Early restaging positron emission tomography with 18F-fluorodeoxyglucose predicts outcome in patients with aggressive non-Hodgkin’s lymphoma
Open accessAbstract
Background Less than half of all patients with aggressive non-Hodgkin's lymphoma (NHL) are cured with standard chemotherapy. Therefore, it is important to distinguish between responders to standard treatment and non-responders who may benefit from an early change to a more effective therapy. This study was intended to assess the value of a midtreatment fluorine-18 fluorodeoxyglucose positron emission tomography ([(18)F]FDG-PET) scan to predict clinical outcome in patients with aggressive NHL.Patients and methods Seventy newly diagnosed patients with aggressive NHL, who were treated with doxorubicin-containing chemotherapy, underwent a [(18)F]FDG-PET scan at midtreatment. Presence or absence of abnormal [(18)F]FDG uptake was related to progression-free survival (PFS) and overall survival (OS) using Kaplan-Meier survival analysis. Multivariate analysis was performed to evaluate the effect of the International Prognostic Index (IPI) and early [(18)F]FDG-PET findings on PFS and OS.Results At midtreatment, 33 patients showed persistent abnormal [(18)F]FDG uptake and none of these patients achieved a durable complete remission (CR), whereas 37 patients showed a negative scan; 31/37 remained in CR, with a median follow-up of 1107 days. Only 6/37 patients either achieved a partial response or relapsed. Comparison between groups indicated a statistically significant association between [(18)F]FDG-PET findings and PFS (P <1 x 10(-5)) and OS (P <1 x 10(-5)). In multivariate analysis, [(18)F]FDG-PET at midtreatment was a stronger prognostic factor for PFS (P <1 x 10(-7)) and OS (P <9 x 10(-6)) than the IPI (P <0.11 and P <0.03, respectively).Conclusions Early restaging [(18)F]FDG-PET may be used to tailor induction chemotherapy in patients with aggressive NHL.
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- Authors
- Spaepen, K., Stroobants, S., Dupont, P., Vandenberghe, P., Thomas, J., de Groot, T., Balzarini, J., De Wolf-Peeters, C., Mortelmans, L., & Verhoef, G.
- Affiliations
- Universitair Ziekenhuis Leuven (BE)
- Corresponding author
- Spaepen, K.
- Venue
- Annals of Oncology
- Publisher
- Elsevier BV
- Published
- 2002-09
- Volume
- 13
- Issue
- 9
- Pages
- 1356-1363
- ISSN
- 0923-7534 (ISSN-L)
- OpenAlex
- W1990827442
- Cited by
- 410
- References
- 30
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 3 · 2022: 11 · 2021: 7 · 2020: 6 · 2019: 4 · 2018: 2 · 2017: 15 · 2016: 18 · 2015: 17 · 2014: 14 · 2013: 25 · 2012: 25
- FWCI
- 12.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Annals of Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fonds Wetenschappelijk Onderzoek
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Emergency Medicine › Hematological disorders and diagnostics
- Keywords
- aggressive non-Hodgkin lymphoma, 18F-FDG PET, treatment response prediction, progression-free survival, overall survival, International Prognostic Index, complete remission, prognostic factors, treatment response monitoring
- MeSH terms
- Adolescent, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Child, Child, Preschool, Cyclophosphamide, Doxorubicin, Evaluation Studies as Topic, Female, Humans, Lymphoma, Non-Hodgkin, Male, Middle Aged, Monitoring, Physiologic, Neoplasm Staging, Predictive Value of Tests, Prednisolone, Probability, Prognosis, Prospective Studies, Sensitivity and Specificity, Time Factors, Tomography, Emission-Computed, Vincristine, Survival Rate, Multivariate Analysis, Treatment Outcome, Fluorodeoxyglucose F18
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