Abstract
Purpose: Starting from November 2001, 260 newly diagnosed patients with Hodgkin's lymphoma (HL) were consecutively enrolled in parallel Italian and Danish prospective trials to evaluate the prognostic role of an early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) scan and the International Prognostic Score (IPS) in advanced HL, treated with conventional ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) therapy. Patients and Methods: Most patients (n = 190) presented with advanced disease (stages IIB through IVB), whereas 70 presented in stage IIA with adverse prognostic factors. All but 11 patients were treated with standard ABVD therapy followed by consolidation radiotherapy in case of bulky presentation or residual tumor mass. Conventional radiologic staging was performed at baseline. FDG-PET scan was performed at baseline and after two courses of ABVD (PET-2). No treatment change was allowed on the basis of the PET-2 results. Results: After a median follow-up of 2.19 years (range, 0.32 to 5.18 years), 205 patients were in continued complete remission and two patients were in partial remission. Forty-three patients progressed during therapy or immediately after, whereas 10 patients relapsed. The 2-year progression-free survival for patients with positive PET-2 results was 12.8% and for patients with negative PET-2 results was 95.0% (P <.0001). In univariate analysis, the treatment outcome was significantly associated with PET-2 (P <.0001), stage IV (P <.0001), WBC more than 15,000 (P <.0001), lymphopenia (P <.001), IPS as a continuous variable (P <.0001), extranodal involvement (P <.0001), and bulky disease (P = .012). In multivariate analyses, only PET-2 turned out to be significant (P <.0001). Conclusion: PET-2 overshadows the prognostic value of IPS and emerges as the single most important tool for planning of risk-adapted treatment in advanced HL.
| Original language | English |
|---|---|
| Pages (from-to) | 3746-3752 |
| Number of pages | 7 |
| Journal | Journal of Clinical Oncology |
| Volume | 25 |
| Issue number | 24 |
| DOIs | |
| Publication status | Published - Aug 20 2007 |
Fingerprint
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma : A report from a joint Italian-Danish study. / Gallamini, Andrea; Hutchings, Martin; Rigacci, Luigi; Specht, Lena; Merli, Francesco; Hansen, Mads; Patti, Caterina; Loft, Annika; Di Raimondo, Francesco; D'Amore, Francesco; Biggi, Alberto; Vitolo, Umberto; Stelitano, Caterina; Sancetta, Rosario; Trentin, Livio; Luminari, Stefano; Iannitto, Emilio; Viviani, Simonetta; Pierri, Ivana; Levis, Alessandro.
In: Journal of Clinical Oncology, Vol. 25, No. 24, 20.08.2007, p. 3746-3752.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma
T2 - A report from a joint Italian-Danish study
AU - Gallamini, Andrea
AU - Hutchings, Martin
AU - Rigacci, Luigi
AU - Specht, Lena
AU - Merli, Francesco
AU - Hansen, Mads
AU - Patti, Caterina
AU - Loft, Annika
AU - Di Raimondo, Francesco
AU - D'Amore, Francesco
AU - Biggi, Alberto
AU - Vitolo, Umberto
AU - Stelitano, Caterina
AU - Sancetta, Rosario
AU - Trentin, Livio
AU - Luminari, Stefano
AU - Iannitto, Emilio
AU - Viviani, Simonetta
AU - Pierri, Ivana
AU - Levis, Alessandro
PY - 2007/8/20
Y1 - 2007/8/20
N2 - Purpose: Starting from November 2001, 260 newly diagnosed patients with Hodgkin's lymphoma (HL) were consecutively enrolled in parallel Italian and Danish prospective trials to evaluate the prognostic role of an early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) scan and the International Prognostic Score (IPS) in advanced HL, treated with conventional ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) therapy. Patients and Methods: Most patients (n = 190) presented with advanced disease (stages IIB through IVB), whereas 70 presented in stage IIA with adverse prognostic factors. All but 11 patients were treated with standard ABVD therapy followed by consolidation radiotherapy in case of bulky presentation or residual tumor mass. Conventional radiologic staging was performed at baseline. FDG-PET scan was performed at baseline and after two courses of ABVD (PET-2). No treatment change was allowed on the basis of the PET-2 results. Results: After a median follow-up of 2.19 years (range, 0.32 to 5.18 years), 205 patients were in continued complete remission and two patients were in partial remission. Forty-three patients progressed during therapy or immediately after, whereas 10 patients relapsed. The 2-year progression-free survival for patients with positive PET-2 results was 12.8% and for patients with negative PET-2 results was 95.0% (P <.0001). In univariate analysis, the treatment outcome was significantly associated with PET-2 (P <.0001), stage IV (P <.0001), WBC more than 15,000 (P <.0001), lymphopenia (P <.001), IPS as a continuous variable (P <.0001), extranodal involvement (P <.0001), and bulky disease (P = .012). In multivariate analyses, only PET-2 turned out to be significant (P <.0001). Conclusion: PET-2 overshadows the prognostic value of IPS and emerges as the single most important tool for planning of risk-adapted treatment in advanced HL.
AB - Purpose: Starting from November 2001, 260 newly diagnosed patients with Hodgkin's lymphoma (HL) were consecutively enrolled in parallel Italian and Danish prospective trials to evaluate the prognostic role of an early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) scan and the International Prognostic Score (IPS) in advanced HL, treated with conventional ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) therapy. Patients and Methods: Most patients (n = 190) presented with advanced disease (stages IIB through IVB), whereas 70 presented in stage IIA with adverse prognostic factors. All but 11 patients were treated with standard ABVD therapy followed by consolidation radiotherapy in case of bulky presentation or residual tumor mass. Conventional radiologic staging was performed at baseline. FDG-PET scan was performed at baseline and after two courses of ABVD (PET-2). No treatment change was allowed on the basis of the PET-2 results. Results: After a median follow-up of 2.19 years (range, 0.32 to 5.18 years), 205 patients were in continued complete remission and two patients were in partial remission. Forty-three patients progressed during therapy or immediately after, whereas 10 patients relapsed. The 2-year progression-free survival for patients with positive PET-2 results was 12.8% and for patients with negative PET-2 results was 95.0% (P <.0001). In univariate analysis, the treatment outcome was significantly associated with PET-2 (P <.0001), stage IV (P <.0001), WBC more than 15,000 (P <.0001), lymphopenia (P <.001), IPS as a continuous variable (P <.0001), extranodal involvement (P <.0001), and bulky disease (P = .012). In multivariate analyses, only PET-2 turned out to be significant (P <.0001). Conclusion: PET-2 overshadows the prognostic value of IPS and emerges as the single most important tool for planning of risk-adapted treatment in advanced HL.
UR - http://www.scopus.com/inward/record.url?scp=34548486030&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34548486030&partnerID=8YFLogxK
U2 - 10.1200/JCO.2007.11.6525
DO - 10.1200/JCO.2007.11.6525
M3 - Article
C2 - 17646666
AN - SCOPUS:34548486030
VL - 25
SP - 3746
EP - 3752
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 24
ER -