Recent advances in lymphoma treatment have significantly improved the survival of patients;however,the current approaches also have varying side effects.To overcome these,it is critical to implement individualized tre...Recent advances in lymphoma treatment have significantly improved the survival of patients;however,the current approaches also have varying side effects.To overcome these,it is critical to implement individualized treatment according to the patient’s condition.Therefore,the early identification of high-risk groups and targeted treatment are important strategies for prolonging the survival time and improving the quality of life of patients.Interim positron emission tomography-computed tomography(PET-CT)has a high prognostic value,which can reflect chemosensitivity and identify patients for whom treatment may fail under this regimen.To date,many prospective clinical studies on interim PET(iPET)-adapted therapy have been conducted.In this review,we focus on the treatment strategies entailed in these studies,as well as the means and timing of iPET assessment,with the aim of exploring the efficacy and existing issues regarding iPET-adapted treatment.It is expected that the improved use of PET-CT examination can facilitate treatment decision-making to identify precise treatment options.展开更多
目的:探讨中期正电子发射计算机断层显像(positron emission tomography-computed tomography,PET-CT)检查在复发性弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中的作用。方法:回顾性分析2009年1月至2017年12月中山大学肿...目的:探讨中期正电子发射计算机断层显像(positron emission tomography-computed tomography,PET-CT)检查在复发性弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中的作用。方法:回顾性分析2009年1月至2017年12月中山大学肿瘤防治中心收治的38例行中期PET-CT检查的复发性DLBCL患者临床病例资料,其中男性21例、女性17例。采用SPSS 20.0软件进行统计学分析。基线数据采用t、χ~2检验或Fisher精确检验进行比较。生存数据应用寿命表、Kaplan-Meier法、Cox回归等方法进行分析。结果:全组患者中,中期PET-CT评价为有效组[完全缓解(complete response,CR)+部分缓解(partial response,PR)]和无效组[疾病稳定(stable disease,SD)+疾病进展(progression of disease,PD)]患者分别为30例和8例。全组患者的中位总生存期(median overall survival,mOS)和无进展生存期(progression free survival,PFS)分别为77.69和8.44个月。有效组和无效组的mOS分别为77.93和16.37个月(P=0.017);有效组和无效组的中位PFS(median PFS,m PFS)分别为9.86个月和1.80个月(P=0.001)。单因素与多因素分析均显示,中期PET-CT评价为有效的患者获得更长的OS与PFS(P=0.006,P=0.001)。最大标准摄取值(maximum standard uptake value,SUVmax)≤11.05的患者获得更长的PFS和OS,ΔSUVmax>8和最大标准摄取值变化率(maximum standard uptake value%,ΔSUVmax%)>54.5%的患者仅表现出更长的PFS,OS则差异无统计学意义。结论:依照中期PET-CT结果分为有效组和无效组,按照临界值将SUVmax分组对复发性DLBCL患者的OS和PFS均有良好的预测作用,而按照临界值将ΔSUVmax、ΔSUVmax%分组能很好地预测复发性DLBCL患者的PFS。展开更多
基金supported by the National Natural Science Foundation of China(No.82270206)the Zhejiang Provincial Natural Science Foundation of China(No.LZ22H160009).
文摘Recent advances in lymphoma treatment have significantly improved the survival of patients;however,the current approaches also have varying side effects.To overcome these,it is critical to implement individualized treatment according to the patient’s condition.Therefore,the early identification of high-risk groups and targeted treatment are important strategies for prolonging the survival time and improving the quality of life of patients.Interim positron emission tomography-computed tomography(PET-CT)has a high prognostic value,which can reflect chemosensitivity and identify patients for whom treatment may fail under this regimen.To date,many prospective clinical studies on interim PET(iPET)-adapted therapy have been conducted.In this review,we focus on the treatment strategies entailed in these studies,as well as the means and timing of iPET assessment,with the aim of exploring the efficacy and existing issues regarding iPET-adapted treatment.It is expected that the improved use of PET-CT examination can facilitate treatment decision-making to identify precise treatment options.
