title: Post-ABVD/pre-radiotherapy (18)F-FDG-PET provides additional prognostic information for early-stage Hodgkin lymphoma: a retrospective analysis on 165 patients.
abstract: OBJECTIVE
  To evaluate the prognostic role of both interim fluorine-18 fludeoxyglucose positron emission tomography (i-(18)F-FDG-PET) and end-of-chemotherapy fluorine-18 fludeoxyglucose positron emission tomography (eoc-(18)F-FDG-PET) in patients with early-stage Hodgkin lymphoma (HL).
  
  
  METHODS
  We screened 257 patients with early-stage HL treated with combined modality therapy between March 2003 and July 2011. All were staged using fluorine-18 fludeoxyglucose positron emission tomography ((18)F-FDG-PET) before chemotherapy and after two doxorubicin, bleomycin, vinblastine and dacarbazine cycles (i-(18)F-FDG-PET); 165 patients were also evaluated by (18)F-FDG-PET at the end of chemotherapy (eoc-(18)F-FDG-PET).
  
  
  RESULTS
  After revision, 85% of patients were negative for i-(18)F-FDG-PET and 15% were positive. After eoc-(18)F-FDG-PET revision, 23 patients had a positive scan. The median follow-up was 56 months. The 5-year overall survival (OS) and progression-free survival (PFS) for the whole cohort were 97.5% and 95.6%, respectively. For i-(18)F-FDG-PET-negative and i-(18)F-FDG-PET-positive patients, the 5-year PFS rates were 98% and 84%, respectively; for eoc-(18)F-FDG-PET-negative and eoc-(18)F-FDG-PET-positive patients, the 5-year PFS rates were 97% and 78%, respectively. Combining the i-(18)F-FDG-PET and eoc-(18)F-FDG-PET results, the 5-year PFS were 97%, 100% and 82% in negative/negative, positive/negative and positive/positive groups, respectively. The 5-year OS rates were 98% and 83% in eoc-(18)F-FDG-PET-negative and eoc-(18)F-FDG-PET-positive patients, respectively; the 5-year OS was 98%, 100% and 83% in negative/negative, positive/negative and positive/positive groups, respectively.
  
  
  CONCLUSIONS
  This study provides additional information on the prognostic role of i-(18)F-FDG-PET and eoc-(18)F-FDG-PET in early-stage HL. As data are accumulating and the clinical scenario is rapidly evolving, we might need to rethink the use of (18)F-FDG-PET as a prognostic marker for early-stage HL in the near future.
  
  
  CONCLUSIONS
  This study provides additional information on the prognostic role of i-(18)F-FDG-PET and eoc-(18)F-FDG-PET in early-stage HL. On the basis of the present data, we may suggest to use eoc-(18)F-FDG-PET as a strong prognostic marker, especially for patients with i-(18)F-FDG-PET positivity.
authors.affiliation: 1 Radiation Oncology Unit, Department of Oncology and Advanced Technology, Arcispedale S Maria Nuova-IRCCS of Reggio Emilia, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ciammella
authors.affiliation: 2 Radiation Oncology Unit, Department of Oncology, University of Torino, Torino, Italy.
authors.forename: Andrea Riccardo
authors.initials: AR
authors.lastname: Filippi
authors.affiliation: 3 Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Simontacchi
authors.affiliation: 4 Radiation Oncology Department, University and Spedali Civili, Brescia, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Buglione
authors.affiliation: 5 Hematology Unit, Department of Oncology, University of Torino, Torino, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Botto
authors.affiliation: 3 Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Mangoni
authors.affiliation: 1 Radiation Oncology Unit, Department of Oncology and Advanced Technology, Arcispedale S Maria Nuova-IRCCS of Reggio Emilia, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Iotti
authors.affiliation: 6 Hematology Unit, Arcispedale S Maria Nuova-IRCCS of Reggio Emilia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Merli
authors.affiliation: 7 Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Marcheselli
authors.affiliation: 8 Nuclear Medicine, Department of Medical Sciences, University of Torino, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Bisi
authors.affiliation: 2 Radiation Oncology Unit, Department of Oncology, University of Torino, Torino, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
authors.affiliation: 9 Nuclear Medicine, Arcispedale S Maria Nuova-IRCCS of Reggio Emilia, Italy.
authors.forename: Annibale
authors.initials: A
authors.lastname: Versari
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014747:Vinblastine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin