title: Prognostic Role of Pre-Radiation Therapy (18)F-Fluorodeoxyglucose Positron Emission Tomography for Primary Mediastinal B-Cell Lymphomas Treated with R-CHOP or R-CHOP-Like Chemotherapy Plus Radiation.
abstract: To validate, in a monoinstitutional cohort with extended follow-up, that post-rituximab chemotherapy (R-CT) (18)F-fluorodeoxyglucose positron emission tomography ((18)FDG-PET) is a prognostic factor allowing discrimination of primary mediastinal B-cell lymphoma (PMBCL) patients at higher risk for progression after radiation therapy.
  
  
  
  We analyzed 51 patients, and (18)FDG-PET scans were re-examined evaluating both the Deauville 5-point scale (D5PS) score and the standardized uptake value (SUV) of residual activity, if present. These parameters were then tested by univariate analysis for a potential correlation with progression-free survival (PFS) as the primary study endpoint.
  
  
  
  Median follow-up time was 51 months (range, 9-153 months). After R-CT, D5PS score was 1 in 10 (19.6%), 2 in 11 (21.6%), 3 in 7 (13.8%), 4 in 17 (33.3%), and 5 in 6 patients (11.7%). Forty-three out of 51 patients (84.3%) had an SUVmax ≤5, and 8 out of 51 (15.7%) had an SUVmax ≥5. Overall, 6 patients experienced progression or relapse: 1 had a D5PS score 2 (with SUVmax ≤5), and 5 had a D5PS score 5 (and SUVmax ≥5). Patients with a D5PS score 5 showed significantly lower PFS rates versus all other scores (log-rank P<.001), as did patients with SUVmax ≥5 when compared with those with SUVmax ≤5 (log-rank P<.001).
  
  
  
  The present study confirmed the prognostic role of (18)FDG-PET after R-CT, with patients with a D5PS score of 5 and/or an SUVmax ≥5 being at high risk of progression/relapse after RT.
authors.affiliation: Department of Oncology, University of Torino, Torino, Italy. Electronic address: andreariccardo.filippi@unito.it.
authors.forename: Andrea Riccardo
authors.initials: AR
authors.lastname: Filippi
authors.affiliation: Department of Oncology, University of Torino, Torino, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Piva
authors.affiliation: Department of Oncology, University of Torino, Torino, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Levis
authors.affiliation: Hematology, Città della Salute e della Scienza, Torino, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Chiappella
authors.affiliation: Hematology, Città della Salute e della Scienza and University of Torino, Torino, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Caracciolo
authors.affiliation: Nuclear Medicine, Città della Salute e della Scienza, Torino, Italy.
authors.forename: Marilena
authors.initials: M
authors.lastname: Bellò
authors.affiliation: Nuclear Medicine, Città della Salute e della Scienza, Torino, Italy; Department of Medical Sciences, University of Torino, Torino, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Bisi
authors.affiliation: Hematology, Città della Salute e della Scienza, Torino, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Vitolo
authors.affiliation: Department of Oncology, University of Torino, Torino, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016393:Lymphoma, B-Cell / Q000401:mortality / Q000628:therapy*; D008297:Male; D008479:Mediastinal Neoplasms / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012189:Retrospective Studies; D000069283:Rituximab; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D019788:Fluorodeoxyglucose F18; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone