Skip Navigation LinksHome > October 2013 - Volume 34 - Issue 10 > Predictive value of interim 18F-FDG-PET/CT for event-free su...
Nuclear Medicine Communications:
doi: 10.1097/MNM.0b013e328363c695
Original Articles

Predictive value of interim 18F-FDG-PET/CT for event-free survival in patients with diffuse large B-cell lymphoma homogenously treated in a phase II trial with six cycles of R-CHOP-14 plus pegfilgrastim as first-line treatment

González-Barca, Evaa; Canales, Miguele; Cortés, Montseb; Vidal, M. Jesusg; Salar, Antonioc; Oriol, Albertd; Bargay, Joanh; Bello, José L.i; Sánchez, José J.j; Tomás, José F.f; Donato, Evak; Ferrer, Secundinol; Caballero, Doloresm; on behalf of the GELTAMO (Grupo Español de Linfoma y Trasplante de Médula Ósea)

Collapse Box


Objective: The predictive value of interim PET/computed tomography (I-PET/CT) in diffuse large B-cell lymphoma (DLBCL) is controversial. Our aim was to evaluate the predictive value of I-PET/CT for an event-free survival.

Patients and methods: We analyzed patients with DLBCL included in a prospective clinical trial who were treated with six cycles of dose-dense R-CHOP followed by pegfilgrastim and who had undergone an I-PET/CT (after two cycles) and a final PET [F-PET/CT (60 days after the sixth cycle)]. Event was defined as nonresponse, relapse, or death.

Results: A total of 69 patients were included. Their median age was 60 years; 54% were male, 25% had bulky disease, and 67% had an International Prognostic Index of 0–2. The median follow-up duration was 28.8 months. I-PET/CT was positive in 34 (49%) patients and F-PET/CT was positive in 12 (17.4%). The 3-year event-free survival was 86% for patients who were I-PET/CT negative as against 64% for those who were I-PET/CT positive (P=0.036). The negative and positive predictive values, sensitivity, and specificity of I-PET/CT for an event were 83, 32, 65, and 56%, respectively. In a multivariate analysis including baseline characteristics, I-PET/CT, and F-PET/CT, F-PET/CT was the only significant predictor (P<0.0005).

Conclusion: In patients with DLBCL treated with dose-dense R-CHOP plus pegfilgrastim, a negative I-PET/CT is highly predictive of a favorable outcome and a positive I-PET/CT is of limited clinical value. These results do not support treatment intensification after a short course of chemotherapy based solely on a positive I-PET/CT.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.