Midtreatment 18F-fluorodeoxyglucose positron-emission tomography in aggressive non-Hodgkin lymphoma.
BACKGROUND
The use of (18) F-fluorodeoxyglucose positron-emission tomography (PET) scan has increased considerably in the clinical management of non-Hodgkin lymphoma patients, and its role as a prognostic factor during chemotherapy has been established recently.


METHODS
Between May 2003 and May 2009, 91 newly diagnosed patients with primary mediastinal large B-cell lymphoma (PMLBCL) and diffuse large B-cell lymphoma (DLBCL) were treated with 12 weekly cycles of rituximab-MACOP-B (n = 12 patients with PMLBCL), 6 cycles of rituximab-CHOP21 (n = 65 patients with DLBCL, aged < 60 years and 1 patient with PMLBCL), or 8 weekly cycles of rituximab-VNCOP-B (n = 13 DLBCL patients, aged ≥ 60 years). All patients underwent a staging PET examination at baseline and a midtreatment (interim) PET examination after 6 weeks of rituximab-MACOP-B treatment, 3 cycles of rituximab-CHOP21 treatment, or 4 weeks of rituximab-VNCOP-B treatment and again at the end of the chemo-immunotherapy regimen.


RESULTS
At midtreatment evaluation, 35 patients showed a persistently positive PET scan; only 6 (17%) of these patients achieved a continuous complete response (CCR). However, 56 patients presented with a negative interim PET, and 50 (89%) of these patients achieved and maintained a CCR. Comparison between the 2 PET groups indicated a statistically significant association between PET findings and event-free survival (P = .0001) and overall survival (P = .0001).


CONCLUSIONS
The results of this study indicated that midtreatment PET may represent a significant step forward in helping physicians make crucial decisions on further treatment. Cancer 2011. © 2010 American Cancer Society.
Zinzani
Pier Luigi
PL
Institute of Hematology and Medical Oncology L. e A. Seràgnoli, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy. pierluigi.zinzani@unibo.it
Gandolfi
Letizia
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Broccoli
Alessandro
A
Argnani
Lisa
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Fanti
Stefano
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Pellegrini
Cinzia
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Stefoni
Vittorio
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Derenzini
Enrico
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Quirini
Federica
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Baccarani
Michele
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D058846:Antibodies, Monoclonal, Murine-Derived; D019788:Fluorodeoxyglucose F18; D001761:Bleomycin; D000069283:Rituximab; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D008942:Mitoxantrone; D002955:Leucovorin; D011241:Prednisone; D008727:Methotrexate