FDG–PET for assessment of early treatment response after four cycles of chemotherapy in patients with advanced-stage Hodgkin's lymphoma has a high negative predictive value

• Published in: Annals of oncology Vol. 20; no. 7; pp. 1270 - 1274
• Main Authors: Markova, J., Kobe, C., Skopalova, M., Klaskova, K., Dedeckova, K., Plütschow, A., Eich, H.T., Dietlein, M., Engert, A., Kozak, T.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-07-2009; Oxford University Press; Oxford Publishing Limited (England)
• Subjects: Adolescent; Adult; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; BEACOPP; Biological and medical sciences; Bleomycin - administration & dosage; chemotherapy; Cyclophosphamide - administration & dosage; Disease Progression; Doxorubicin - administration & dosage; Etoposide - administration & dosage; Female; Fluorodeoxyglucose F18 - administration & dosage; Hematologic and hematopoietic diseases; Hodgkin Disease - diagnostic imaging; Hodgkin Disease - drug therapy; Hodgkin's lymphoma; Humans; Kaplan-Meier Estimate; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Middle Aged; PET; Pharmacology. Drug treatments; Positron-Emission Tomography - methods; Predictive Value of Tests; Prednisone - administration & dosage; Procarbazine - administration & dosage; Prognosis; Radiopharmaceuticals - administration & dosage; response assessment; Treatment Outcome; Vincristine - administration & dosage; Young Adult; response assessment; chemotherapy; PET; BEACOPP; Hodgkin's lymphoma; Radionuclide study; Human; Evaluation; 2-deoxy-2-fluoroglucose; Treatment efficiency; Patient; Hodgkin disease; Early stage; Malignant hemopathy; Lymphoma; Cycle; Chemotherapy; Treatment; Lymphoproliferative syndrome; Predictive value; Advanced stage; Positron emission tomography; Cancer
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdn768

Background: As positron emission tomography (PET) seems to be a powerful prognostic marker in the treatment of Hodgkin's lymphoma (HL), we analysed the prognostic value of PET after four cycles of combination therapy with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone (BEACOPP) in patients with advanced-stage HL.
Patients and methods: From January 2004 to March 2007, 50 patients with newly diagnosed HL in clinical stages IIB with large mediastinal mass or extranodal disease, III and IV were treated according to the HD15 protocol of the German Hodgkin Study Group. All patients received a PET scan after four cycles of BEACOPP (PET-4).
Results: Of the overall group, 14 of 50 patients had a positive PET-4 while 36 had a negative PET-4. At a median observation time of 25 months, 2 of the 14 patients with a positive PET-4 had progressed or relapsed, while there was no progression or relapse in PET-4-negative patients.
Conclusion: Our results indicate a very good negative predictive value of PET-4 in advanced-stage HL patients treated with BEACOPP.