The role of FDG‐PET imaging as a prognostic marker of outcome in primary mediastinal B‐cell lymphoma

Cancer Medicine

Sarah J. Nagle¹  Elise A. Chong¹  Seble Chekol⁴  Nirav N. Shah¹  Sunita D. Nasta¹  Eli Glatstein²  John P. Plastaras²  Drew A. Torigian³  Stephen J. Schuster¹ 

[1]Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania

[2]Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania

[3]Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania

[4]Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

关键词: Non‐Hodgkin lymphoma;    positron emission tomography;    prognosis;    R‐CHOP protocol;    treatment outcome;   

DOI  :  10.1002/cam4.322

来源: Wiley

【 摘 要 】

Abstract

Primary mediastinal B-cell lymphoma (PMBL) is a subtype of diffuse large B-cell lymphoma (DLBCL) that arises in the mediastinum from B-cells of thymic origin. Optimal management of patients with PMBL remains controversial. The present study evaluates outcomes of 27 PMBL patients treated with R-CHOP with or without radiation therapy (RT). It investigates the role of both interim and posttreatment fluorodeoxyglucose-positron emission tomography (FDG-PET) as prognostic markers of outcome. Additionally, it assesses postprogression therapies in the six patients who had progressive disease. At a median follow-up of 41.5 months (range: 6.1–147.2 months), OS was 95.5% (95% CI = 71.9–99.4) and progression-free survival (PFS) was 70.4% (95% CI = 49.4–83.9) for the entire cohort. The negative predictive values of interim and posttreatment FDG-PET scans were both 100%. Patients who failed initial therapy and were treated with salvage regimens and autologous stem cell transplantation (ASCT) all achieved and maintained CR. PMBL patients can achieve excellent outcomes with minimal toxicities when treated with R-CHOP with or without RT. Negative interim and negative posttreatment FDG-PET results identified PMBL patients who achieve long-term remission. However, the significance of both positive interim and positive posttreatment FDG-PET results needs to be better defined. Those who failed initial therapy were successfully treated with salvage regimens and ASCT.

【 授权许可】

CC BY   
© 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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