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Annals of Oncology Advance Access originally published online on February 19, 2009
Annals of Oncology 2009 20(7):1270-1274; doi:10.1093/annonc/mdn768
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

hematologic malignancies

FDG–PET for assessment of early treatment response after four cycles of chemotherapy in patients with advanced-stage Hodgkin's lymphoma has a high negative predictive value

J. Markova1,*,{dagger}, C. Kobe2,{dagger}, M. Skopalova3, K. Klaskova1, K. Dedeckova4, A. Plütschow5, H. T. Eich6, M. Dietlein2, A. Engert5,7 and T. Kozak1

1 Department of Clinical Hematology, University Hospital Kralovske Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
2 Department of Nuclear Medicine, University of Cologne, Cologne, Germany
3 Department of Nuclear Medicine, PET Center, Na Homolce Hospital
4 Institute of Radiation Oncology, University Hospital Na Bulovce, First Faculty of Medicine, Charles University, Prague, Czech Republic
5 German Hodgkin Study Group
6 Department of Radiation Oncology
7 Department of I of Internal Medicine, University of Cologne, Cologne, Germany

* Correspondence to: Dr J. Markova, Oddeleni klinicke hematologie, Fakultni nemocnice Kralovske Vinohrady, Srobarova 50, 100 34 Praha 10, Czech Republic. Tel: +420-267162886; Fax: +420-267163058; E-mail: markova{at}fnkv.cz

Background: As positron emission tomography (PET) seems to be a powerful prognostic marker in the treatment of Hodgkin's lymphoma (HL), we analysed the prognostic value of PET after four cycles of combination therapy with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone (BEACOPP) in patients with advanced-stage HL.

Patients and methods: From January 2004 to March 2007, 50 patients with newly diagnosed HL in clinical stages IIB with large mediastinal mass or extranodal disease, III and IV were treated according to the HD15 protocol of the German Hodgkin Study Group. All patients received a PET scan after four cycles of BEACOPP (PET-4).

Results: Of the overall group, 14 of 50 patients had a positive PET-4 while 36 had a negative PET-4. At a median observation time of 25 months, 2 of the 14 patients with a positive PET-4 had progressed or relapsed, while there was no progression or relapse in PET-4-negative patients.

Conclusion: Our results indicate a very good negative predictive value of PET-4 in advanced-stage HL patients treated with BEACOPP.

Key words: BEACOPP, chemotherapy, Hodgkin's lymphoma, PET, response assessment

{dagger} Both authors contributed equally to this work.

Received for publication August 25, 2008. Revision received November 24, 2008. Accepted for publication December 3, 2008.


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