title: Prognostic value of interim and restaging PET/CT in Hodgkin lymphoma. Results of the CHEAP (Chemotherapy Effectiveness Assessment by PET/CT) study - long term observation.
abstract: Very few studies have determined the prognostic value of interim and restaging PET/CT in patients with Hodgkin lymphoma using current standard of care therapy outside clinical trials. We analyzed the effect of the results of interim and restaging PET/CT on the survival (overall- and relapse-free) in patients who received standard first-line treatment based on the stage of disease and risk factors. We investigated the differences between the relapse and non-relapse groups based on the clinical pathological characteristics of patients who had positive interim PET/CT results.Between January 1, 2007 and December 31, 2011, the staging, interim and restaging PET/CT scans of patients with Hodgkin lymphoma were analyzed. The Deauville criteria were used for the evaluation of interim PET/CT scans. One hundred and thirteen Hodgkin lymphoma patients underwent staging, interim and restaging PET/CT scans. None of the therapy was modified based on the interim PET/CT results. The median follow-up time was 43.5 months. A total of 62 early stage patients and 51 advanced stage patients were identified. The five-year overall survival rates were 93.4% in the interim PET negative group and 58% in the interim PET positive group (p<0.001). The five-year relapse-free survival rates for the negative and positive groups were 92.7% and 40.8%, respectively (p<0.001). The negative predictive value was 100% in the early stage group and 82.35% in the advanced stage group. By comparison, the positive predictive values were 53.8% and 58.8%, respectively, in these two groups. In the interim PET positive group, patients over 40 years of age had a significantly higher probability of relapse (p=0.057).The routine clinical use of interim PET/CT is highly recommended based on our investigation. However, patients with positive interim PET/CT results required frequent additional evaluations.
authors.forename: Z
authors.initials: Z
authors.lastname: Miltenyi
authors.forename: S
authors.initials: S
authors.lastname: Barna
authors.forename: I
authors.initials: I
authors.lastname: Garai
authors.forename: Z
authors.initials: Z
authors.lastname: Simon
authors.forename: A
authors.initials: A
authors.lastname: Jona
authors.forename: F
authors.initials: F
authors.lastname: Magyari
authors.forename: M
authors.initials: M
authors.lastname: Gergely
authors.forename: Z
authors.initials: Z
authors.lastname: Nagy
authors.forename: K
authors.initials: K
authors.lastname: Keresztes
authors.forename: P
authors.initials: P
authors.lastname: Pettendi
authors.forename: A
authors.initials: A
authors.lastname: Illes
keywords: Hodgkin lymphoma; PET/CT.; predictive value