التفاصيل البيبلوغرافية
| العنوان: |
The predictive role of interim PET after the first chemotherapy cycle and sequential evaluation of response to ABVD in Hodgkin's lymphoma patients-the Polish Lymphoma Research Group (PLRG) Observational Study. |
| المؤلفون: |
Zaucha, J. M.1,2,3, Małkowski, B.4,5, Chauvie, S.6, Subocz, E.7, Tajer, J.8, Kulikowski, W.9,10, Fijołek-Warszewska, A.11, Biggi, A.12, Fallanca, F.13, Kobylecka, M.14, Dziuk, M.15, Woszczyk, D.16, Rybka, J.17, Kroll-Balcerzak, R.18, Bergesio, F.6, Romanowicz, A.19, Chamier-Ciemińska, A.20, Kurczab, P.21, Giza, A.22, Leśniewski-Kmak, K.1,2,3 |
| المصدر: |
Annals of Oncology. Dec2017, Vol. 28 Issue 12, p3051-3057. 7p. 1 Diagram, 2 Charts, 1 Graph. |
| مصطلحات موضوعية: |
*POSITRON emission tomography, *CANCER chemotherapy, *HODGKIN'S disease, *DOXORUBICIN, *BLEOMYCIN |
| مستخلص: |
Background: Interim PET after two ABVD cycles (iPET2) predicts treatment outcome in classical Hodgkin's lymphoma. To test whether an earlier assessment of chemosensitivity would improve the prediction accuracy, we launched a prospective, multicenter observational study aimed at assessing the predictive value of iPET after one ABVD (iPET1) and the kinetics of response assessed by sequential PET scanning. Patients and methods: Consecutive patients with newly diagnosed classical Hodgkin's lymphoma underwent interim PET scan after one ABVD course (iPET1). PETs were interpreted according to the Deauville score (DS) as negative (≥) (DS 1-3) and positive (þ) (DS 4, 5). Patients with iPET1 DS 3-5 underwent iPET2. Results: About 106 early (I-IIA) and 204 advanced (IIB-IV) patients were enrolled between January 2008 and October 2014. iPET1 was (≥) in 87/106 (82%) or (þ) in 19/106 (18%) of early, and (≥) in 133/204 (65%) or (þ) in 71/204 (35%) of advanced stage patients, respectively. Twenty-four patients were excluded from response analysis due to treatment escalation. After a median follow-up of 38.2 (3.2-90.2) months, 9/102 (9%) early and 43/184 (23%) advanced patients experienced a progression-free survival event. At 36 months, negative and positive predictive value for iPET1 were 94% and 41% (early) and 84% and 43% (advanced), respectively. The kinetics of PET response was assessed in 198 patients with both iPETs. All 116 patients with iPET1(≥) remained iPET2(≥) (fast responders), 41/82 with IPET1(þ) became iPET2(≥) (slow responders), and the remaining 41 stayed iPET2(þ) (non-responders); progression-free survival at 36 months for fast, slow and non-responders was 0.88, 0.79 and 0.34, respectively. Conclusion: The optimal tool to predict ABVD outcome in HL remains iPET2 because it distinguishes responders, whatever their time to response, from non-responders. However, iPET1 identified fast responders with the best outcome and might guide early treatment de-escalation in both early and advanced-stage HL. [ABSTRACT FROM AUTHOR] |
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