Prognostic value of baseline metabolic tumor volume in early-stage Hodgkin lymphoma in the standard arm of the H10 trial

被引：147

作者：

Cottereau, Anne-Segolene ^{[1
]}

Versari, Annibale ^{[2
]}

Loft, Annika ^{[3
]}

Casasnovas, Olivier ^{[4
]}

Bellei, Monica ^{[5
]}

Ricci, Romain ^{[6
]}

Bardet, Stephane ^{[7
]}

Castagnoli, Antonio ^{[8
]}

Brice, Pauline ^{[9
]}

Raemaekers, John ^{[10
]}

Deau, Benedicte ^{[11
]}

Fortpied, Catherine ^{[12
]}

Raveloarivahy, Tiana ^{[12
]}

Van Zele, Emelie ^{[6
]}

Chartier, Loic ^{[13
]}

Borght, Thierry Vander ^{[14
]}

Federico, Massimo ^{[5
]}

Hutchings, Martin ^{[15
]}

Ricardi, Umberto ^{[16
]}

Andre, Marc ^{[17
]}

Meignan, Michel ^{[18
,19
]}

机构：

[1] Paris Descartes Univ, AP HP, Dept Nucl Med, Cochin Hosp,AP HP, Paris, France

[2] Santa Maria Nuova Hosp, IRCCS Reggio Emilia, Reggio Emilia, Italy

[3] Copenhagen Univ Hosp, Nucl Med, Dept Clin Physiol, Rigshosp, Copenhagen, Denmark

[4] Univ Hosp, Hematol Dept, INSERM 1231, Dijon, France

[5] Univ Modena & Reggio Emilia, Dept Diagnost Clin & Publ Hlth Med, Modena, Italy

[6] Hop Henri Mondor, Lymphoma Acad Res Org LYSARC Lymphoma Study Assoc, Creteil, France

[7] Ctr Lutte Canc Francois Baclesse, Dept Nucl Med, Caen, France

[8] Osped Santo Stefano, Nucl Med Unit, Prato, Italy

[9] Hop St Louis, AP HP, Hematol, Paris, France

[10] Radboud Univ Nijmegen, Med Ctr, Hematol, Nijmegen, Netherlands

[11] Hop Cochin, Hematol, Paris, France

[12] European Org Res Treatment Canc, Brussels, Belgium

[13] Ctr Hosp Lyon Sud, LYSARC, Biostat Dept, Lyon, France

[14] Catholic Univ Louvain, Ctr Hosp Univ, Nucl Med Div, Namur, Yvoir, Belgium

[15] Copenhagen Univ Hosp, Rigshosp, Dept Hematol, Copenhagen, Denmark

[16] Univ Turin, Dept Oncol, Turin, Italy

[17] Catholic Univ Louvain, Ctr Hosp Univ, Hematol Dept, Namur, Yvoir, Belgium

[18] Hop Henri Mondor, Lymphoma Study Assoc Imaging, Creteil, France

[19] Univ Paris Est, Creteil, France

来源：

BLOOD | 2018年 / 131卷 / 13期

关键词：

INTERIM-PET SCAN; B-CELL LYMPHOMA; ADAPTED TREATMENT; FDG-PET/CT; DISEASE; TOMOGRAPHY; BURDEN; RISK; MULTICENTER; PREDICTION;

D O I：

10.1182/blood-2017-07-795476

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We tested baseline positron emission tomography (PET)/computed tomography (CT) as a measure of total tumor burden to better identify high-risk patients with early-stage Hodgkin lymphoma (HL). Patients with stage I-II HL enrolled in the standard arm (combined modality treatment) of the H10 trial (NCT00433433) with available baseline PET and interim PET (iPET2) after 2 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine were included. Total metabolic tumor volume (TMTV) was measured on baseline PET. iPET2 findings were reported negative (DS1-3) or positive (DS4-5) with the Deauville scale (DS). The prognostic value of TMTV was evaluated and compared with baseline characteristics, staging classifications, and iPET2. A total of 258 patients were eligible: 101 favorable and 157 unfavorable. The median follow-up was 55 months, with 27 progression-free survival (PFS) and 12 overall survival (OS) events. TMTV was a prognosticator of PFS (P < .0001) and OS (P = .0001), with 86% and 84% specificity, respectively. Five-year PFS and OS were 71% and 83% in the high-TMTV (>147 cm(3)) group (n = 46), respectively, vs 92% and 98% in the low-TMTV group (<= 147 cm(3)). In multi-variable analysis including iPET2, TMTV was the only baseline prognosticator compared with the current staging systems proposed by the European Organization for Research and Treatment of Cancer/Groupe d'Etude des Lymphomes de l'Adulte, German Hodgkin Study Group, or National Comprehensive Cancer Network. TMTV and iPET2 were independently prognostic and, combined, identified 4 risk groups: low (TMTV <= 147 + DS1-3; 5-year PFS, 95%), low-intermediate (TMTV> 147 + DS1-3; 5-year PFS, 81.6%), high-intermediate (TMTV <= 147 + DS4-5; 5-year PFS, 50%), and high (TMTV> 147 + DS4-5; 5-year PFS, 25%). TMTV improves baseline risk stratification of patients with early-stage HL compared with current staging systems and the predictive value of early PET response as well.

引用

页码：1456 / 1463

页数：8

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