FDG-PET after 1 cycle of therapy predicts outcome in diffuse large cell lymphoma and classic Hodgkin disease
Article first published online: 24 OCT 2006
Copyright © 2006 American Cancer Society
Volume 107, Issue 11, pages 2678–2687, 1 December 2006
How to Cite
Kostakoglu, L., Goldsmith, S. J., Leonard, J. P., Christos, P., Furman, R. R., Atasever, T., Chandramouly, A., Verma, S., Kothari, P. and Coleman, M. (2006), FDG-PET after 1 cycle of therapy predicts outcome in diffuse large cell lymphoma and classic Hodgkin disease. Cancer, 107: 2678–2687. doi: 10.1002/cncr.22276
- Issue published online: 17 NOV 2006
- Article first published online: 24 OCT 2006
- Manuscript Accepted: 23 AUG 2006
- Manuscript Revised: 9 AUG 2006
- Manuscript Received: 6 JUL 2006
- diffuse large cell lymphoma;
- Hodgkin disease;
- therapy response;
- early response
Early prediction of response to therapy may offer the potential to identify patients who will benefit from standard conventional therapy. The objective of this study was to determine the predictive value of FDG-PET as an early response indicator after 1 cycle of chemotherapy for progression-free survival (PFS) in diffuse large cell lymphoma (DLCL) and classic Hodgkin disease (HD).
FDG-PET was performed before, after 1 cycle, and after completion of chemotherapy in 47 patients. The patients were followed with a median follow-up of 21 months (range, 3–47 months). PFS was compared between PET-positive and PET-negative patients after 1 cycle and after completion of therapy.
All PET-negative patients after 1 cycle (n = 31) had sustained complete remission with a median follow-up of 28 months. Fourteen of 16 PET-positive patients after 1 cycle had refractory disease or relapsed (median PFS, 5.5 months). There were 2 false-positive results, 1 with an active infection at the biopsy site and the other in a patient who had been in remission after radiation therapy. There was good agreement between the results obtained after 1 cycle and at completion of therapy (kappa, 0.80); however, the negative predictive value was higher for FDG-PET after 1 cycle than after completion of chemotherapy (100% vs 91.4%), although not statistically different (P = .40).
FDG-PET had a high prognostic value after 1 cycle of chemotherapy, thus it can be a valid alternative for posttreatment evaluation of DLCL and HD and may offer the potential for change in treatment paradigms. Cancer 2006. © 2006 American Cancer Society.