Importance of F18-fluorodeoxy-D-2-glucose positron emission tomography (FDG-PET) for staging and therapy control of Hodgkin's lymphoma in childhood and adolescence - consequences for the GPOH-HD 2003 protocol.
The prognosis for children and adolescents with Hodgkin's lymphoma is excellent. However, many patients will show secondary malignancies 15-30 years after the initial diagnosis, which appears to be connected with the intensity of treatment during primary disease. In the GPOH-HD 95 trial, the indication for radiotherapy was limited to patients who did not show a complete remission after chemotherapy, as determined radiographically. In the future protocol, the indication for radiotherapy in patients with early-stage Hodgkin's lymphoma should be further refined by using FDG-PET for evaluating the response to chemotherapy. Furthermore, in patients at an advanced stage of the disease, it should be determined if sequential FDG-PET research during chemotherapy can separate patients into subgroups with an excellent or a poor prognosis. This article gives a review of the current literature on FDG-PET in patients with Hodgkin's lymphoma and outlines the consequences for future protocols.
Körholz
D
D
Department of Pediatrics, University of Leipzig Medical Center; Germany. koerd@medizin.uni-leipzig.de
Kluge
R
R
Wickmann
L
L
Hirsch
W
W
Lüders
H
H
Lotz
I
I
Dannenberg
C
C
Hasenclever
D
D
Dörffel
W
W
Sabri
O
O
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D006801:Humans; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome; D014915:Whole-Body Counting
D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18