TY - JOUR
T1 - Limited role of interim PET/CT in patients with diffuse large B-cell lymphoma treated with R-CHOP
AU - Yoo, Changhoon
AU - Lee, Dae Ho
AU - Kim, Jeong Eun
AU - Jo, Jungmin
AU - Yoon, Dok Hyun
AU - Sohn, Byeong Seok
AU - Kim, Sang We
AU - Lee, Jung Shin
AU - Suh, Cheolwon
PY - 2011/7
Y1 - 2011/7
N2 - Positron emission tomography (PET) has been found useful in monitoring response to treatment of malignant lymphoma. We investigated the ability of interim PET to monitor response to standard dose R-CHOP chemotherapy in chemotherapy-naïve patients with diffuse large B-cell lymphoma (DLBCL). Between March 2004 and April 2009, 155 DLBCL patients treated with R-CHOP and available for interim and post-treatment PET/CT were identified and included in this analysis. Response, progression-free survival (PFS), and overall survival (OS) were compared between interim PET/CT-negative and positive group, and among three patient groups which were categorized based on their interim and post-treatment PET/CT: those with early metabolic complete response (mCR), delayed mCR, and never mCR. Interim PET/CT-negative patients (n = 100) showed superior CR rates to interim PET/CT-positive patients (n = 55; 93% vs 62%, P < 0.001). However, there was no difference in PFS (P = 0.07) and OS (P = 0.24) between interim PET/CT-negative and positive group. We categorized patients into three groups, with 100 (64%) in the early mCR group, 35 (23%) in the delayed mCR group, and 20 (13%) in the never mCR group. Early mCR and delayed mCR group did not differ significantly in PFS (P = 0.84) or OS (P = 0.20). However, the survival outcome in the never mCR group was significantly inferior to the combined early and delayed mCR group. The result from this study suggests that interim PET/CT might be an inappropriate tool for designing risk-adaptive therapy in chemotherapy-naïve DLBCL patients treated with R-CHOP. Prospective trials should be performed to clearly determine the role of interim PET/CT.
AB - Positron emission tomography (PET) has been found useful in monitoring response to treatment of malignant lymphoma. We investigated the ability of interim PET to monitor response to standard dose R-CHOP chemotherapy in chemotherapy-naïve patients with diffuse large B-cell lymphoma (DLBCL). Between March 2004 and April 2009, 155 DLBCL patients treated with R-CHOP and available for interim and post-treatment PET/CT were identified and included in this analysis. Response, progression-free survival (PFS), and overall survival (OS) were compared between interim PET/CT-negative and positive group, and among three patient groups which were categorized based on their interim and post-treatment PET/CT: those with early metabolic complete response (mCR), delayed mCR, and never mCR. Interim PET/CT-negative patients (n = 100) showed superior CR rates to interim PET/CT-positive patients (n = 55; 93% vs 62%, P < 0.001). However, there was no difference in PFS (P = 0.07) and OS (P = 0.24) between interim PET/CT-negative and positive group. We categorized patients into three groups, with 100 (64%) in the early mCR group, 35 (23%) in the delayed mCR group, and 20 (13%) in the never mCR group. Early mCR and delayed mCR group did not differ significantly in PFS (P = 0.84) or OS (P = 0.20). However, the survival outcome in the never mCR group was significantly inferior to the combined early and delayed mCR group. The result from this study suggests that interim PET/CT might be an inappropriate tool for designing risk-adaptive therapy in chemotherapy-naïve DLBCL patients treated with R-CHOP. Prospective trials should be performed to clearly determine the role of interim PET/CT.
KW - Diffuse large B-cell lymphoma
KW - Interim PET
KW - Prognosis
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UR - http://www.scopus.com/inward/citedby.url?scp=79960247466&partnerID=8YFLogxK
U2 - 10.1007/s00277-010-1135-6
DO - 10.1007/s00277-010-1135-6
M3 - Article
C2 - 21181163
AN - SCOPUS:79960247466
SN - 0939-5555
VL - 90
SP - 797
EP - 802
JO - Annals of Hematology
JF - Annals of Hematology
IS - 7
ER -