Fluorodeoxyglucose positron emission tomography-computed tomography after doxorubicin-bleomycin-vinblastine-dacarbazine chemotherapy predicts event-free survival in Hodgkin's lymphoma
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摘要:
目的 评估18氟-氟代脱氧葡萄糖-正电子发射计算机断层显像(fluorine-18 fluorodeoxyglucose positron emission tomography, 18F-FDG PET/CT)对接受4个周期阿霉素、博来霉素、长春新碱、达卡巴嗪(ABVD)方案化疗的霍奇金淋巴瘤(Hodgkin's lymphoma, HL)患者预后的预测价值。 方法 回顾分析2005年8月至2009年7月共62例初治的霍奇金淋巴瘤患者在接受4个周期ABVD方案化疗后18F-FDG PET/CT的检查结果, 并与3年无事件生存率(EFS)、3年总生存率(OS)进行比较, 评价其对接受4个周期ABVD方案化疗的霍奇金淋巴瘤患者无事件生存的预测价值。 结果 治疗结束后, PET/CT阳性患者18例, 其中11例患者(61.1%)治疗失败, PET/CT阴性患者46例, 其中5例患者(11.4%)治疗失败, PET/CT阳性组的治疗失败率显著高于阴性组(P < 0.01)。PET/CT阳性组和PET/CT阴性组患者的3年EFS分别是44.4%和81.8%(P < 0.01), 单因素分析显示PET/CT是霍奇金淋巴瘤患者3年EFS的独立预测因素(P < 0.01)。 结论 PET-CT是预测HL患者在接受4个周期ABVD方案化疗后EFS的可靠方法。 -
关键词:
- 霍奇金淋巴瘤 /
- 18氟-氟代脱氧葡萄糖 /
- 正电子发射计算机断层显像 /
- 预后
Abstract:Objective To evaluate the prognostic value of fluorodeoxyglucose(18F-FDG) positron emission tomography-computed tomography(PET/CT) after four cycles of chemotherapy using doxorubicin, bleomycin, vinblastine, and dacarbazine(ABVD) for Hodgkin's lymphoma(HL) patients. Methods The data of 62 HL patients were retrospectively analyzed between August 2005 and July 2009. All patients underwent standard ABVD therapy. After four cycles of ABVD, the patients were evaluated with 18F-FDG PET/CT. The prognostic value of 18F-FDG PET/CT in HL was analyzed. Results Treatment failure was seen in 11 of the 18 PET/CT-positive patients(61.1%) and in only 5 of the 46 PET/CT-negative patients(11.4%). The treatment failure rate in PET/CT-positive patients was significantly higher than in the PET/CT-negative ones(P < 0.01). The three-year event-free survival(EFS) was 44.4% for PET/CT-positive patients and 81.8% for PET/CT-negative ones(P < 0.01). Univariate survival analysis revealed that 18F-FDG PET/CT was the independent predictive factor of three-year EFS for patients with HL(P < 0.01). Conclusion After four cycles of ABVD chemotherapy, PET/CT is found to be an independent predictor of EFS in HL. However, due to the limited number of patients in this study, the conclusion needs to be confirmed. -
图 1 PET/CT阳性组和阴性组患者的3年EFS生存曲线
Figure 1. Three-year event-free survival (EFS) curves of patients with different PET/CT results
图 2 IPS高危组PET/CT阳性组和阴性组患者的3年EFS曲线
Figure 2. Three-year EFS curves of patients with different PET/CT results in IPS high-risk group
图 3 不同病理分期患者3年EFS
Figure 3. EFS of patients in different pathological stages
A: Three-year EFS curves of patients with different PET/CT results in Stages Ⅰto Ⅱ Hodgkin's lymphoma. B: Three-year EFS curves of patients with different PET/CT results in Stages Ⅲto Ⅳ Hodgkin's lymphoma
表 1 霍奇金淋巴瘤（HL）患者临床病例资料及预后分析
Table 1. Clinical characteristics of Hodgkin's lymphoma patients and univariate survival analysis
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