The prognostic value of mid- and post-treatment [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in indolent follicular lymphoma
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[18F]fluorodeoxyglucose positron emission tomography (PET) is a useful staging investigation for follicular lymphoma (FL). Recent studies have shown that positive post-treatment PET is also a strong predictor of inferior overall survival.
To evaluate the predictive value of mid- and post-treatment PET in FL patients with respect to progression-free survival (PFS) and overall survival (OS).
We included 57 patients with indolent FL (grade 1, 2, and 3a) who received induction chemotherapy. Mid- and post-treatment PET results were correlated with PFS and OS retrospectively and analysed using Kaplan–Meier survival analysis and Cox regression.
Post-treatment PET was predictive of OS (mean OS 95.2 vs. 45.0 months for PET-negative vs. PET-positive, p < 0.001) and showed a trend towards significance for PFS (mean PFS 74.4 vs. 38.2 months for PET− vs. PET+, p = 0.083). 3-year PFS for post-treatment PET− and PET+ patients were 72 and 30 %, respectively. 3-year OS were 96 and 60 %, respectively. Mid-treatment PET was not predictive of PFS (mean PFS 78.5 vs. 51.0 months for PET− vs. PET+, p = 0.35) nor OS (mean OS 89.9 vs. 76.6 months for PET− vs. PET+, p = 0.92).
Post-treatment PET is predictive of OS in indolent FL. It identifies patients who might benefit from more intensive follow-up, enrolment in clinical trials or second-line therapy. Mid-treatment PET scan results did not appear to predict long-term treatment outcomes.
KeywordsFDG PET PET/CT Follicular lymphoma Survival
Conflict of interest
The authors declare that there are no conflict of interests.
Ethics approval was obtained from the Research and Ethics Office of the South Western Sydney Local Health District.
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