scholarly journals Post-ABVD/pre-radiotherapy18F-FDG-PET provides additional prognostic information for early-stage Hodgkin lymphoma: a retrospective analysis on 165 patients

2016 ◽  
Vol 89 (1061) ◽  
pp. 20150983 ◽  
Author(s):  
Patrizia Ciammella ◽  
Andrea Riccardo Filippi ◽  
Gabriele Simontacchi ◽  
Michela Buglione ◽  
Barbara Botto ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Early Stage ◽  
Prognostic Information

Clinical impact of FDG-PET/CT in the planning of radiotherapy for early-stage Hodgkin lymphoma

2007 ◽  
Vol 78 (3) ◽  
pp. 206-212 ◽  
Author(s):  
Martin Hutchings ◽  
Annika Loft ◽  
Mads Hansen ◽  
Anne Kiil Berthelsen ◽  
Lena Specht
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Early Stage ◽  
Clinical Impact ◽  
Pet Ct ◽  
Fdg Pet Ct

EARLY Interim FDG-PET Scan in Localised Hodgkin Lymphoma: Evaluation of Practice in 5 French Centers

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4935-4935
Author(s):  
Olivier Fitoussi ◽  
Pauline Brice ◽  
Sandrine Hirt ◽  
Philippe Solal-Celigny ◽  
Marie-Sarah Dilhuydy ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Early Stage ◽  
Dose Intensity ◽  
Pet Scan ◽  
Treatment Intensification ◽  
Term Survival ◽  
Early Stage Disease ◽  
Fdg Pet Scan ◽  
Pre Treatment

Abstract Background: Long-term survival from Hodgkin lymphoma (HL) in early-stage (I–II) patients is more than 85%. However, certain patients have a primary refractory disease with a worse evolution. Early interim FDG-PET scan performed after 2 courses of chemotherapy (PET-2) provides an early and accurate assessment of response and a correlation has been demonstrated between normalization of PET-2 and patient outcome. Aim: To evaluate the percentage of negative PET-2 in early-stage patients, and to seek clinical or biological factors predictive of positive PET-2. Methods: Sixty-five patients from five French centers with early-stage Hodgkin lymphoma received ABVD as firstline chemotherapy. PET-2 was performed 3 weeks after the second course of ABVD. Radiotherapy and changes in management according to FDG-PET scan result could be decided by the clinician. Evaluation was retrospective. Results: The median age was 36 years (range17–77). Thirty-nine patients were male. Seventy-three percent of patients were in unfavorable group according to EORTC criteria (one or more of the following criteria: age > 50, systemic symptoms, elevated ESR >50 mm, bulk disease and more than three lymph node areas involved). Fifty-seven patients had a pre-treatment FDGPET scan with a modification of staging in 6 cases. Initial staging according to CT scan or FDG-PET scan was as follows: IA: 5 patients, IB: no patient, IIA: 35 patients and IIB: 25 patients. Fifty-three patients (82%) had a negative PET-2 whereas 12 patients (18%) had a clearly positive PET-2. Among the 53 patients with negative PET-2, 47 patients underwent radiation therapy after completion of four courses of ABVD. Among the 12 patients with positive PET-2, treatment intensification (BEACOPP) occurred for 7 patients with a negative FDG-PET scan for 6 of them after two courses. For the 5 PET+ patients pursuing with ABVD: three had a negative FDG-PET scan and two had a positive FDGPET scan after four cycles of ABVD. At a median follow-up of 30 months, 6 patients relapsed early after the end of the treatment (2 in the negative PET-2 group and 4 in the positive PET-2 group). Out of the 7 patients of the positive PET-2 group receiving an increase dose intensity of chemotherapy (BEACOPP), 3 of them relapsed. The 59 other patients did not presented any failure or relapse at the present time. Conclusion: We showed in this series that negative PET-2 is obtained in 82% of patients with early stage disease. These results are similar to those expected in the EORTC H10 trial which evaluates PET-2 guided treatment adaptation and expect about 85–90% of negative PET-2. This retrospective study augurs that positive TEP2 is a pejorative prognostic factor and the utilisation of the BEACOPP treatment in these population remains to define. Prospective studies, like H10 EORTC trial are warranted to confirm these results and find predictive factors for a positive PET-2.

