End-of-treatment but not interim PET scan predicts outcome in nonbulky limited-stage Hodgkin's lymphoma.
BACKGROUND
Early interim positron emission tomography (PET) scans appear powerfully predictive of outcome in Hodgkin's lymphoma (HL), particularly in advanced-stage disease where it has been predominantly studied. The prognostic value of interim PET in limited-stage patients with nonbulky disease has not been well established.


METHODS
Ninety-six patients with nonbulky limited-stage HL were identified who had interim and end-of-treatment PET scans. Response rate, overall survival (OS), and progression-free survival (PFS) were calculated.


RESULTS
Four-year PFS and OS for the entire cohort were 88% and 97%, respectively. Interim PET did not predict outcome, with PFS in positive and negative patients 87% versus 91% (P=0.57), respectively. End-of-treatment PET result was predictive of outcome, with PFS of 94% in end PET-negative patients versus 54% in end PET-positive patients (P<0.0001). Four-year OS was 100% in end PET-negative patients and 84% in end PET-positive patients (P<0.0001).


CONCLUSIONS
Interim PET scans were not predictive of outcome, compared with scans carried out at completion of therapy. End-of-treatment PET was highly predictive of PFS and OS, regardless of interim PET result. In this low-risk patient population, even patients with interim positive PET scans show a favorable prognosis.
Center for Lymphoma, Massachusetts General Hospital Cancer Center; Department of Medicine, Harvard Medical School.
J A
JA
Barnes
Department of Medical Oncology, Dana-Farber Cancer Institute; Department of Medicine, Harvard Medical School.
A S
AS
LaCasce
Department of Imaging, Dana-Farber Cancer Institute; Department of Radiology, Harvard Medical School.
K
K
Zukotynski
Department of Imaging, Dana-Farber Cancer Institute; Department of Radiology, Harvard Medical School.
D
D
Israel
Department of Biostatistics, Dana-Farber Cancer Institute.
Y
Y
Feng
Department of Biostatistics, Dana-Farber Cancer Institute; Department of Biostatistics, Harvard School of Public Health, Boston, USA.
D
D
Neuberg
Center for Lymphoma, Massachusetts General Hospital Cancer Center.
C E
CE
Toomey
Center for Lymphoma, Massachusetts General Hospital Cancer Center; Department of Medicine, Harvard Medical School.
E P
EP
Hochberg
Department of Medical Oncology, Dana-Farber Cancer Institute; Department of Medicine, Harvard Medical School.
G P
GP
Canellos
Center for Lymphoma, Massachusetts General Hospital Cancer Center; Department of Medicine, Harvard Medical School. Electronic address: jabramson@partners.org.
J S
JS
Abramson
D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D016896:Treatment Outcome