Response assessment of aggressive non-Hodgkin's lymphoma by integrated international workshop criteria and fluorine-18-fluorodeoxyglucose positron emission tomography

被引:285
作者
Juweid, ME
Wiseman, GA
Vose, JM
Ritchie, JM
Menda, Y
Wooldridge, JE
Mottaghy, FM
Rohren, EM
Blumstein, NM
Stolpen, A
Link, BK
Reske, SN
Graham, MM
Cheson, BD
机构
[1] Univ Iowa, Dept Radiol, Iowa City, IA 52242 USA
[2] Univ Iowa, Dept Internal Med, Iowa City, IA 52242 USA
[3] Univ Iowa, Dept Biostat, Iowa City, IA 52242 USA
[4] Univ Iowa, Holden Comprehens Canc Ctr, Iowa City, IA 52242 USA
[5] Mayo Clin, Dept Radiol, Rochester, MN USA
[6] Ulm Univ Hosp, Div Nucl Med, Ulm, Germany
[7] Univ Nebraska, Med Ctr, Dept Internal Med, Omaha, NE USA
[8] Georgetown Univ Hosp, Dept Internal Med, Washington, DC 20007 USA
关键词
D O I
10.1200/JCO.2005.01.891
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose To determine whether a response classification based on integration of fluorine-18-fluorrodeoxyglucose positron emission tomography (FDG-PET) into the International Workshop Criteria (IWC) provides a more accurate response assessment than IWC alone in patients with non-Hodgkin's lymphoma (NHL). Patients and Methods Fifty-four patients with aggressive NHL who underwent FDG-PET and computed tomography 1 to 16 weeks after four to eight cycles of chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone were assessed for complete response (CR), unconfirmed CR (CRu), partial response (PR), stable disease (SD), and progressive disease (PD) by the IWC and by integrated IWC and FDG-PET (IWC+PET). Progression-free survival (PFS) was also compared between IWC- and IWC+PET-assigned response designations. Results By IWC, 17 patients had a CR, seven had a CRu, 19 had a PR, nine had SD, and two had PD. In comparison, by IWC+PET, 35 patients had a CR, 12 had a PR, six had SD, one had PD, and zero had a CRu. In separate multivariate models, PFS was significantly shorter in patients with PR than in those with a CR using IWC (hazard ratio [HR], 8.9; P =.021) or IWC+PET (HR, 29.7; P =.0003). However, when the two classifications were included in the same multivariate model, only IWC+PET was a statistically significant independent predictor for PFS (P =.008 v P =.72 for IWC). In addition, when patients with a PR by IWC and a CR by IWC+PET were compared with those with a CR by IWC and a CR by IWC+PET, there was no significant difference in PFS (HR, 1.6; P =.72), indicating that IWC+PET identified a subset of IWC-PR patients with a more favorable prognosis. Conclusion Compared with IWC, the IWC+PET-based assessment provides a more accurate response classification in patients with aggressive NHL.
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收藏
页码:4652 / 4661
页数:10
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