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Dynamic evaluation of the prognostic value of 18F-FDG PET/CT in extranodal NK/T-cell lymphoma, nasal type

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Abstract

Extranodal natural killer/T-cell lymphoma, nasal-type (ENKTL) is a type of rare and distinct entity of non-Hodgkin lymphoma with poor prognosis. It is important to evaluate the early treatment response accurately to decide further treatment strategy. 18F-FDG PET/CT plays an important role in response evaluation and prognostic prediction in some kinds of lymphomas. However, data available regarding patients with ENKTL are limited. Thus, in this prospective study, we analyzed the prognostic value of 18F-FDG PET/CT in ENKTL. Thirty-four patients with newly diagnosed ENKTL were enrolled in this phase 2 study (NCT02825147, July 7, 2016). The patients received pre-, mid-, and end-treatment 18F-FDG PET/CT scans. Deauville score (DS), maximal standardized uptake values (SUVmax), and the change in SUVmax (ΔSUVmax) were recorded for response assessment. The median follow-up period was 42.2 months. The 2-year overall survival (OS) and progression-free survival (PFS) were 82.4% and 73.5%, respectively. Univariate analysis revealed that Ann Arbor stage (P < 0.002), mid-treatment DS (P = 0.005), mid-SUVmax (P = 0.001), mid-∆SUVmax (P = 0.004), end-treatment DS (P < 0.001), and end-SUVmax (P = 0.014) were prognostic factors for OS. Ann Arbor stage (P = 0.001), mid-treatment DS (P = 0.008), mid-SUVmax (P = 0.029), mid-∆SUVmax (P < 0.001), and end-treatment DS (P =0.021) were of prognostic significance for PFS. Multivariate analysis showed that mid-SUVmax (P = 0.042) and DS at the middle (P = 0.050) and end (P = 0.044) of treatment were significant independent predictors of PFS. 18F-FDG PET/CT is useful for predicting the prognosis of ENKTL.

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Data availability

The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors acknowledge the assistance provided by the clinicians and nurses at Ruijin Hospital who treated the patients and also the patients who participated in this study.

Funding

This work was supported by the National Natural Science Foundation of China (No. 82070204), the Foundation of National Facility for Translational Medicine (Shanghai), the 3-year plan of the Shanghai Shen-Kang Promoting Hospital’s Clinical Skills and Innovative Ability Project (No. 16CR3110B) and Shanghai Municipal Key Clinical Specialty (No. shslczdzk03403).

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Author notes

  1. Pengpeng Xu, Rui Guo and Jianhua You contributed equally to this work.

Authors and Affiliations

  1. Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Pengpeng Xu, Jianhua You, Shu Cheng, Huijuan Zhong & Weili Zhao

  2. Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Rui Guo, Chenwei Sun & Biao Li

  3. Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Jian Li

  4. Department of Radiation, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Haoping Xu

  5. School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Hengye Huang

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  1. Pengpeng Xu
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Contributions

Pengpeng Xu, Rui Guo, and Jianhua You contributed equally to this work. Pengpeng Xu and Rui Guo collected and analyzed the data and wrote the article. Jianhua You collected and analyzed clinical data. Shu Cheng and Huijuan Zhong collected clinical data. Jian Li and Hengye Huang were responsible for the statistical review. Chenwei Sun performed PET/CT scans. Haoping Xu was responsible for planning patients’ radiotherapy. Biao Li and Weili Zhao designed and supervised the study and wrote the article.

Corresponding authors

Correspondence to Biao Li or Weili Zhao.

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Approval was obtained from the ethics committees of all participating centers. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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The authors declare no competing interests.

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Xu, P., Guo, R., You, J. et al. Dynamic evaluation of the prognostic value of 18F-FDG PET/CT in extranodal NK/T-cell lymphoma, nasal type. Ann Hematol 100, 1039–1047 (2021). https://doi.org/10.1007/s00277-021-04466-3

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