Oncotarget

Research Papers:

Predictive value of interim FDG-PET/CT findings in patients with diffuse large B-cell lymphoma treated with R-CHOP

Kazuhiro Kitajima _, Masaya Okada, Kyoko Yoshihara, Tazuko Tokugawa, Akihiro Sawada, Satoshi Yoshihara, Hiroya Tamaki, Yoshihiro Fujimori, Syuji Ueda, Hiroyuki Kawamoto, Junichi Taniguchi and Koichiro Yamakado

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Oncotarget. 2019; 10:5403-5411. https://doi.org/10.18632/oncotarget.27103

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Abstract

Kazuhiro Kitajima1, Masaya Okada2, Kyoko Yoshihara2, Tazuko Tokugawa2, Akihiro Sawada2, Satoshi Yoshihara2, Hiroya Tamaki2, Yoshihiro Fujimori2, Syuji Ueda3, Hiroyuki Kawamoto4, Junichi Taniguchi5 and Koichiro Yamakado5

1 Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

2 Division of Hematology, Departments of Internal Medicine, Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

3 Department of Hematology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan

4 Department of Hematology, Uegahara Hospital, Nishinomiya, Hyogo, Japan

5 Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

Correspondence to:

Kazuhiro Kitajima,email: ka-kitajima@hyo-med.ac.jp

Keywords: non-Hodgkin lymphoma; PET-CT; progression-free survival

Received: May 27, 2019     Accepted: July 05, 2019     Published: September 10, 2019

ABSTRACT

Objectives: To examine the prognostic value of interim 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) findings after 2–4 cycles of rituximab, plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with diffuse large B-cell lymphoma (DLBCL) receiving standardized treatment.

Results: After a median 3.36 years (range 0.33 to 9.14 years), 24 of the 80 patients had documented relapse. In Interim-PET findings, 2-year PFS was significantly shorter for PET-positive as compared with PET-negative patients (50.0% vs. 86.4%; p = 0.0012). In End-PET findings, 2-year PFS was significantly shorter for PET-positive as compared with PET-negative patients (25.0% vs. 84.7%; p < 0.0001). The positive predictive value (PPV) and negative predictive value (NPV) of Interim-PET for predicting relapse or disease progression were 57.1% and 75.8%, respectively, while those for End-PET were 75.0% and 75.0%, respectively.

Methods: Eighty DLBCL patients treated with first-line 6–8 R-CHOP courses regardless of interim imaging findings were enrolled. Each underwent FDG-PET/CT scanning at staging, and again during (Interim-PET) and at the end of (End-PET) therapy. PET positivity or negativity at Interim-PET and End-PET as related to progression-free survival (PFS) was examined using Kaplan–Meier analysis.

Conclusion: Mid-treatment FDG-PET/CT findings may be useful for determining disease status in patients with DLBCL undergoing induction R-CHOP chemotherapy, though are not recommended for treatment decisions as part of routine clinical practice.


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