Midtreatment 18F-fluorodeoxyglucose positron-emission tomography in aggressive non-Hodgkin lymphoma.

Abstract

BACKGROUND:

The use of (18) F-fluorodeoxyglucose positron-emission tomography (PET) scan has increased considerably in the clinical management of non-Hodgkin lymphoma patients, and its role as a prognostic factor during chemotherapy has been established recently.

METHODS:

Between May 2003 and May 2009, 91 newly diagnosed patients with primary mediastinal large B-cell lymphoma (PMLBCL) and diffuse large B-cell lymphoma (DLBCL) were treated with 12 weekly cycles of rituximab-MACOP-B (n = 12 patients with PMLBCL), 6 cycles of rituximab-CHOP21 (n = 65 patients with DLBCL, aged < 60 years and 1 patient with PMLBCL), or 8 weekly cycles of rituximab-VNCOP-B (n = 13 DLBCL patients, aged ≥ 60 years). All patients underwent a staging PET examination at baseline and a midtreatment (interim) PET examination after 6 weeks of rituximab-MACOP-B treatment, 3 cycles of rituximab-CHOP21 treatment, or 4 weeks of rituximab-VNCOP-B treatment and again at the end of the chemo-immunotherapy regimen.

RESULTS:

At midtreatment evaluation, 35 patients showed a persistently positive PET scan; only 6 (17%) of these patients achieved a continuous complete response (CCR). However, 56 patients presented with a negative interim PET, and 50 (89%) of these patients achieved and maintained a CCR. Comparison between the 2 PET groups indicated a statistically significant association between PET findings and event-free survival (P = .0001) and overall survival (P = .0001).

CONCLUSIONS:

The results of this study indicated that midtreatment PET may represent a significant step forward in helping physicians make crucial decisions on further treatment. Cancer 2011. © 2010 American Cancer Society.

• Authors: Pier Luigi Zinzani, Letizia Gandolfi, Alessandro Broccoli, Lisa Argnani, Stefano Fanti, Cinzia Pellegrini, Vittorio Stefoni, Enrico Derenzini, Federica Quirini, Michele Baccarani
• Journal: Cancer (Cancer) Vol. 117 Issue 5 Pg. 1010-8 (Mar 01 2011) ISSN: 0008-543X [Print] United States
• PMID: 20960498 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 American Cancer Society.

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Fluorodeoxyglucose F18
• Bleomycin
• Rituximab
• Vincristine
• Etoposide
• Doxorubicin
• Cyclophosphamide
• Mitoxantrone
• Leucovorin
• Prednisone
• Methotrexate

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Algorithms
• Antibodies, Monoclonal, Murine-Derived (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Bleomycin (administration & dosage)
• Cyclophosphamide (administration & dosage)
• Doxorubicin (administration & dosage)
• Drug Administration Schedule
• Etoposide (administration & dosage)
• Female
• Fluorodeoxyglucose F18
• Humans
• Leucovorin (administration & dosage)
• Lymphoma, Non-Hodgkin (diagnostic imaging, drug therapy, mortality, pathology)
• Male
• Methotrexate (administration & dosage)
• Middle Aged
• Mitoxantrone (administration & dosage)
• Monitoring, Physiologic (methods)
• Neoplasm Invasiveness
• Neoplasm Staging
• Positron-Emission Tomography (methods)
• Prednisone (administration & dosage)
• Retrospective Studies
• Rituximab
• Survival Analysis
• Time Factors
• Vincristine (administration & dosage)
• Young Adult