腫瘤學

腫瘤學

來源出版物：Chinese Journal of Cancer，2015，34（2）： 70-78

封面介紹：This cover art shows the image of a diffuse large B-cell lymphoma patient who underwent ET/CT at the time of diagnosis and after 2 cycles of rituximab，cyclophosphamide，doxorubicin，vincristine，and prednisone. These patients who have a positive PET/CT result after 2 cycles of induction chemotherapy are thought to have a poorer prognosis than those patients who have a negative result.（The original cover art is provided by Wei Fan and Xu Zhang.）

Use of subsequent PET/CT in diffuse large B-cell lymphoma patients in complete remission following primary therapy

Xu Zhang，Wei Fan，Zhong-Jun Xia，et al.

Interim18F-fluorodeoxyglucose（FDG）positron emission tomography/computed tomography（I-PET/CT）is a powerful tool for monitoring the response to therapy in diffuse large B-cell lymphoma（DLBCL）. This retrospective study aimed to determine when and how to use I-PET/CT in DLBCL. A total of 197 patients treated with rituximab，cyclophosphamide，doxorubicin，vincristine，and prednisone（R-CHOP）were enrolled between October 2005 and July 2011； PET/CT was performed at the time of diagnosis（PET/CT0），after 2 and 4 cycles of chemotherapy（PET/CT2 and PET/CT4，respectively），and at the end of treatment（F-PET/CT）. According to the International Harmonization Project for Response Criteria in Lymphoma，110 patients had negative PET/CT2 scans，and 87 had positive PET/CT2 scans. The PET/CT2-negative patients had significantly higher 3-year progression-free survival rate（75.8% vs. 38.2%）and 3-year overall survival rate（93.5% vs. 55.6%）than PET/CT2-positive patients. All PET/CT2-negative patients remained negative at PET/CT4，but 3 were positive at F-PET/ CT. Among the 87 PET/CT2-positive patients，57 remained positive at F-PET/CT，and 32 progressed during chemotherapy（15 at PET/CT4 and 17 at F-PET/CT）. Comparing PET/CT4 with PET/CT0，7 patients exhibited progression，and 8 achieved partial remission. Comparing FPET/CT with PET/CT0，10 patients exhibited progression，and 7 achieved partial remission. In conclusion，our results indicate that I-PET/CT should be performed after 2 rather than 4 cycles of immunochemotherapy in DLBCL patients. There is a limited role for subsequent PET/CT in the detection of relapse in PET/CT2-negative patients，but repeat PET/CT is required if the PET/CT2 findings are positive.

Inte rim PET/CT； diffuse large B-celllymphoma； predictive value