Incidence of post-treatment PET-positivity and relapse in Hodgkin lymphoma patients with a negative interim FDG-PET
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Citações na Scopus
Tipo de produção
conferenceObject
Data de publicação
2012
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER
Autores
ZANONI, L.
LOPCI, E.
BIANCHI, A.
HUTCHINGS, M.
LEE, S. Ting
DELBEKE, D.
CELLI, M.
CHITI, A.
FANTI, S.
Citação
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, v.39, suppl.2, p.S374-S374, 2012
Resumo
Background: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), used for assessment of early response in Hodgkin’s lymphoma (HL) patients, is an accurate predictor of progression-free survival. Is has been suggested that end-treatment PET (PETe) is unnecessary if interim PET (PETi) results are negative. The purpose of this study was to evaluate the incidence and clinical characteristics of HL patients with PETi-negative and PETe-positive scans. Material and Methods: For this purpose we retrospectively analyzed data from HL patients enrolled in seven different nuclear medicine centers worldwide. Scans were read by at least one board certified nuclear physician. PETi-negative was defined as no pathologic FDG uptake at any site, including all sites of previously increased pathologic uptake. PETi minimal residual uptake (MRU) was defined as low-grade FDG uptake, although PETi-MRU scans were considered as PETi-negative scan for the purpose of the analysis. A study was considered PETi-positive in case of focal FDG uptake that could not be attributed to physiological distribution. There was no modification in treatment based on PETi results. The incidence of a PETi-negative scan in combination with a PETe-positive scan was calculated. Results: A total of 868 patients were analysed and after two or three cycles of chemotherapy, 643/868 (74.1%) patients were PETi-negative, and 225/868 (25.9%) were PETi-positive. Of the 643 PETi-negative patients, 7.2% (46/643) showed PETe-positive scans. HL was confirmed in 5.1% (33/643) patients, while 2.2% (14/643) were false positive results. Four of those patients died during follow-up, due to HL complications, with a median follow up of 47 (±24.1) months. Clinical characteristics of the 33 early relapsed patients were investigated (sex; age; pathological subtype; B symptoms; Bulky diseae; Clinical stage; International Prognostic Score). Of those patients, 81.8% (27/33) were treated with ABVD. Radiotherapy was administrated in 12 (33.6%) patients. Of the 13 patients with early stage disease, six (46.1%) were submitted to combined therapy. Of the 14 patients with advanced disease, six (42.8%) were submitted to combined therapy. Conclusion: We conclude that, although a rare occurrence, a small number of HL patients will show recurrent signs of disease at the end of treatment, despite a negative PETi. Thus, there is at present not evidence for the omission of PETe. PETe should still be performed as part of the patient's management plan , in order to identify these patients who need additional therapy.