title: Can positron emission tomography with [(18)F]-fluorodeoxyglucose after first-line treatment distinguish Hodgkin's disease patients who need additional therapy from others in whom additional therapy would mean avoidable toxicity?
abstract: To assess the ability of restaging positron emission tomography (PET) scanning to predict clinical outcome after first-line treatment in patients with Hodgkin's disease, we included 60 patients with histologically proven HD, who underwent whole-body [(18)F]-fluorodeoxygenase ([(18)F]-FDG)-PET studies after first-line treatment and with a follow-up of at least 1 year. Persistence or absence of residual disease on PET was related to progression-free survival (PFS) using Kaplan-Meier survival analysis. After treatment, 55 patients showed a normal [(18)F]-FDG-PET scan; 50 of 55 remained in complete remission (CR), with a median follow-up of 955 d. Only five patients relapsed (median PFS, 296 d). During follow-up in all five patients, [(18)F]-FDG-PET was the first tool that became positive for relapse. Persistent abnormal [(18)F]-FDG uptake was seen in only five patients; all of them relapsed (median PFS, 296 d). In four of five patients, only PET predicted persistent disease. All relapses were proven histologically. Two-year actuarial PFS rate for negative patients was 91% compared with 0% for positive patients. We concluded that [(18)F]-FDG-PET has an important prognostic role in the post-treatment evaluation of HD patients.
authors.affiliation: Department of Nuclear Medicine, University Hospital Gasthuisberg and Catholic University of Leuven, Leuven, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Spaepen
authors.forename: S
authors.initials: S
authors.lastname: Stroobants
authors.forename: P
authors.initials: P
authors.lastname: Dupont
authors.forename: J
authors.initials: J
authors.lastname: Thomas
authors.forename: P
authors.initials: P
authors.lastname: Vandenberghe
authors.forename: J
authors.initials: J
authors.lastname: Balzarini
authors.forename: C
authors.initials: C
authors.lastname: De Wolf-Peeters
authors.forename: L
authors.initials: L
authors.lastname: Mortelmans
authors.forename: G
authors.initials: G
authors.lastname: Verhoef
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D018579:Patient Selection; D011379:Prognosis; D019275:Radiopharmaceuticals; D012008:Recurrence; D012189:Retrospective Studies; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18