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Risk-adapted FDG-PET/CT-based follow-up in patients with diffuse large B-cell lymphoma after first-line therapy

Petrausch, U. ; Samaras, P. ; Haile, S. R. ; Veit-Haibach, P. ; Soyka, J. D. ; Knuth, A. ; Hany, T. F. ; Mischo, A. ; Renner, C. ; Schäefer, N. G.

In: Annals of Oncology, 2010, vol. 21, no. 8, p. 1694-1698

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    Titel
    • Risk-adapted FDG-PET/CT-based follow-up in patients with diffuse large B-cell lymphoma after first-line therapy
    Autor
    • Petrausch, U.. Department of Oncology, University Hospital Zurich
    • Samaras, P.. Department of Oncology, University Hospital Zurich
    • Haile, S. R.. Biostatistics Unit, Institute of Social and Preventive Medicine, University of Zurich
    • Veit-Haibach, P.. Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich, Zürich, Switzerland
    • Soyka, J. D.. Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich, Zürich, Switzerland
    • Knuth, A.. Department of Oncology, University Hospital Zurich
    • Hany, T. F.. Division of Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich, Zürich, Switzerland
    • Mischo, A.. Department of Oncology, University Hospital Zurich
    • Renner, C.. Department of Oncology, University Hospital Zurich
    • Schäefer, N. G.. Department of Oncology, University Hospital Zurich
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • Annals of Oncology, 2010, vol. 21, no. 8, p. 1694-1698. Oxford University Press
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:292700
    Summary
    Background: The purpose of this study was to evaluate the impact of 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) during follow-up of patients with diffuse large B-cell lymphoma (DLBCL) being in complete remission or unconfirmed complete remission after first-line therapy. Patients and methods: DLBCL patients receiving FDG-PET/CT during follow-up were analyzed retrospectively. Confirmatory biopsy was mandatory in cases of suspected disease recurrence. Results: Seventy-five patients were analyzed and 23 (30%) had disease recurrence. The positive predictive value (PPV) of FDG-PET/CT was 0.85. Patients >60 years [P = 0.036, hazard ratio (HR) = 3.82, 95% confidence interval (CI) 1.02-7.77] and patients with symptoms indicative of a relapse (P = 0.015; HR = 4.1; 95% CI 1.20-14.03) had a significantly higher risk for relapse. A risk score on the basis of signs of relapse, age >60 years, or a combination of these factors identified patients at high risk for recurrence (P = 0.041). Conclusions: FDG-PET/CT detects recurrent DLBCL after first-line therapy with high PPV. However, it should not be used routinely and if only in selected high-risk patients to reduce radiation burden and costs. On the basis of our retrospective data, FDG-PET/CT during follow-up is indicated for patients <60 years with clinical signs of relapse and in patients >60 years with and without clinical signs of relapse