Positron emission tomography after first cycle of chemotherapy predicts outcome at one year in aggressive lymphoma and hodgkin's disease
Genetic Association Studies
Translational Medical Research
Early identification of chemotherapy refractory patients with lymphoma may indicate a need for alternative treatment strategies to optimize the possibility for cure. Metabolic imaging with positron emission tomography using F-18 fluorodeoxyglucose (FDG-PET) offers advantages of functional tissue characterization that can be used to assess response to therapy. Our purpose was to evaluate the predictive value of FDG-PET early during chemotherapy for subsequent failure-free survival in patients with aggressive nonHodgkin's (NHL) and Hodgkin's lymphoma (HD). Materials and Methods: FDG-PET was performed prior to and after one cycle of chemotherapy in 27 patients ( 17 NHL and 10 HD). All patients had a follow-up period of at least 12 months. The 1-year failure-free survival was compared between patients with positive and negative FDG-PET obtained after first cycle of chemotherapy. ANOVA test was used for statistical analysis. Results: The results are presented below (Prog/Recur: progression or recurrence, CR:complete remission). The differences in failure-free survival between patients with positive versus negative FDGPET findings were statistically significant (p=0.0004). The positive and negative predictive values for FDG-PET were 83.3% and 80%, respectively. Conclusion: FDG-PET findings after one-cycle of chemotherapy are predictive of one-year outcome in patients with aggressive NHL and HD. Therefore early FDG-PET imaging during chemotherapy may be a good indicator of patients who could potentially benefit from a change to a more intensive treatment program. FDG PET + FDG PET - Prog/Recur 10 3 CR 2 12.