Background/Objectives This study aimed to evaluate whether very early interim18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) after a single cycle of first-line chemotherapy predicts long-term survival outcome in patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 51 patients (31 males and 20 females; mean age 55 years) had four FDG PET/CT studies, at baseline and after one, three, and six cycles of chemotherapy (PET0, PET1, PET3, and PET6). Visually and quantitatively assessed PET parameters were analyzed for associations with long-term survival. Results The estimated 10-year progression-free survival (PFS) and overall survival (OS) was 48% and 61%, respectively. During a median follow-up of 63 months (range 9–134), 17 patients (33%) exhibited disease progression and 15 (29%) died. On PET1, all but one showed decreased FDG uptake, and all showed decreased metabolic tumor volume. None of the PET1 or PET3 parameters were associated with survival. The PET6 parameters retained independent predictive value for OS after adjustment for the International Prognostic Index. Negative PET6 was associated with longer PFS (mean 99 vs. 50 mo,p= 0.04) and OS (mean 107 vs. 57 mo,p= 0.02). Con-clusions The FDG PET/CT parameters obtained after a single cycle of chemotherapy were not associated with long-term survival in DLBCL, while negative end-of-therapy FDG PET/CT was associated with longer PFS and OS. Tumor regression very early into first-line chemotherapy was not as clinically relevant as the presence of viable tumor on FDG PET/CT at the end of therapy for predicting long-term outcomes.
背景/目的：本研究旨在评估弥漫性大B细胞淋巴瘤患者在接受一线化疗单周期后，早期进行的¹⁸F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描能否预测长期生存结局。方法：共纳入51例患者（男性31例，女性20例；平均年龄55岁），分别在基线期及化疗第1、3、6周期后接受四次FDG PET/CT检查（PET0、PET1、PET3、PET6）。通过视觉评估与定量分析PET参数，探究其与长期生存的关联性。结果：患者10年无进展生存率与总生存率分别为48%和61%。中位随访63个月（范围9-134个月）期间，17例（33%）出现疾病进展，15例（29%）死亡。PET1显示除1例外所有患者FDG摄取均降低，代谢肿瘤体积全部减小。PET1与PET3参数均未显示与生存相关。在校正国际预后指数后，PET6参数仍对总生存具有独立预测价值。PET6阴性患者表现出更长的无进展生存期（平均99月 vs 50月，p=0.04）与总生存期（平均107月 vs 57月，p=0.02）。结论：单周期化疗后获得的FDG PET/CT参数与DLBCL长期生存无显著关联，而治疗结束时FDG PET/CT阴性结果与更长的无进展生存期和总生存期相关。在预测长期结局方面，一线化疗极早期的肿瘤消退现象，其临床意义不及治疗结束时FDG PET/CT显示的活性肿瘤残留状态。
肿瘤(癌症)患者之家