| Objective To explore the value of the Deauville 5-point scoring?5-PS?interim 18F-FDG PET/CT in evaluation of chemotherapy response in patients with Hodgkin's lymphoma?HL?.To investigate the prognostic value of 5-PS and the rate of maximum standardized uptake value reduction??SUVmax%?in patients with HL.To compare the clinical usefulness of both methods in HL patients.Methods Seventy eight patients?43 males,35 females,median age 36 years?with confirmed HL by pathological examination were retrospectively analyzed from March 2010 to October 2014.18F-FDG PET/CT imaging was performed before?PET-0?and after 4 cycles?PET-4?of chemotherapy.All patients were scored according to Deauville 5-PS in PET-4.Grouped by reference to the Lugano criteria for lymphoma response assessment.The progression free survival?PFS?was compared between the 4 groups,and the value of interim 18F-FDG PET/CT in evaluation of chemotherapy response was studied.Patients were evaluated by Deauville 5-PS,and grouped into patients with scores?4 and those with scores<4.Patients were also evaluated by ?SUVmax% criterion,and grouped into patients with ?SUVmax% ?71% and those with ?SUVmax%>71% respectively.We intended to analyze the correlation between related factors and 2 years PFS,and to compare the prognostic value of the two methods.Survival curves were obtained by using Kaplan-Meier curves and log-rank test.Cox regression analysis was used for predicting the related factors analysis.Results?1?78 patients were scored according to Deauville 5-PS after 4 cycles of chemotherapy with 18F-FDG PET/CT imaging,1 point scored?11 cases?,2 points scored?27 cases?,3 points scored?19 cases?,4 points scoreed?13cases?,5 points scored?8 cases?.According to the standards for assessing lymphoma response to treatment of the Lugano criterion,The group of CMR has 57 patients,of whom 5 cases with disease recurrence during the follow-up period,and there were 3 patients with disease recurrence or progress of the 11 patients in PMR group,3 patients with disease recurrence or progress of the 7 patients in NMR group,2 patients with disease recurrence or progress of the 3 patients in PMD group.2-year PFS were 91.2%,72.2%,57.1%,and 33.3% in the above four groups.The differences were statistically significant among the groups.?2?According to Deauville 5-PS in PET-4,57 patients?73.1%?achieved a negative?PS<4?PET-4 result,5 of whom with disease recurrence during the follow-up period,21 patients?26.9%?achieved a positive?PS?4?result,8 of whom failed treatment.The negative group was significantly better than the positive group for identifying patients with different 2-year PFS?91.2% vs.61.9%;P = 0.001?.?3?When the ?SUVmax% was used,60 patients?76.9%?achieved a negative??SUVmax% >71%?result,6 of whom failed treatment;18 patients?23.1%?achieved a positive??SUVmax%?71%?result,7 of whom failed treatment.The negative group was significantly better than the positive group for identifying patients with different 2-year PFS?90.0% vs.61.1%;P =0.001?.?4?We obtained sensitivity?S?,specificity?Sp?,positive predictive values?PPV?,negative predictive values?NPV?and accuracy ratio?AR?for Deauville 5-PS and ?SUVmax% with different 2-year PFS of 61.5% vs.53.8%;80% vs.83.1%;38.1% vs.38.9%;91.2 vs.90.0% and 76.9% vs.78.2%,respectively.?5?Single factor analysis results showed that Deauville 5-PS and ?SUVmax% were prognostic factors for PFS?P<0.05?.Cox multivariate survival analysis demonstrated Deauville 5-PS and ?SUVmax% were not the independent predictor for PFS.Conclusions The Deauville 5-PS interim 18F-FDG PET/CT imaging can accurately evaluate chemotherapy response for patients with HL,and both Deauville 5-PS and ?SUVmax% methods have significant value in predicting the outcome of HL patients. |
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