PET-CT Prognostic After Induction Tx in Follicular Lymphoma
(HealthDay News) — The five-point Deauville scale (5PS), used to score 18F-fluorodeoxyglucose (FDG) uptake on FDG positron emission tomography-computed tomography (PET-CT) scans, has prognostic value in follicular lymphoma, according to a study published online September 18 in The Lancet Haematology.
Judith Trotman, MBChB, from the University of Sydney, and colleagues examined the correlation between post-induction PET status and survival in patients with follicular lymphoma. Data were collected from three multicenter prospective studies of first-line rituximab chemotherapy; 439 patients received at least six cycles of rituximab and chemotherapy before a conventional contrast-enhanced CT and PET low-dose CT (PET) response assessment. Of these patients, 246 had centrally reviewed post-induction PET scans.
The researchers found that 17% of the 246 patients who had a PET scan within three months of the last dose of induction rituximab had a positive scan, with a cut-off of ≥4 on the 5PS. For patients with a positive versus a negative PET scan, the hazard ratio for progression-free survival was 3.9 and for overall survival was 6.7, during a median follow-up of 54.8 months. At four years, 23.2% of patients with a positive PET scan were progression-free, compared with 63.4% of those with a negative PET scan (P<0.0001).
"PET-CT rather than contrast-enhanced CT scanning should be considered as a new standard for response assessment of follicular lymphoma in clinical practice, and could help guide response-adapted therapy," the authors write.