Postchemotherapy PET evaluation correlates with patient outcome in paediatric Hodgkin's disease

Egesta Lopci, Roberta Burnelli, Luca Guerra, Angelina Cistaro, Arnoldo Piccardo, Pietro Zucchetta, Enrico Derenzini, Alessandra Todesco, Alberto Garaventa, Fabio Schumacher, Piero Farruggia, Salvatore Buffardi, Alessandra Sala, Fiorina Casale, Paolo Indolfi, Samanta Biondi, Andrea Pession, Stefano Fanti

Research output: Contribution to journalArticle

Abstract

Aim: To evaluate the role of postchemotherapy FDG PET and compare it with other predictive factors in paediatric Hodgkin's disease (HD). Materials and methods: In this retrospective study, 98 paediatric patients with HD (enrolled in eight Italian centres) were analysed. Their mean age was 13.8 years (range 5-19 years). A PET scan was performed at the end of chemotherapy and reported as positive or negative on the basis of visual and/or semiquantitative analysis. True outcome was defined as remission or disease on the basis of combined criteria (clinical, instrumental and/or histological) with a mean follow-up period of 25 months. Statistical analyses were performed for the postchemotherapy PET results and other potential predictive factors (age cut-off, stage, presence of bulky masses and therapeutic group) with respect to patient outcome and progression-free survival (PFS). Results: Overall the patients had a mean PFS of 23.5 months (range 4-46 months): 87 achieved remission (88.8%) and 11 showed disease. Of the 98 patients, 17 were positive on postchemotherapy PET. Seven patients (41%) showed disease during follow-up, and relapse occurred in only four out of the 81 patients who were negative on PET (p=0.0001). Kaplan-Meier analysis demonstrated significant correlations between PFS and the postchemotherapy PET result (p=0.0001) and a cut-off age at diagnosis of 13.3 years (p=0.0337), whereas disease stage (p=0.7404), therapeutic group (p=0.5240) and presence of bulky masses (p=0.2208) were not significantly correlated with PFS. Multivariate analysis confirmed a statistically significant correlation with PFS only for the postchemotherapy PET findings (p=0.0009). Conclusion: In paediatric HD, age at diagnosis and postchemotherapy PET results are the main predictors of patient outcome and PFS, with FDG PET being the only independent predictive factor for PFS.

Original languageEnglish
Pages (from-to)1620-1627
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume38
Issue number9
DOIs
Publication statusPublished - Sep 2011

Keywords

  • FDG PET
  • Hodgkin's disease
  • Paediatric lymphoma
  • Patient outcome
  • PFS
  • Predictive factors

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Lopci, E., Burnelli, R., Guerra, L., Cistaro, A., Piccardo, A., Zucchetta, P., Derenzini, E., Todesco, A., Garaventa, A., Schumacher, F., Farruggia, P., Buffardi, S., Sala, A., Casale, F., Indolfi, P., Biondi, S., Pession, A., & Fanti, S. (2011). Postchemotherapy PET evaluation correlates with patient outcome in paediatric Hodgkin's disease. European Journal of Nuclear Medicine and Molecular Imaging, 38(9), 1620-1627. https://doi.org/10.1007/s00259-011-1836-7