Prognostic Value of Very Early Interim FDG PET/CT After Single Cycle of Chemotherapy for 10-Year Survival in Diffuse Large B-Cell Lymphoma
Background/Objectives This study aimed to evaluate whether very early interim 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after a single cycle of first-line chemotherapy predicts long-term survival outcome in patients with diffuse large B-cell lymphoma...
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| Published in | Cancers Vol. 17; no. 6; p. 926 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
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MDPI AG
08.03.2025
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| ISSN | 2072-6694 2072-6694 |
| DOI | 10.3390/cancers17060926 |
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| Abstract | Background/Objectives This study aimed to evaluate whether very early interim 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after a single cycle of first-line chemotherapy predicts long-term survival outcome in patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 51 patients (31 males and 20 females; mean age 55 years) had four FDG PET/CT studies, at baseline and after one, three, and six cycles of chemotherapy (PET0, PET1, PET3, and PET6). Visually and quantitatively assessed PET parameters were analyzed for associations with long-term survival. Results The estimated 10-year progression-free survival (PFS) and overall survival (OS) was 48% and 61%, respectively. During a median follow-up of 63 months (range 9–134), 17 patients (33%) exhibited disease progression and 15 (29%) died. On PET1, all but one showed decreased FDG uptake, and all showed decreased metabolic tumor volume. None of the PET1 or PET3 parameters were associated with survival. The PET6 parameters retained independent predictive value for OS after adjustment for the International Prognostic Index. Negative PET6 was associated with longer PFS (mean 99 vs. 50 mo, p = 0.04) and OS (mean 107 vs. 57 mo, p = 0.02). Con-clusions The FDG PET/CT parameters obtained after a single cycle of chemotherapy were not associated with long-term survival in DLBCL, while negative end-of-therapy FDG PET/CT was associated with longer PFS and OS. Tumor regression very early into first-line chemotherapy was not as clinically relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes. |
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| AbstractList | Background/Objectives This study aimed to evaluate whether very early interim 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after a single cycle of first-line chemotherapy predicts long-term survival outcome in patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 51 patients (31 males and 20 females; mean age 55 years) had four FDG PET/CT studies, at baseline and after one, three, and six cycles of chemotherapy (PET0, PET1, PET3, and PET6). Visually and quantitatively assessed PET parameters were analyzed for associations with long-term survival. Results The estimated 10-year progression-free survival (PFS) and overall survival (OS) was 48% and 61%, respectively. During a median follow-up of 63 months (range 9–134), 17 patients (33%) exhibited disease progression and 15 (29%) died. On PET1, all but one showed decreased FDG uptake, and all showed decreased metabolic tumor volume. None of the PET1 or PET3 parameters were associated with survival. The PET6 parameters retained independent predictive value for OS after adjustment for the International Prognostic Index. Negative PET6 was associated with longer PFS (mean 99 vs. 50 mo, p = 0.04) and OS (mean 107 vs. 57 mo, p = 0.02). Con-clusions The FDG PET/CT parameters obtained after a single cycle of chemotherapy were not associated with long-term survival in DLBCL, while negative end-of-therapy FDG PET/CT was associated with longer PFS and OS. Tumor regression very early into first-line chemotherapy was not as clinically relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes. Through FDG PET/CT obtained at four different time points, lymphoma lesions were followed during first-line therapy and FDG PET/CT had prognostic value for long-term survival at 10 years. The rate of tumor regression very early into first-line chemotherapy was not as relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes. Background/Objectives This study aimed to evaluate whether very early interim 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after a single cycle of first-line chemotherapy predicts long-term survival outcome in patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 51 patients (31 males and 20 females; mean age 55 years) had four FDG PET/CT studies, at baseline and after one, three, and six cycles of chemotherapy (PET0, PET1, PET3, and PET6). Visually and quantitatively assessed PET parameters were analyzed for associations with long-term