Prognostic value of the baseline 18F-FDG PET/CT metabolic tumour volume (MTV) and further stratification in low-intermed
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ORIGINAL ARTICLE
Prognostic value of the baseline 18F‑FDG PET/CT metabolic tumour volume (MTV) and further stratification in low‑intermediate (L‑I) and high‑intermediate (H‑I) risk NCCNIPI subgroup by MTV in DLBCL MTV predict prognosis in DLBCL Peng Zhao1 · Tao Yu2 · Zheng Pan2 Received: 3 August 2020 / Accepted: 16 September 2020 © The Author(s) 2020
Abstract Introduction In the era of rituximab, the NCCNIPI is widely used in clinical practice as a tool for the prognosis and risk stratification of diffuse large B-cell lymphoma (DLBCL). In recent years, FDG PET/CT has also shown unique prognostic value. We try to further confirm the prognostic role of metabolic parameters in the overall and subgroups patients. Methods We retrospectively analysed 87 DLBCL patients who underwent baseline FDG PET/CT and followed the R-CHOP or R-CHOP-like strategy. The clinical parameters and PET-related metabolic parameters were evaluated. Results For all patients, the 2-year PFS rate was 65.5% and the 2-year OS rate was 66.7%. According to Cox multivariate analysis, a high NCCNIPI score (4–8 points) and an MTV greater than 64.1 cm3 (defined by ROC) were independent prognostic factors for PFS and OS. The patients were divided into low, low-intermediate, high-intermediate and high-risk groups by NCCNIPI score. The 2-year PFS rates in each group were 90.9%, 71.3%, 33.2% and 16.7%, and the 2-year OS rates were 100%, 81.6%, 48.4% and 16.7%. In the subsequent subgroup analysis by MTV, it could further stratified low-intermediate and high-intermediate NCCNIPI groups, the P value was 0.068 and 0.069 for PFS, 0.078 and 0.036 for OS. Conclusions MTV, as a tumor metabolic volume parameter, and the NCCNIPI score were independent predictors of prognosis in general DLBCL patients. In the low-intermediate and high-intermediate NCCNIPI subgroup, we further confirm the risk stratification abilities of MTV, which could add the prognostic value of NCCNIPI. Keywords PET/CT · Diffuse large B-cell lymphoma · Metabolic tumour volume · Prognosis
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12149-020-01531-1) contains supplementary material, which is available to authorized users. * Tao Yu yutao@cancerhosp‑ln‑cmu.com 1
Cancer Hospital of China Medical University, Liaoning Cancer Hospital &Institute, Shenyang, Liaoning, People’s Republic of China
Cancer Hospital of China Medical University, Liaoning Cancer Hospital &Institute, No. 44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning 110042, People’s Republic of China
2
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma, accounting for approximately one-third of adult cases of non-Hodgkin’s lymphoma [1]. In the past 20 years, the long-term remission rate and cure rate of this aggressive lymphoma have been improved by adding rituximab to the standard CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) strategy [2]. However, despite the significant improvement, more than 3
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