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  • Interim 18-FDG-PET/CT faile...
    Pregno, Patrizia; Chiappella, Annalisa; Bellò, Marilena; Botto, Barbara; Ferrero, Simone; Franceschetti, Silvia; Giunta, Francesca; Ladetto, Marco; Limerutti, Giorgio; Menga, Massimo; Nicolosi, Maura; Priolo, Giorgio; Puccini, Benedetta; Rigacci, Luigi; Salvi, Flavia; Vaggelli, Luca; Passera, Roberto; Bisi, Gianni; Vitolo, Umberto

    Blood, 03/2012, Letnik: 119, Številka: 9
    Journal Article

    Role of interim-PET (I-PET) in diffuse large B-cell Lymphoma (DLBCL) is controversial. To determine predictive value of I-PET on progression-free survival (PFS), we enrolled 88 first-line DLBCL patients treated with 6-8 R-CHOP courses regardless of I-PET. PET/CT were performed at diagnosis, after 2 to 4 courses and at the end of therapy with central reviewing according to visual dichotomous criteria. Results are as follows: I-PET, 72% negative, 28% positive; final-PET (F-PET), 88% negative, 12% positive; clinical complete response 90%. Concordance between clinical response and F-PET negativity was 97% because of 2 false positive. With a median follow-up of 26.2 months, 2-year overall survival and PFS were 91% and 77%, respectively. Two-year PFS for I-PET and F-PET negative versus positive were as follows: I-PET 85% versus 72% (P = .0475); F-PET 83% versus 64% (P < .001). Because of a small number of events, 2 independent bivariate Cox models were tested for PFS. In model 1, F-PET contradicted I-PET (hazard ratio HR = 5.03, P = .015 vs 1.27, P = 691); in model 2, F-PET (HR = 4.54) and International propnostic Index score (HR = 5.36, P = .001) remained independent prognostic factors. In conclusion, positive I-PET is not predictive of a worse outcome in DLBCL; larger prospective studies and harmonization of I-PET reading criteria are needed.