title: Impact of [(18)F]fluorodeoxyglucose positron emission tomography response evaluation in patients with high-tumor burden follicular lymphoma treated with immunochemotherapy: a prospective study from the Groupe d'Etudes des Lymphomes de l'Adulte and GOELAMS.
abstract: OBJECTIVE
  [(18)F]Fluorodeoxyglucose positron emission tomography (PET) is widely used for the staging and restaging of patients with aggressive lymphoma, but less is known about the utility of PET in patients with follicular lymphoma (FL). In a prospective study, we evaluated the prognostic value of PET performed during treatment and at the end of treatment in 121 patients with FL treated with first-line immunochemotherapy.
  
  
  METHODS
  Patients with previously untreated high-tumor burden FL were treated with six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) plus two cycles of rituximab, without rituximab maintenance. PET was performed before treatment, after four cycles of R-CHOP (interim PET), and at the end of treatment (final PET). PET scans were centrally reviewed.
  
  
  RESULTS
  The total number of patients included was 121. Median age was 57 years. After central review, interim PET (n = 111) was negative in 76% of patients, and final PET (n = 106) was negative in 78%. With a median follow-up of 23 months, 2-year progression-free survival rates were 86% for interim PET-negative versus 61% for interim PET-positive patients (P = .0046) and 87% for final PET-negative versus 51% for final PET-positive patients (P < .001), respectively. Two-year overall survival also significantly differed according to final PET results: 100% versus 88% (P = .0128).
  
  
  CONCLUSIONS
  PET performed either after four cycles of R-CHOP or at the end of therapy was strongly predictive of outcome in this prospective study. Therapeutic intervention based on PET results during or after inductive treatment should be evaluated.
authors.affiliation: Hôpital Henri Mondor, Créteil, France.
authors.forename: Jehan
authors.initials: J
authors.lastname: Dupuis
authors.forename: Alina
authors.initials: A
authors.lastname: Berriolo-Riedinger
authors.forename: Anne
authors.initials: A
authors.lastname: Julian
authors.forename: Pauline
authors.initials: P
authors.lastname: Brice
authors.forename: Christelle
authors.initials: C
authors.lastname: Tychyj-Pinel
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mounier
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallamini
authors.forename: Pierre
authors.initials: P
authors.lastname: Feugier
authors.forename: Pierre
authors.initials: P
authors.lastname: Soubeyran
authors.forename: Philippe
authors.initials: P
authors.lastname: Colombat
authors.forename: Guy
authors.initials: G
authors.lastname: Laurent
authors.forename: Nathalie
authors.initials: N
authors.lastname: Berenger
authors.forename: Rene-Olivier
authors.initials: RO
authors.lastname: Casasnovas
authors.forename: Pierre
authors.initials: P
authors.lastname: Vera
authors.forename: Gaetano
authors.initials: G
authors.lastname: Paone
authors.forename: Luc
authors.initials: L
authors.lastname: Xerri
authors.forename: Gilles
authors.initials: G
authors.lastname: Salles
authors.forename: Corinne
authors.initials: C
authors.lastname: Haioun
authors.forename: Michel
authors.initials: M
authors.lastname: Meignan
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008224:Lymphoma, Follicular / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D011446:Prospective Studies; D000069283:Rituximab; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D019788:Fluorodeoxyglucose F18; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone