Hodgkin's lymphoma in remission after first-line therapy: which patients need FDG-PET/CT for follow-up?

Abstract

BACKGROUND:

The purpose of the study was to evaluate the impact of 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) during follow-up of patients with Hodgkin's lymphoma.

PATIENTS AND METHODS:

Patients in complete remission or an unconfirmed complete remission after first-line therapy who received FDG-PET/CT during their follow-up were analyzed retrospectively. Confirmatory biopsy was mandatory in case of recurrence.

RESULTS:

Overall, 134 patients were analyzed. Forty-two (31.3%) patients had a recurrence. The positive predictive value of FDG-PET/CT was 0.98. Single-factor analysis identified morphological residual mass [P = 0.0005, hazard ratio (HR) 3.4, 95% confidence interval (CI) 1.7-6.6] and symptoms (P < 0.0001, HR 4.9, 95% CI 2.4-9.9) as significant risk factors for relapse. By multivariate analysis, morphological residual mass was the only significant risk factor for early follow-up (<24 months) (P = 0.0019, HR 7.6, 95% CI 2.1-27.3). Advanced stage (P = 0.0426, HR 3.6, 95% CI 1.1-12.3) and the presence of symptoms (P = 0.0009, HR = 14.6, 95% CI 3.0-69.7) were found to be significant risk factors for later follow-up (>24 months).

CONCLUSIONS:

Asymptomatic patients without morphological residues and an early stage of disease do not need a routine FDG-PET/CT for follow-up. Asymptomatic patients with morphological residues should receive routine follow-up FDG-PET/CT for the first 24 months. Only patients with advanced initial stage do need a routine follow-up FDG-PET/CT beyond 24 months.

• Authors: U Petrausch, P Samaras, P Veit-Haibach, A Tschopp, J D Soyka, A Knuth, T F Hany, A Mischo, C Renner, N G Schaefer
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 21 Issue 5 Pg. 1053-7 (May 2010) ISSN: 1569-8041 [Electronic] England
• PMID: 19914963 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Female
• Fluorodeoxyglucose F18
• Follow-Up Studies
• Hodgkin Disease (diagnostic imaging, drug therapy)
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (diagnosis)
• Neoplasm Staging
• Positron-Emission Tomography (statistics & numerical data)
• Prognosis
• Radiopharmaceuticals
• Remission Induction
• Retrospective Studies
• Risk Factors
• Survival Rate
• Tomography, X-Ray Computed (statistics & numerical data)