Oncotarget

Research Papers:

Predictive value of interim FDG-PET/CT findings in patients with diffuse large B-cell lymphoma treated with R-CHOP

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Oncotarget. 2019; 10:5403-5411. https://doi.org/10.18632/oncotarget.27103

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Kazuhiro Kitajima _, Masaya Okada, Kyoko Yoshihara, Tazuko Tokugawa, Akihiro Sawada, Satoshi Yoshihara, Hiroya Tamaki, Yoshihiro Fujimori, Syuji Ueda, Hiroyuki Kawamoto, Junichi Taniguchi and Koichiro Yamakado

Abstract

Kazuhiro Kitajima1, Masaya Okada2, Kyoko Yoshihara2, Tazuko Tokugawa2, Akihiro Sawada2, Satoshi Yoshihara2, Hiroya Tamaki2, Yoshihiro Fujimori2, Syuji Ueda3, Hiroyuki Kawamoto4, Junichi Taniguchi5 and Koichiro Yamakado5

1 Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

2 Division of Hematology, Departments of Internal Medicine, Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

3 Department of Hematology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan

4 Department of Hematology, Uegahara Hospital, Nishinomiya, Hyogo, Japan

5 Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

Correspondence to:

Kazuhiro Kitajima,email: ka-kitajima@hyo-med.ac.jp

Keywords: non-Hodgkin lymphoma; PET-CT; progression-free survival

Received: May 27, 2019     Accepted: July 05, 2019     Published: September 10, 2019

ABSTRACT

Objectives: To examine the prognostic value of interim 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) findings after 2–4 cycles of rituximab, plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with diffuse large B-cell lymphoma (DLBCL) receiving standardized treatment.

Results: After a median 3.36 years (range 0.33 to 9.14 years), 24 of the 80 patients had documented relapse. In Interim-PET findings, 2-year PFS was significantly shorter for PET-positive as compared with PET-negative patients (50.0% vs. 86.4%; p = 0.0012). In End-PET findings, 2-year PFS was significantly shorter for PET-positive as compared with PET-negative patients (25.0% vs. 84.7%; p < 0.0001). The positive predictive value (PPV) and negative predictive value (NPV) of Interim-PET for predicting relapse or disease progression were 57.1% and 75.8%, respectively, while those for End-PET were 75.0% and 75.0%, respectively.

Methods: Eighty DLBCL patients treated with first-line 6–8 R-CHOP courses regardless of interim imaging findings were enrolled. Each underwent FDG-PET/CT scanning at staging, and again during (Interim-PET) and at the end of (End-PET) therapy. PET positivity or negativity at Interim-PET and End-PET as related to progression-free survival (PFS) was examined using Kaplan–Meier analysis.

Conclusion: Mid-treatment FDG-PET/CT findings may be useful for determining disease status in patients with DLBCL undergoing induction R-CHOP chemotherapy, though are not recommended for treatment decisions as part of routine clinical practice.


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