Kobe, Carsten, Kuhnert, Georg, Kahraman, Deniz, Haverkamp, Heinz ORCID: 0000-0001-6895-4132, Eich, Hans-Theodor, Franke, Mareike, Persigehl, Thorsten, Klutmann, Susanne, Amthauer, Holger, Bockisch, Andreas, Kluge, Regine, Wolf, Hans-Heinrich, Maintz, David, Fuchs, Michael, Borchmann, Peter, Diehl, Volker, Drzezga, Alexander, Engert, Andreas and Dietlein, Markus (2014). Assessment of Tumor Size Reduction Improves Outcome Prediction of Positron Emission Tomography/Computed Tomography After Chemotherapy in Advanced-Stage Hodgkin Lymphoma. J. Clin. Oncol., 32 (17). S. 1776 - 1782. ALEXANDRIA: AMER SOC CLINICAL ONCOLOGY. ISSN 1527-7755

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Abstract

Purpose Positron emission tomography (PET) after chemotherapy can guide consolidating radiotherapy in advanced-stage Hodgkin lymphoma (HL). This analysis aims to improve outcome prediction by integrating additional criteria derived by computed tomography (CT). Patients and Methods The analysis set consisted of 739 patients with residues > 2.5 cm after chemotherapy from a total of 2,126 patients treated in the HD15 trial (HD15 for advanced stage Hodgkin's disease: Quality assurance protocol for reduction of toxicity and the prognostic relevance of fluorodeoxyglucose-positron-emission tomography [FDG-PET] in the first-line treatment of advanced-stage Hodgkin's disease) performed by the German Hodgkin Study Group. A central panel performed image analysis and interpretation of CT scans before and after chemotherapy as well as PET scans after chemotherapy. Prognosis was evaluated by using progression-free survival (PFS); groups were compared with the log-rank test. Potential prognostic factors were investigated by using receiver operating characteristic analysis and logistic regression. Results In all, 548 (74%) of 739 patients had PET-negative residues after chemotherapy; these patients did not receive additional radiotherapy and showed a 4-year PFS of 91.5%. The 191 PET-positive patients (26%) receiving additional radiotherapy had a 4-year PFS of 86.1% (P = .022). CT alone did not allow further separation of patients in partial remission by risk of recurrence (P = .9). In the subgroup of the 54 PET-positive patients with a relative reduction of less than 40%, the risk of progression or relapse within the first year was 23.1% compared with 5.3% for patients with a larger reduction (difference, 17.9%; 95% CI, 5.8% to 30%). Conclusion Patients with HL who have PET-positive residual disease after chemotherapy and poor tumor shrinkage are at high risk of progression or relapse.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Kobe, CarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuhnert, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kahraman, DenizUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haverkamp, HeinzUNSPECIFIEDorcid.org/0000-0001-6895-4132UNSPECIFIED
Eich, Hans-TheodorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Franke, MareikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Persigehl, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klutmann, SusanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Amthauer, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bockisch, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kluge, RegineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wolf, Hans-HeinrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maintz, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuchs, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borchmann, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Diehl, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Drzezga, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Engert, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dietlein, MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-435901
DOI: 10.1200/JCO.2013.53.2507
Journal or Publication Title: J. Clin. Oncol.
Volume: 32
Number: 17
Page Range: S. 1776 - 1782
Date: 2014
Publisher: AMER SOC CLINICAL ONCOLOGY
Place of Publication: ALEXANDRIA
ISSN: 1527-7755
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INTERNATIONAL WORKSHOP; RESPONSE ASSESSMENT; INTERIM-PET; F-18-FDG; DISEASE; ERLOTINIB; STANDARD; CRITERIA; THERAPY; ABVDMultiple languages
OncologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/43590

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