sup 18^F-FDG PET After 2 Cycles of ABVD Predicts Event-Free Survival in Early and Advanced Hodgkin Lymphoma

• Published in: The Journal of nuclear medicine (1978) Vol. 51; no. 9; p. 1337
• Main Authors: Cerci, Juliano J, Pracchia, Luís F, Linardi, Camila C G, Pitella, Felipe A, Delbeke, Dominique, Izaki, Marisa, Trindade, Evelinda, Junior, José Soares, Buccheri, Valeria, Meneghetti, José C
• Format: Journal Article
• Language: English
• Published: New York Society of Nuclear Medicine 01-09-2010
• Subjects: Biopsy; Blood; Chemotherapy; Medical treatment; Mortality; Radiation therapy
• ISSN: 0161-5505; 1535-5667

Our objective was to assess the prognostic value of ^sup 18^F-FDG PET after 2 cycles of chemotherapy using doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in Hodgkin lymphoma (HL) patients overall and in subgroups of patients with early and advanced stages and with low and high risks according to the International Prognostic Score (IPS). Methods: One hundred fifteen patients with newly diagnosed HL were prospectively included in the study. All underwent standard ABVD therapy followed by consolidation radiotherapy in cases of bulky disease. After 2 cycles of ABVD, the patients were evaluated with PET (PET2). Prognostic analysis compared the 3-y event-free survival (EFS) rate to the PET2 results, clinical data, and IPS. Results: Of the 104 evaluated patients, 93 achieved complete remission after first-line therapy. During a median follow-up of 36 mo, relapse or disease progression was seen in 22 patients. Treatment failure was seen in 16 of the 30 PET2-positive patients and in only 6 of the 74 PET2-negative patients. PET2 was the only significant prognostic factor. The 3-y EFS was 53.4% for PET2-positive patients and 90.5% for PET2-negative ones (P < 0.001). When patients were categorized according to low or high IPS risk and according to early or advanced stage of disease, PET2 was also significantly associated with treatment outcome. Conclusion: PET2 is an accurate and independent predictor of EFS in HL. A negative interim ^sup 18^F-FDG PET result is highly predictive of treatment success in overall HL patients, as well as in subgroups with early or advanced-stage disease and with low or high IPS risk. [PUBLICATION ABSTRACT]