The predictive role of interim positron emission tomography for Hodgkin lymphoma treatment outcome is confirmed using the interpretation criteria of the Deauville five-point scale

被引:176
作者
Gallamini, Andrea [1 ]
Barrington, Sally F. [2 ]
Biggi, Alberto [3 ]
Chauvie, Stephane [4 ]
Kostakoglu, Lale [5 ]
Gregianin, Michele [6 ]
Meignan, Michel [7 ]
Mikhaeel, George N. [8 ]
Loft, Annika [9 ]
Zaucha, Jan M. [10 ,11 ]
Seymour, John F. [12 ,13 ]
Hofman, Michael S. [14 ]
Rigacci, Luigi [15 ]
Pulsoni, Alessandro [16 ]
Coleman, Morton [17 ]
Dann, Eldad J. [18 ]
Trentin, Livio [19 ]
Casasnovas, Olivier [20 ]
Rusconi, Chiara [21 ]
Brice, Pauline [22 ]
Bolis, Silvia
Viviani, Simonetta [23 ]
Salvi, Flavia [24 ]
Luminari, Stefano [25 ]
Hutchings, Martin [26 ]
机构
[1] Ctr Antoine Lacassagne, Res & Med Innovat Dept, F-06054 Nice, France
[2] Guys & St Thomas Hosp, PET Ctr, Kings Coll London, Div Imaging, London SE1 9RT, England
[3] Azienda Osped S Croce & Carle, PET Ctr, Nucl Med Dept, Cuneo, Italy
[4] Azienda Osped S Croce & Carle, Med Phys Unit, Cuneo, Italy
[5] Mt Sinai Med Ctr, Dept Radiol, Div Nucl Med, New York, NY 10029 USA
[6] Ist Oncol Veneto IOV IRCCS, Radiotherapy & Nucl Med Unit, Padua, Italy
[7] CHU Henri Mondor, Nucl Med Dept, Creteril, France
[8] Guys & St Thomas Hosp, Clin Oncol Dept, London SE1 9RT, England
[9] Copenhagen Univ Hosp, Rigshosp, Dept Clin Physiol Nucl Med & PET, PET & Cyclotron Unit, Copenhagen, Denmark
[10] Univ Gdansk, Dept Oncol, Gdynia Oncol Ctr, PL-80952 Gdansk, Poland
[11] Univ Gdansk, Dept Propedeut Oncol, PL-80952 Gdansk, Poland
[12] Peter MacCallum Canc Ctr, Haematol Dept, Melbourne, Vic, Australia
[13] Univ Melbourne, Parkville, Vic 3052, Australia
[14] Peter MacCallum Canc Ctr, Ctr Canc Imaging, Melbourne, Vic, Australia
[15] Univ Florence, Careggi Hosp, Dept Hematol, I-50121 Florence, Italy
[16] Univ Roma La Sapienza, Cellular Biotechnol & Hematol Dept, Rome, Italy
[17] Weill Cornell Med Ctr, Ctr Lymphoma & Myeloma, Hematol Oncol Div, New York, NY USA
[18] Rambam Med Ctr, Dept Hematol & Bone Marrow Transplantat, Haifa, Israel
[19] Univ Padua, Dept Hematol, I-35100 Padua, Italy
[20] Hop La Bocage, Dept Hematol, Dijon, France
[21] Osped Niguarda Ca Granda, Dept Hematol, Milan, Italy
[22] Ctr Hosp Univ St Louis, Dept Hematol, Paris, France
[23] Fdn IRCCS Ist Nazl Tumori, Dept Med Oncol, Milan, Italy
[24] SS Antonio & Biagio Hosp, Dept Hematol, Alessandria, Italy
[25] Univ Modena, Oncohematol Dept, I-41100 Modena, Italy
[26] Copenhagen Univ Hosp, Rigshosp, Dept Hematol, Copenhagen, Denmark
关键词
B-CELL LYMPHOMA; FDG-PET; F-18-FDG PET; INTERNATIONAL WORKSHOP; PROGNOSTIC SCORE; FREE SURVIVAL; CYCLES; DISEASE; CHEMOTHERAPY; CONCORDANCE;
D O I
10.3324/haematol.2013.103218
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A retrospective, international, multicenter study was undertaken to assess: (i) the prognostic role of 'interim' positron emission tomography performed during treatment with doxorubicin, bleomycin, vinblastine and dacarbazine in patients with Hodgkin lymphoma; and (ii) the reproducibility of the Deauville five-point scale for the interpretation of interim positron emission tomography scan. Two hundred and sixty patients with newly diagnosed Hodgkin lymphoma were enrolled. Fifty-three patients with early unfavorable and 207 with advanced-stage disease were treated with doxorubicin, bleomycin, vinblastine and dacarbazine +/- involved-field or consolidation radiotherapy. Positron emission tomography scan was performed at baseline and after two cycles of chemotherapy. Treatment was not changed according to the results of the interim scan. An international panel of six expert reviewers independently reported the scans using the Deauville five-point scale, blinded to treatment outcome. Forty-five scans were scored as positive (17.3%) and 215 (82.7%) as negative. After a median follow up of 37.0 (2-110) months, 252 patients are alive and eight have died. The 3-year progression-free survival rate was 83% for the whole study population, 28% for patients with interim positive scans and 95% for patients with interim negative scans (P<0.0001). The sensitivity, specificity, and negative and positive predictive values of interim positron emission tomography scans for predicting treatment outcome were 0.73, 0.94, 0.94 and 0.73, respectively. Binary concordance amongst reviewers was good (Cohen's kappa 0.69-0.84). In conclusion, the prognostic role and validity of the Deauville five-point scale for interpretation of interim positron emission tomography scans have been confirmed by the present study.
引用
收藏
页码:1107 / 1113
页数:7
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