title: The prognostic role of post-induction FDG-PET in patients with follicular lymphoma: a subset analysis from the FOLL05 trial of the Fondazione Italiana Linfomi (FIL).
abstract: BACKGROUND
  [18F]fluorodeoxyglucose-positron emission tomography (PET) is emerging as a strong diagnostic and prognostic tool in follicular lymphoma (FL) patients.
  
  
  METHODS
  In a subset analysis of the FOLL05 trial (NCT00774826), we investigated the prognostic role of post-induction PET (PI-PET) scan. Patients were eligible to this study if they had a PI-PET scan carried out within 3 months from the end of induction immunochemotherapy. Progression-free survival (PFS) was the primary study end point.
  
  
  RESULTS
  A total of 202 patients were eligible and analysed for this study. The median age was 55 years (range 33-75). Overall, PI-PET was defined as positive in 49 (24%) patients. Conventional response assessment with CT scan was substantially modified by PET: 15% (22/145) of patients considered as having a complete response (CR) after CT were considered as having partial response (PR) after PI-PET and 53% (30/57) patients considered as having a PR after CT were considered as a CR after PI-PET. With a median follow-up of 34 months, the 3-year PFS was 66% and 35%, respectively, for patients with negative and positive PI-PET (P<0.001). At multivariate analysis, PI-PET (hazard ratio 2.57, 95% confidence interval 1.52-4.34, P<0.001) was independent of conventional response, FLIPI and treatment arm. Also, the prognostic role of PI-PET was maintained within each FLIPI risk group.
  
  
  CONCLUSIONS
  In FL patients, PI-PET substantially modifies response assessment and is strongly predictive for the risk of progression. PET should be considered in further updates of response criteria.
authors.affiliation: Oncology Unit, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Luminari
authors.forename: I
authors.initials: I
authors.lastname: Biasoli
authors.forename: A
authors.initials: A
authors.lastname: Versari
authors.forename: S
authors.initials: S
authors.lastname: Rattotti
authors.forename: C
authors.initials: C
authors.lastname: Bottelli
authors.forename: C
authors.initials: C
authors.lastname: Rusconi
authors.forename: F
authors.initials: F
authors.lastname: Merli
authors.forename: M
authors.initials: M
authors.lastname: Spina
authors.forename: A J M
authors.initials: AJ
authors.lastname: Ferreri
authors.forename: P L
authors.initials: PL
authors.lastname: Zinzani
authors.forename: A
authors.initials: A
authors.lastname: Gallamini
authors.forename: A
authors.initials: A
authors.lastname: Franceschetto
authors.forename: C
authors.initials: C
authors.lastname: Boccomini
authors.forename: S
authors.initials: S
authors.lastname: Franceschetti
authors.forename: F
authors.initials: F
authors.lastname: Salvi
authors.forename: F D
authors.initials: FD
authors.lastname: Raimondo
authors.forename: A M
authors.initials: AM
authors.lastname: Carella
authors.forename: Q
authors.initials: Q
authors.lastname: Micol
authors.forename: M
authors.initials: M
authors.lastname: Balzarotti
authors.forename: P
authors.initials: P
authors.lastname: Musto
authors.forename: M
authors.initials: M
authors.lastname: Federico
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D008224:Lymphoma, Follicular / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG-PET; follicular lymphoma; prognosis