PET Predicts Prognosis After 1 Cycle of Chemotherapy in Aggressive Lymphoma and Hodgkin's Disease Export

@article{citeulike:1182680, abstract = {Early identification of chemotherapy-refractory lymphoma patients provides a basis for alternative treatment strategies. Metabolic imaging with 18F-FDG PET offers functional tissue characterization that is useful for assessing response to therapy. Our objective was to determine the predictive value of 18F-FDG PET early during chemotherapy (after 1 cycle) and at the completion of chemotherapy for subsequent progression-free survival (PFS) in patients with aggressive non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD). Methods: 18F-FDG PET (dual-head coincidence camera with attenuation correction) was performed before and after 1 cycle of chemotherapy on 30 patients (17 NHL, 13 HD; mean age, 52.3 {+/-} 16.0 y). For 23 of the 30 patients, 18F-FDG PET data were also obtained after the completion of chemotherapy. The patients had a median follow-up of 19 mo (range, 18-24 mo). Follow-up of PFS was compared between patients with positive and negative 18F-FDG PET results obtained after the first cycle of chemotherapy and at the completion of chemotherapy. Results: Positive 18F-FDG PET results obtained both after the first cycle and at the completion of therapy were associated with a shorter PFS (median, 5 and 0 mo, respectively) than were negative 18F-FDG PET results (PFS medians not reached). A statistically significant difference in PFS between positive and negative 18F-FDG PET results was obtained both after the first cycle and at the completion of chemotherapy (P [\<=] 0.001). The PFS and 18F-FDG PET results obtained after the first cycle correlated better than those obtained after the completion of chemotherapy (r2 = 0.45 vs. 0.17). 18F-FDG PET had more false-negative results after the last cycle (6/17 cases, or 35\%) than after the first cycle (2/13 cases, or 15\%). Thus, 18F-FDG PET had greater sensitivity and positive predictive values after the first cycle (82\% vs. 45.5\% and 90\% vs. 83\%, respectively) than after the last cycle. Conclusion: 18F-FDG PET after 1 cycle of chemotherapy is predictive of 18-mo outcome in patients with aggressive NHL and HD and may earlier identify patients who would benefit from more intensive treatment programs.}, author = {Kostakoglu, Lale and Coleman, Morton and Leonard, John P. and Kuji, Ichiei and Zoe, Holly and Goldsmith, Stanley J.}, citeulike-article-id = {1182680}, citeulike-linkout-0 = {http://jnm.snmjournals.org/cgi/content/abstract/43/8/1018}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/12163626}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=12163626}, comment = {paper reference}, day = {1}, journal = {J Nucl Med}, keywords = {chemotherapy, glycolysis, lymphoma, paper1, pet, treatment-response}, month = {August}, number = {8}, pages = {1018--1027}, posted-at = {2007-03-24 13:24:00}, priority = {2}, title = {PET Predicts Prognosis After 1 Cycle of Chemotherapy in Aggressive Lymphoma and Hodgkin's Disease}, url = {http://jnm.snmjournals.org/cgi/content/abstract/43/8/1018}, volume = {43}, year = {2002} }

TY - JOUR ID - citeulike:1182680 L3 - citeulike-article-id:1182680 N2 - Early identification of chemotherapy-refractory lymphoma patients provides a basis for alternative treatment strategies. Metabolic imaging with 18F-FDG PET offers functional tissue characterization that is useful for assessing response to therapy. Our objective was to determine the predictive value of 18F-FDG PET early during chemotherapy (after 1 cycle) and at the completion of chemotherapy for subsequent progression-free survival (PFS) in patients with aggressive non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD). Methods: 18F-FDG PET (dual-head coincidence camera with attenuation correction) was performed before and after 1 cycle of chemotherapy on 30 patients (17 NHL, 13 HD; mean age, 52.3 {+/-} 16.0 y). For 23 of the 30 patients, 18F-FDG PET data were also obtained after the completion of chemotherapy. The patients had a median follow-up of 19 mo (range, 18-24 mo). Follow-up of PFS was compared between patients with positive and negative 18F-FDG PET results obtained after the first cycle of chemotherapy and at the completion of chemotherapy. Results: Positive 18F-FDG PET results obtained both after the first cycle and at the completion of therapy were associated with a shorter PFS (median, 5 and 0 mo, respectively) than were negative 18F-FDG PET results (PFS medians not reached). A statistically significant difference in PFS between positive and negative 18F-FDG PET results was obtained both after the first cycle and at the completion of chemotherapy (P [<=] 0.001). The PFS and 18F-FDG PET results obtained after the first cycle correlated better than those obtained after the completion of chemotherapy (r2 = 0.45 vs. 0.17). 18F-FDG PET had more false-negative results after the last cycle (6/17 cases, or 35%) than after the first cycle (2/13 cases, or 15%). Thus, 18F-FDG PET had greater sensitivity and positive predictive values after the first cycle (82% vs. 45.5% and 90% vs. 83%, respectively) than after the last cycle. Conclusion: 18F-FDG PET after 1 cycle of chemotherapy is predictive of 18-mo outcome in patients with aggressive NHL and HD and may earlier identify patients who would benefit from more intensive treatment programs. IS - 8 JF - J Nucl Med EP - 1027 TI - PET Predicts Prognosis After 1 Cycle of Chemotherapy in Aggressive Lymphoma and Hodgkin's Disease VL - 43 SP - 1018 KW - chemotherapy KW - glycolysis KW - lymphoma KW - paper1 KW - pet KW - treatment-response N1 - paper reference AU - Kostakoglu, Lale AU - Coleman, Morton AU - Leonard, John AU - Kuji, Ichiei AU - Zoe, Holly AU - Goldsmith, Stanley PY - 2002/08/01/ UR - http://jnm.snmjournals.org/cgi/content/abstract/43/8/1018 ER -