Annals of Oncology Advance Access originally published online on June 24, 2005
Annals of Oncology 2005 16(9):1514-1523; doi:10.1093/annonc/mdi272
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© 2005 European Society for Medical Oncology
FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma
Departments of 1 Clinical Oncology 2 Haematology and 3 The Clinical PET Centre, Guy's and St. Thomas’ Hospital, London, UK
* Correspondence to: Dr N. G. Mikhaeel, Department of Clinical Oncology, Lambeth Wing, St. Thomas’ Hospital, London SE1 7EH, UK. Tel: +44 207 188 4219; Email: george.mikhaeel{at}gstt.nhs.uk
Background: Less than 50% of all high-grade non-Hodgkin lymphoma (NHL) patients experience lasting disease-free survival. Risk-adapted treatment strategies require better tools for prediction of outcome. This investigation aimed to assess the value of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) after two to three cycles of chemotherapy for prediction of progression-free survival (PFS) and overall survival (OS).
Patients and methods: One hundred and twenty-one patients with high-grade NHL underwent FDG-PET. The therapy response on FDG-PET was correlated to PFS and OS using Kaplan–Meier survival analysis. Cox regression analyses were employed to test for independence of known pretreatment prognostic factors.
Results: Fifty FDG-PET scans were negative, 19 scans showed minimal residual uptake (MRU), and 52 scans were positive. The estimated 5 year PFS was 88.8% for the PET-negative group, 59.3% for the MRU group, and 16.2% for the PET-positive group. Kaplan–Meier analyses showed strong associations between FDG-PET results and PFS (P <0.0001) and OS (P <0.01). Early interim FDG-PET was independent of the other prognostic factors.
Conclusions: Early interim FDG-PET is an accurate and independent predictor of PFS and OS. An early assessment of chemotherapy response with FDG-PET could provide the basis for selection of patients for alternative therapeutic strategies.
Key words: fluorodeoxyglucose F18, non-Hodgkin lymphoma, positron emission tomography, prognosis
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