| PART ONE:Prognostic values of baseline 18F-FDG PET/CT semi-quantitative parameter and interim?end-of therapy PET response in patients with follicular lymphomaObjectives:To investigate the role of baseline,interim and end-of treatment positron emission tomography/computed tomography(PET/CT)in assessing the prognosis of follicular lymphoma(FL).Methods:A total of 84 FL patients were retrospectively analyzed in this study.Baseline(n=59),interim(n=24,after 2-4 cycles)and end-of treatment(n=43)PET/CT images were re-evaluated,and baseline total metabolic tumor volume(tMTV),total lesion glycolysis(TLG)and maximum standardized uptake value(SUVmax)were recorded.Interim(I-PET)and end-of treatment(E-PET)PET/CT responses were interpreted by Deauville five-point scale(D-5PS)and International Harmonization Project criteria(IHP).Survival curves were calculated by Kaplan-Meier curves,and differences between groups were compared by log-rank test.Results:Patients with high levels of tMTV and TLG had poorer clinical survival compared with those with low levels of tMTV and TLG.Patients with a high level of tMTV had a 2-year progression-free survival(PFS)of 73.77%,while it became 96.97%in patients with a low level of tMTV(?2=7.878,P=0.005).The 2-year overall survival(OS)of the low-and high-tMTV groups were 70%and 100%,respectively(?2=9.139,P=0.003).Patients with a high level of TLG had a 2-year PFS of 57.14%,while it became 95.56%in patients with a low level of TLG(?2=14.498,P=0.0001).The 2-year OS of the low-and high-TLG groups were 100%and 62.50%,respectively(?2=16.319,P<0.0001).In multivariate analysis,TLG was an independent predictor of both PFS(P=0.001,HR=6.577,95%CI=2.167-19.960)and OS(P=0.030,HR=19.291,95%CI=2.689-137.947)in FL patients.Besides,Eastern Cooperative Oncology Group(ECOG)was also independent predictor of OS(HR=8.924,95%CI=1.273-62.559,P=0.028).Interim PET results based on D-5PS or IHP criteria were not statistically significant correlation with PFS(all P>0.05).However,E-PET results using D-5PS and IHP criteria had a good prognostic significance for FL patients(P=0.0001 and P=0.006).The D-5PS showed the stronger prognostic value compared to IHP criteria.The optimal cutoff value of?SUVmax%was 66.95%according to I-PET and 68.97%according to E-PET.However,only the ?SUVmax%from the baseline to the end-of therapy yielded statistically significant results in the prediction of PFS(P=0.0002).Conclusions:Baseline TLG was an independent prognostic factor for PFS and OS in FL patients;E-PET results based on D-5PS and IHP criteria were significantly correlated with PFS.PART TWO:Prognostic value of baseline 18F-FDG PET/CT metabolic parameter in pediatric lymphomaObjectives:To evaluate the prognostic significance of SUVmax,tMTV and TLG obtained by baseline 18F-FDG PET/CT in pediatric lymphoma.Methods:A total of 47 pediatric lymphoma patients were retrospectively analyzed in this study.The MTV,TLG and SUVmax were recorded.Log-rank test and Cox regression analysis were used to evaluate PFS and OS.Results:The 2-year PFS of the low-TLG(<384)and high-TLG(>384)groups was 95.24%(20/21)and 57.69%(15/26),respectively(x2=8.582,P=0.003).TLG and tMTV were significantly higher in progression-free patients compared with the progression group.Univariate analysis showed that B symptoms(P=0.014),effusion(P=0.010),tMTV(P=0.008)and TLG(P=0.004)were the predictive factors for PFS.The tMTV(P=0.005),TLG(P=0.005)and effusion(P=0.003)were associated with OS.However,PFS and OS were not signifificantly different between the high-and low-SUVmax groups(P=0.102 and P=0.850).In multivariate analysis,TLG was the only independent predictor of PFS in pediatric lymphoma(P=0.021,HR=11.133,95%CI=1.435-86.405).Conclusion:Baseline TLG was an independent prognostic factor for PFS in patients with pediatric lymphoma;TLG increased,PFS shorter. |
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