survival. Results The estimated 10-year progression-free survival (PFS) and overall survival (OS) was 48% and 61%, respectively. During a median follow-up of 63 months (range 9-134), 17 patients (33%) exhibited disease progression and 15 (29%) died. On PET1, all but one showed decreased FDG uptake, and all showed decreased metabolic tumor volume. None of the PET1 or PET3 parameters were associated with survival. The PET6 parameters retained independent predictive value for OS after adjustment for the International Prognostic Index. Negative PET6 was associated with longer PFS (mean 99 vs. 50 mo, p = 0.04) and OS (mean 107 vs. 57 mo, p = 0.02). Con-clusions The FDG PET/CT parameters obtained after a single cycle of chemotherapy were not associated with long-term survival in DLBCL, while negative end-of-therapy FDG PET/CT was associated with longer PFS and OS. Tumor regression very early into first-line chemotherapy was not as clinically relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes.Background/Objectives This study aimed to evaluate whether very early interim 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after a single cycle of first-line chemotherapy predicts long-term survival outcome in patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 51 patients (31 males and 20 females; mean age 55 years) had four FDG PET/CT studies, at baseline and after one, three, and six cycles of chemotherapy (PET0, PET1, PET3, and PET6). Visually and quantitatively assessed PET parameters were analyzed for associations with long-term survival. Results The estimated 10-year progression-free survival (PFS) and overall survival (OS) was 48% and 61%, respectively. During a median follow-up of 63 months (range 9-134), 17 patients (33%) exhibited disease progression and 15 (29%) died. On PET1, all but one showed decreased FDG uptake, and all showed decreased metabolic tumor volume. None of the PET1 or PET3 parameters were associated with survival. The PET6 parameters retained independent predictive value for OS after adjustment for the International Prognostic Index. Negative PET6 was associated with longer PFS (mean 99 vs. 50 mo, p = 0.04) and OS (mean 107 vs. 57 mo, p = 0.02). Con-clusions The FDG PET/CT parameters obtained after a single cycle of chemotherapy were not associated with long-term survival in DLBCL, while negative end-of-therapy FDG PET/CT was associated with longer PFS and OS. Tumor regression very early into first-line chemotherapy was not as clinically relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes. Through FDG PET/CT obtained at four different time points, lymphoma lesions were followed during first-line therapy and FDG PET/CT had prognostic value for long-term survival at 10 years. The rate of tumor regression very early into first-line chemotherapy was not as relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes. Background/Objectives This study aimed to evaluate whether very early interim 18 F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after a single cycle of first-line chemotherapy predicts long-term survival outcome in patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 51 patients (31 males and 20 females; mean age 55 years) had four FDG PET/CT studies, at baseline and after one, three, and six cycles of chemotherapy (PET0, PET1, PET3, and PET6). Visually and quantitatively assessed PET parameters were analyzed for associations with long-term survival. Results The estimated 10-year progression-free survival (PFS) and overall survival (OS) was 48% and 61%, respectively. During a median follow-up of 63 months (range 9–134), 17 patients (33%) exhibited disease progression and 15 (29%) died. On PET1, all but one showed decreased FDG uptake, and all showed decreased metabolic tumor volume. None of the PET1 or PET3 parameters were associated with survival. The PET6 parameters retained independent predictive value for OS after adjustment for the International Prognostic Index. Negative PET6 was associated with longer PFS (mean 99 vs. 50 mo, p = 0.04) and OS (mean 107 vs. 57 mo, p = 0.02). Con-clusions The FDG PET/CT parameters obtained after a single cycle of chemotherapy were not associated with long-term survival in DLBCL, while negative end-of-therapy FDG PET/CT was associated with longer PFS and OS. Tumor regression very early into first-line chemotherapy was not as clinically relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes. Background/Objectives This study aimed to evaluate whether very early interim F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after a single cycle of first-line chemotherapy predicts long-term survival outcome in patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 51 patients (31 males and 20 females; mean age 55 years) had four FDG PET/CT studies, at baseline and after one, three, and six cycles of chemotherapy (PET0, PET1, PET3, and PET6). Visually and quantitatively assessed PET parameters were analyzed for associations with long-term survival. Results The estimated 10-year progression-free survival (PFS) and overall survival (OS) was 48% and 61%, respectively. During a median follow-up of 63 months (range 9-134), 17 patients (33%) exhibited disease progression and 15 (29%) died. On PET1, all but one showed decreased FDG uptake, and all showed decreased metabolic tumor volume. None of the PET1 or PET3 parameters were associated with survival. The PET6 parameters retained independent predictive value for OS after adjustment for the International Prognostic Index. Negative PET6 was associated with longer PFS (mean 99 vs. 50 mo, = 0.04) and OS (mean 107 vs. 57 mo, = 0.02). Con-clusions The FDG PET/CT parameters obtained after a single cycle of chemotherapy were not associated with long-term survival in DLBCL, while negative end-of-therapy FDG PET/CT was associated with longer PFS and OS. Tumor regression very early into first-line chemotherapy was not as clinically relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes. Simple SummaryThrough FDG PET/CT obtained at four different time points, lymphoma lesions were followed during first-line therapy and FDG PET/CT had prognostic value for long-term survival at 10 years. The rate of tumor regression very early into first-line chemotherapy was not as relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes. |
| Audience | Academic |
| Author | Han, Eun Ji Cho, Seok-Goo Park, Gyeongsin Park, Hye Lim Yahng, Seung-Ah O, Joo Hyun Choi, Byung-Ock Min, Gi-June |
| AuthorAffiliation | 6 Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; gspark@catholic.ac.kr 4 Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; beichest@catholic.ac.kr 7 Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea 1 Division of Nuclear Medicine, Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; iwao@catholic.ac.kr 3 Department of Hematology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; saymd@catholic.ac.kr 2 Division of Nuclear Medicine, Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Kor |
| AuthorAffiliation_xml | – name: 3 Department of Hematology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; saymd@catholic.ac.kr – name: 1 Division of Nuclear Medicine, Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; iwao@catholic.ac.kr – name: 2 Division of Nuclear Medicine, Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; prhlim@gmail.com – name: 5 Department of Radiation Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; choibo67@catholic.ac.kr – name: 6 Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; gspark@catholic.ac.kr – name: 7 Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea – name: 4 Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; beichest@catholic.ac.kr |
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| Cites_doi | 10.1007/s00259-018-4103-3 10.1200/JCO.2017.76.8093 10.1093/annonc/mds517 10.1016/j.cpet.2019.03.001 10.1148/rg.220122 10.2967/jnumed.107.042093 10.1002/cncr.22276 10.1007/s00259-018-4198-6 10.1186/s40658-023-00540-z 10.1182/blood.2019003277 10.1111/bjh.16875 10.1097/RLU.0000000000003378 10.1200/JCO.2014.58.9846 10.1148/radiol.2016142043 10.1182/bloodadvances.2021004467 10.3109/10428194.2014.975800 10.1182/blood-2011-06-359943 10.1016/j.radonc.2023.109902 10.1002/hon.2613 10.1182/blood.2019002729 10.3390/diagnostics10121002 10.3390/cancers13205222 10.1200/JCO.2013.54.8800 10.1016/S2352-3026(20)30357-4 10.2967/jnumed.108.057307 10.1200/JCO.2009.24.5860 10.1007/s00259-014-2961-x |
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| Snippet | Background/Objectives This study aimed to evaluate whether very early interim 18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed... Background/Objectives This study aimed to evaluate whether very early interim F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed... Through FDG PET/CT obtained at four different time points, lymphoma lesions were followed during first-line therapy and FDG PET/CT had prognostic value for... Simple SummaryThrough FDG PET/CT obtained at four different time points, lymphoma lesions were followed during first-line therapy and FDG PET/CT had prognostic... |
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| SubjectTerms | B-cell lymphoma Cancer Care and treatment Cell survival Chemotherapy Development and progression Liver Lymphocytes B Lymphoma Medical prognosis Metabolism Non-Hodgkin's lymphomas Nuclear medicine Patients PET imaging Survival analysis Tomography Tumors Vincristine |
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| Title | Prognostic Value of Very Early Interim FDG PET/CT After Single Cycle of Chemotherapy for 10-Year Survival in Diffuse Large B-Cell Lymphoma |
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