I² = 74.4%; = 0.0097), reflecting a significant decrease in OS with positive PET results. Sensitivity analyses confirmed the significance of these findings. Thus, positive interim PET results are associated with worse outcomes in frontline-treated FL patients, suggesting their potential as a valuable prognostic tool.
滤泡性淋巴瘤（FL）是一种惰性非霍奇金淋巴瘤亚型，在预后评估方面存在挑战。虽然中期PET/CT是其他淋巴瘤亚型中公认的疗效评估工具，但其对FL的预后价值仍不确定。本研究旨在评估使用Deauville评分评估的中期PET结果的意义。我们在多个数据库中进行了系统评价和荟萃分析，纳入了评估一线化疗免疫治疗期间中期PET的研究，并对其他预后因素进行了结果调整。由两位作者独立进行数据提取和偏倚风险评估。使用随机效应模型汇总风险比（HR）和95%置信区间（CI），并进行留一法敏感性分析以进一步评估结果。纳入了四项涉及427例患者的研究。无进展生存期（PFS）的汇总HR为2.88（95%CI：1.83 - 4.52；I² = 55.5%；P < 0.0001），表明PET结果为阳性与较差的PFS之间存在显著关联。总生存期（OS）的汇总HR为3.32（95%CI：1.34 - 8.23；I² = 74.4%；P = 0.0097），反映出PET结果为阳性时OS显著降低。敏感性分析证实了这些发现的显著性。因此，一线治疗的FL患者中期PET结果为阳性与较差的预后相关，表明其有可能作为一种有价值的预后工具。