scholarly journals The role of FDG-PET in defining prognosis of Hodgkin lymphoma for early-stage disease

Hematology ◽  
2014 ◽  
Vol 2014 (1) ◽  
pp. 135-143 ◽  
Author(s):  
Andrew M. Evens ◽  
Lale Kostakoglu
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Early Stage ◽  
Combined Modality Therapy ◽  
Imaging Biomarkers ◽  
Predictive Tool ◽  
Early Stage Disease ◽  
Combined Modality ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Given the excellent survival rates for early-stage Hodgkin lymphoma (HL), the young age of many patients, and concerns regarding acute and late treatment-related toxicities, there is a desire to have a predictive tool that enables therapy to be tailored toward the individual patient. Early (or interim) 18F-fluorodeoxyglucose positron emission tomography with computerized tomography (FDG-PET/CT), as a test of tumor sensitivity to ongoing/planned therapy, has been shown to be prognostic for survival in HL. Based on results of interim FDG-PET/CT, therapy may be subsequently modified through minimization or via intensification for low- and high-risk patient populations, respectively (ie, response-adapted therapy). Important data have been generated to standardize the interpretability and reproducibility of interim FDG-PET/CT (eg, the Deauville 5-point system), and observational and noncontrolled prospective studies have produced evidence supporting the hypothesis that response-adapted therapy may potentially serve as a predictive tool. Furthermore, results from noninferiority phase 3 clinical trials randomizing early-stage HL patients with negative interim FDG-PET/CT to combined modality therapy versus chemotherapy alone have been reported. The current collective findings from these randomized early-stage HL studies have shown that acute relapse rates are lower with combined modality therapy, even in patients with negative interim FDG-PET/CT. Additional randomized response-adapted studies are ongoing and novel FDG-PET/CT applications involving quantitative techniques and innovative imaging modalities are being investigated to identify more robust imaging biomarkers. Treatment of early-stage HL remains a clinical management choice for physicians and patients to make with consideration of acute and long-term outcomes.

scholarly journals The role of FDG-PET in defining prognosis of Hodgkin lymphoma for early-stage disease

Blood ◽  
2014 ◽  
Vol 124 (23) ◽  
pp. 3356-3364 ◽  
Author(s):  
Andrew M. Evens ◽  
Lale Kostakoglu
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Early Stage ◽  
Combined Modality Therapy ◽  
Imaging Biomarkers ◽  
Predictive Tool ◽  
Early Stage Disease ◽  
Combined Modality ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Given the excellent survival rates for early-stage Hodgkin lymphoma (HL), the young age of many patients, and concerns regarding acute and late treatment-related toxicities, there is a desire to have a predictive tool that enables therapy to be tailored toward the individual patient. Early (or interim) 18F-fluorodeoxyglucose positron emission tomography with computerized tomography (FDG-PET/CT), as a test of tumor sensitivity to ongoing/planned therapy, has been shown to be prognostic for survival in HL. Based on results of interim FDG-PET/CT, therapy may be subsequently modified through minimization or via intensification for low- and high-risk patient populations, respectively (ie, response-adapted therapy). Important data have been generated to standardize the interpretability and reproducibility of interim FDG-PET/CT (eg, the Deauville 5-point system), and observational and noncontrolled prospective studies have produced evidence supporting the hypothesis that response-adapted therapy may potentially serve as a predictive tool. Furthermore, results from noninferiority phase 3 clinical trials randomizing early-stage HL patients with negative interim FDG-PET/CT to combined modality therapy versus chemotherapy alone have been reported. The current collective findings from these randomized early-stage HL studies have shown that acute relapse rates are lower with combined modality therapy, even in patients with negative interim FDG-PET/CT. Additional randomized response-adapted studies are ongoing and novel FDG-PET/CT applications involving quantitative techniques and innovative imaging modalities are being investigated to identify more robust imaging biomarkers. Treatment of early-stage HL remains a clinical management choice for physicians and patients to make with consideration of acute and long-term outcomes.

Sign in / Sign up

Export Citation Format

Share Document