The IELSG 26 study was designed to evaluate the role of 18-Fluorodeoxyglucose Positron-Emission Tomography/computed tomography (18FDG PET/CT) in the management of primary mediastinal (thymic) large B-cell lymphoma (PMBCL). We examined the prognostic impact of functional PET parameters at diagnosis. The metabolic activity defined by maximum standardized uptake value (SUVmax), the metabolic tumor volume (MTV) and the total lesion glycolysis (TLG) were measured on baseline 18FDG PET/CT following a standard protocol in a prospectively enrolled cohort of 103 PMBCL patients. All received combination chemoimmunotherapy with doxorubicin and rituximab-based regimens; 93 had consolidation radiotherapy. Cut-offs were determined using the receiver operating characteristic curve. At a median follow-up of 36 months, PFS and OS rates were 87\% and 94\%, respectively. In univariate analysis, elevated MTV and TLG, were significantly associated with worse PFS and OS. Only TLG retained statistical significance for both OS (p=0.001) and PFS (p<0.001) in multivariate analysis. At 5 years, OS was 100\% for patients with low TLG vs. 80\% for those with high TLG (p=0.0001) while PFS was 99\% vs. 64\%, respectively (p<0.0001). TLG on baseline PET appeared to be a powerful predictor of PMBCL outcomes and warrants further validation as a biomarker. The IELSG 26 study is registered to www.clinicaltrials.gov as NCT00944567.
Utility of baseline 18FDG PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma / L. Ceriani;M. Martelli;P. L. Zinzani;A. J. M;B. Botto;C. Stelitano;M. Gotti;M. G. Cabras;L. Rigacci;L. Gargantini;F. Merli;G. Pinotti;D. Mannina;S. Luminari;A. Stathis;E. Russo;F. Cavalli;L. Giovanella;P. W. M;E. Zucca. - In: BLOOD. - ISSN 0006-4971. - STAMPA. - 126:8(2015), pp. 950-956. [10.1182/blood-2014-12-616474]
Utility of baseline 18FDG PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma
ZINZANI, PIER LUIGI;
2015
Abstract
The IELSG 26 study was designed to evaluate the role of 18-Fluorodeoxyglucose Positron-Emission Tomography/computed tomography (18FDG PET/CT) in the management of primary mediastinal (thymic) large B-cell lymphoma (PMBCL). We examined the prognostic impact of functional PET parameters at diagnosis. The metabolic activity defined by maximum standardized uptake value (SUVmax), the metabolic tumor volume (MTV) and the total lesion glycolysis (TLG) were measured on baseline 18FDG PET/CT following a standard protocol in a prospectively enrolled cohort of 103 PMBCL patients. All received combination chemoimmunotherapy with doxorubicin and rituximab-based regimens; 93 had consolidation radiotherapy. Cut-offs were determined using the receiver operating characteristic curve. At a median follow-up of 36 months, PFS and OS rates were 87\% and 94\%, respectively. In univariate analysis, elevated MTV and TLG, were significantly associated with worse PFS and OS. Only TLG retained statistical significance for both OS (p=0.001) and PFS (p<0.001) in multivariate analysis. At 5 years, OS was 100\% for patients with low TLG vs. 80\% for those with high TLG (p=0.0001) while PFS was 99\% vs. 64\%, respectively (p<0.0001). TLG on baseline PET appeared to be a powerful predictor of PMBCL outcomes and warrants further validation as a biomarker. The IELSG 26 study is registered to www.clinicaltrials.gov as NCT00944567.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
