Positron Emission Tomography/Computed Tomography Findings During Therapy Predict Outcome in Patients With Diffuse Large B-Cell Lymphoma Treated With Chemotherapy Alone but Not in Those Who Receive Consolidation Radiation

Journal Article · Sun Jun 01 04:00:00 EDT 2014 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2014.02.015· OSTI ID:22416586

Hess, Kenneth ^[1]; Shihadeh, Ferial ^[2]; Podoloff, Donald A. ^[3]; Medeiros, L. Jeffrey ^[4]; Mawlawi, Osama ^[5]; Arzu, Isidora ^[2]; Oki, Yasuhiro; Hagemeister, Fredrick B.; Fayad, Luis E. ^[6]; Reed, Valerie K.; Kedir, Aziza; Wogan, Christine F. ^[2]; Rodriguez, Alma ^[7]

---

1. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
3. Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
4. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
5. Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
6. Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
7. Office of the Executive Vice President and Physician-in-Chief, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

Purpose: To assess the value of mid-therapy positron emission tomography (PET) findings for predicting survival and disease progression in patients with diffuse large B-cell lymphoma, considering type of therapy (chemotherapy with or without radiation therapy). Methods and Materials: We retrospectively evaluated 294 patients with histologically confirmed diffuse large B-cell lymphoma with respect to age, sex, disease stage, International Prognostic Index score, mid-therapy PET findings (positive or negative), and disease status after therapy and at last follow-up. Overall survival (OS) and progression-free survival (PFS) were compared according to mid-therapy PET findings. Results: Of the 294 patients, 163 (55%) were male, 144 (49%) were age >61 years, 110 (37%) had stage I or II disease, 219 (74%) had International Prognostic Index score ≤2, 216 (73%) received ≥6 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, and 88 (30%) received consolidation radiation therapy. Five-year PFS and OS rates were associated with mid-therapy PET status: PFS was 78% for those with PET-negative (PET−) disease versus 63% for PET-positive (PET+) disease (P=.024), and OS was 82% for PET− versus 62% for PET+ (P<.002). These associations held true for patients who received chemotherapy only (PFS 71% for PET− vs 52% PET+ [P=.012], OS 78% for PET− and 51% for PET+ [P=.0055]) but not for those who received consolidation radiation therapy (PFS 84% PET− vs 81% PET+ [P=.88]; OS 90% PET− vs 81% PET+ [P=.39]). Conclusion: Mid-therapy PET can predict patient outcome, but the use of consolidation radiation therapy may negate the significance of mid-therapy findings.

• OSTI ID: 22416586
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 89; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
COMPARATIVE EVALUATIONS
DOXORUBICIN
ENDOXAN
LYMPHOMAS
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
PREDNISONE
RADIOTHERAPY