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Role of [18F]-fluoro-2-deoxy-D-glucose positron emission tomography in early and late therapy assessment of patients with advanced Hodgkin lymphoma treated with bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine and prednisone
J. Markova, D. Kahraman, C. Kobe, M. Skopalova, H. Mocikova, K. Klaskova, K. Dedeckova, HT. Eich, B. Böll, M. Dietlein, T. Kozak,
Language English Country England, Great Britain
Document type Journal Article
- MeSH
- Bleomycin administration & dosage MeSH
- Time Factors MeSH
- Cyclophosphamide administration & dosage MeSH
- Adult MeSH
- Doxorubicin administration & dosage MeSH
- Etoposide administration & dosage MeSH
- Fluorodeoxyglucose F18 diagnostic use MeSH
- Hodgkin Disease diagnosis drug therapy MeSH
- Kaplan-Meier Estimate MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Follow-Up Studies MeSH
- Positron-Emission Tomography methods MeSH
- Prednisone administration & dosage MeSH
- Prognosis MeSH
- Procarbazine administration & dosage MeSH
- Antineoplastic Combined Chemotherapy Protocols therapeutic use MeSH
- Radiopharmaceuticals diagnostic use MeSH
- Drug Administration Schedule MeSH
- Vincristine administration & dosage MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
The prognostic value of positron emission tomography (PET) in early therapy response assessment, after completion of chemotherapy and 3 months after the end of treatment in advanced Hodgkin lymphoma (HL) remains to be defined. We report the results of 69 patients with first presentation of advanced HL. [18F]-fluoro-2-deoxy-d-glucose (FDG)-PET scan was performed after four cycles (PET-4), on completion of chemotherapy after 6/8 cycles (PET-6/8) and 3 months after the completion of chemotherapy (PET 3-months). Median follow-up was 55 months. The negative predictive value (NPV) for PET-4, PET-6/8 and PET 3-months was 98%, 95% and 97%, respectively. The 4-year progression-free survival (PFS) for PET-4 negative (n = 51) and PET-4 positive (n = 18) patients was 96% and 78%, respectively (p = 0.016). The 4-year PFS for PET-6/8 negative (n = 59) and PET-6/8 positive (n = 9) patients was 95% and 78%, respectively (p = 0.046). Patients with a large mediastinal mass constituted nearly all of the PET-4 positive (16/18) and PET-6/8 positive (8/9) patients. After radiotherapy of PET-6/8 positive patients, PET 3-months was negative in 64 (97%) and positive in two (3%) patients. PET 3-months after the end of chemotherapy was of limited value when the interim PET-4 was negative. Interim PET after four cycles of bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine and prednisone (BEACOPP) is a strong prognostic marker for PFS in advanced HL.
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