title: Impact of 18F-fluoro-2-deoxyglucose positron emission tomography on treatment strategy and radiotherapy planning for stage I-II Hodgkin disease: a prospective multicenter study.
abstract: OBJECTIVE
  To quantify the impact of preradiotherapy 18F-fluoro-2-deoxyglucose positron-emission tomography (FDG-PET) on treatment strategy and radiotherapy planning for patients with Stage I/II Hodgkin disease included in a large prospective multicenter study.
  
  
  METHODS
  Conventional computed tomography and FDG-PET were performed just before the planned radiotherapy. The radiotherapy plan was first elaborated under blinded conditions for FDG-PET data. Then, the medical staff was asked to confirm or not confirm the treatment strategy and, if appropriate, to modify the radiotherapy plan based on additional information from FDG-PET.
  
  
  RESULTS
  Between January 2004 and January 2006, 137 patients were included (124 were available for analysis) in 11 centers (108 adults, 16 children). All but 1 patient had received chemotherapy before inclusion. Prechemotherapy work-up included FDG-PET for 61 patients, and data were available for elaboration of the first radiotherapy plan. Based on preradiotherapy FDG-PET data, the radiotherapy was cancelled in 6 patients (4.8%), and treatment plan modifications occurred in 16 patients (12.9%): total dose (11 patients), CTV volume (5 patients), number of beam incidences (6 patients), and number of CTV (6 patients). The concordance between the treatment strategies with or without preradiotherapy FDG-PET was 82.3%. Concordance results were not significantly different when prechemotherapy PET-CT information was available.
  
  
  CONCLUSIONS
  Preradiotherapy FDG-PET for treatment planning in Hodgkin lymphoma may lead to significant modification of the treatment strategy and the radiotherapy planning in patients with Stage I or II Hodgkin disease, even in those who have undergone FDG-PET as part of the prechemotherapy work-up.
authors.affiliation: Department of Radiation Oncology, Lyon University-Centre Léon Bérard, Lyon, France. pommier@lyon.fnclcc.fr
authors.forename: Pascal
authors.initials: P
authors.lastname: Pommier
authors.forename: Sophie
authors.initials: S
authors.lastname: Dussart
authors.forename: Théodore
authors.initials: T
authors.lastname: Girinsky
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chabaud
authors.forename: Jean Leon
authors.initials: JL
authors.lastname: Lagrange
authors.forename: Tan Dat
authors.initials: TD
authors.lastname: Nguyen
authors.forename: Véronique
authors.initials: V
authors.lastname: Beckendorff
authors.forename: Anne
authors.initials: A
authors.lastname: D'Hombres
authors.forename: Xavier
authors.initials: X
authors.lastname: Artignan
authors.forename: Pierre Yves
authors.initials: PY
authors.lastname: Bondiau
authors.forename: Christian
authors.initials: C
authors.lastname: Carrie
authors.forename: Francesco
authors.initials: F
authors.lastname: Giammarile
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18