FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma

Abstract

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.

Tumor Burden Assessed by the Maximum Standardized Uptake Value and Greatest Diameter on FDG-PET Predicts Prognosis in Untreated Diffuse Large B-cell Lymphoma

“…The major indication of FDG-PET in NHL was to differentiate between viable tumor tissue and fibrosis after chemotherapy, because complete remission after full cycles of chemotherapy is a determinant of cure in NHL [3,17]. Thereafter, interim evaluation of response during chemotherapy has become a principal reason for conducting FDG-PET in DLBCL [18,19]. The lack of data for prognostic value of pretreatment FDG-PET may lie in multiplicity of lymphoma lesions.…”

Use of PET and PET/CT for Radiation Therapy Planning: IAEA expert report 2006–2007

“…PET commonly influences RT fields in lymphoma by PET is also used to assess the response of lymphomas to CHT [120], either at the end of therapy, or as an interim measure, after e.g. 1-3 cycles [121][122][123][124]. Persistent interim tumor FDG uptake is a powerful negative prognostic factor in patients with…”

“…Hodgkin lymphoma [125] and aggressive non-Hodgkin lymphoma [122] but early complete response cannot yet identify patients who do not require RT as part of combined modality therapy. Baseline PET scans may help determine what sites will require consolidation RT.…”

18F-FDG PET/CT Imaging In Oncology

“…Early interim 18 F-FDG PET/CT results (after two to four cycles) correlate well with event-free survival in HL ( Figure 6 )105–107 and high-grade NHL 108109. In high-grade NHL, the event-free survival at 2 years and 5 years has been reported to be 82% and 88.8%, respectively, for negative interim PET patients in compassion to 43% and 16.2%, respectively, for positive interim PET patients 108109. In another study, the 2-year event-free survival in HL patients with negative interim 18 F-FDG PET was 95% in comparison to 12.8% in those with positive interim 18 F-FDG PET 107…”