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首页> 美国卫生研究院文献>Blood >Clinical Trials and Observations: Positron emission tomography has a high negative predictive value for progression or early relapse for patients with residual disease after first-line chemotherapy in advanced-stage Hodgkin lymphoma
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Clinical Trials and Observations: Positron emission tomography has a high negative predictive value for progression or early relapse for patients with residual disease after first-line chemotherapy in advanced-stage Hodgkin lymphoma

机译：临床试验和观察：对于晚期霍奇金淋巴瘤一线化疗后残留病患者正电子发射断层扫描对进展或早期复发具有较高的阴性预测价值

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In the HD15 trial of the German Hodgkin Study Group, the negative predictive value (NPV) of positron emission tomography (PET) using [18F]-fluorodeoxyglucose in advanced-stage Hodgkin lymphoma (HL) was evaluated. A total of 817 patients were enrolled and randomly assigned to receive BEACOPP-based chemotherapy. After completion of chemotherapy, residual disease measuring more than or equal to 2.5 cm in diameter was assessed by PET in 311 patients. The NPV of PET was defined as the proportion of PET− patients without progression, relapse, or irradiation within 12 months after PET review panel. The progression-free survival was 96% for PET− patients (95% confidence interval [CI], 94%-99%) and 86% for PET+ patients (95% CI, 78%-95%, P = .011). The NPV for PET in this analysis was 94% (95% CI, 91%-97%). Thus, consolidation radiotherapy can be omitted in PET− patients with residual disease without increasing the risk for progression or early relapse compared with patients in complete remission. The impact of this finding on the overall survival at 5 years must be awaited. Until then, response adapted therapy guided by PET for HL patients seems to be a promising approach that should be further evaluated in clinical trials. This trial is registered at study as #ISRCTN32443041.
机译：在德国霍奇金研究小组的HD15试验中，评估了使用[ 18 F]-氟脱氧葡萄糖对晚期霍奇金淋巴瘤（HL）进行正电子发射断层扫描（PET）的阴性预测值（NPV） 。共有817例患者入组并随机分配接受基于BEACOPP的化疗。化疗完成后，通过PET对311例患者评估了直径大于或等于2.5厘米的残留疾病。 PET的NPV定义为PET审查小组后12个月内无进展，复发或放疗的PET -患者的比例。 PET -患者的无进展生存率为96％（95％置信区间[CI]，94％-99％），PET + 患者为86％（95 ％CI，78％-95％，P = .011）。该分析中PET的NPV为94％（95％CI，91％-97％）。因此，与完全缓解的患者相比，残留疾病的PET -患者可以省略巩固放疗，而不会增加进展或早期复发的风险。必须等待这一发现对5年总生存的影响。在此之前，PET指导的针对HL患者的适应性治疗似乎是一种有前途的方法，应在临床试验中进一步评估。该试验已在研究中注册为＃ISRCTN32443041。

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