Journal article
Response Assessment of Aggressive Non-Hodgkin’s Lymphoma by Integrated International Workshop Criteria and Fluorine-18–Fluorodeoxyglucose Positron Emission Tomography
Journal of clinical oncology, Vol.23(21), pp.4652-4661
07/20/2005
DOI: 10.1200/JCO.2005.01.891
PMID: 15837965
Abstract
Purpose To determine whether a response classification based on integration of fluorine-18–fluorodeoxyglucose positron emission tomography (FDG-PET) into the International Workshop Criteria (IWC) provides a more accurate response assessment than IWC alone in patients with non-Hodgkin's lymphoma (NHL). Patients and Methods Fifty-four patients with aggressive NHL who underwent FDG-PET and computed tomography 1 to 16 weeks after four to eight cycles of chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone were assessed for complete response (CR), unconfirmed CR (CRu), partial response (PR), stable disease (SD), and progressive disease (PD) by the IWC and by integrated IWC and FDG-PET (IWC+PET). Progression-free survival (PFS) was also compared between IWC- and IWC+PET-assigned response designations. Results By IWC, 17 patients had a CR, seven had a CRu, 19 had a PR, nine had SD, and two had PD. In comparison, by IWC+PET, 35 patients had a CR, 12 had a PR, six had SD, one had PD, and zero had a CRu. In separate multivariate models, PFS was significantly shorter in patients with PR than in those with a CR using IWC (hazard ratio [HR], 8.9; P = .021) or IWC+PET (HR, 29.7; P = .0003). However, when the two classifications were included in the same multivariate model, only IWC+PET was a statistically significant independent predictor for PFS (P = .008 v P = .72 for IWC). In addition, when patients with a PR by IWC and a CR by IWC+PET were compared with those with a CR by IWC and a CR by IWC+PET, there was no significant difference in PFS (HR, 1.6; P = .72), indicating that IWC+PET identified a subset of IWC-PR patients with a more favorable prognosis. Conclusion Compared with IWC, the IWC+PET-based assessment provides a more accurate response classification in patients with aggressive NHL.
Details
- Title: Subtitle
- Response Assessment of Aggressive Non-Hodgkin’s Lymphoma by Integrated International Workshop Criteria and Fluorine-18–Fluorodeoxyglucose Positron Emission Tomography
- Creators
- Malik E Juweid - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCGregory A Wiseman - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCJulie M Vose - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCJustine M Ritchie - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCYusuf Menda - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCJames E Wooldridge - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCFelix M Mottaghy - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCEric M Rohren - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCNorbert M Blumstein - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCAlan Stolpen - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCBrian K Link - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCSven N Reske - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCMichael M Graham - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DCBruce D Cheson - From the Departments of Radiology, Internal Medicine, and Biostatistics, and the Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Department of Radiology, Mayo Clinic, Rochester, MN; Division of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE; and Department of Internal Medicine, Georgetown University Hospital, Washington, DC
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.23(21), pp.4652-4661
- DOI
- 10.1200/JCO.2005.01.891
- PMID
- 15837965
- NLM abbreviation
- J Clin Oncol
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 07/20/2005
- Academic Unit
- Radiology; Hematology, Oncology, and Blood & Marrow Transplantation; Radiation Oncology; Internal Medicine
- Record Identifier
- 9984047680002771
Metrics
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