End-of-treatment and serial PET imaging in primary mediastinal B-cell lymphoma following dose-adjusted EPOCH-R: a paradigm shift in clinical decision making

Haematologica
Christopher MelaniWyndham H Wilson

Abstract

Dose-adjusted-EPOCH-R obviates the need for radiotherapy in most patients with primary mediastinal B-cell lymphoma. End-of-treatment PET, however, does not accurately identify patients at risk of treatment failure, thereby confounding clinical decision making. To define the role of PET in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R, we extended enrollment and follow up on our published phase II trial and independent series. Ninety-three patients received dose-adjusted-EPOCH-R without radiotherapy. End-of-treatment PET was performed in 80 patients, of whom 57 received 144 serial scans. One nuclear medicine physician from each institution blindly reviewed all scans from their respective institution. End-of-treatment PET was negative (Deauville 1-3) in 55 (69%) patients with one treatment failure (8-year event-free and overall survival of 96.0% and 97.7%). Among 25 (31%) patients with a positive (Deauville 4-5) end-of-treatment PET, there were 5 (20%) treatment failures (8-year event-free and overall survival of 71.1% and 84.3%). Linear regression analysis of serial scans showed a significant decrease in SUVmax in positive end-of-treatment PET non-progressors compared to an increase in treatment failures. A...Continue Reading

Citations

Jan 5, 2019·British Journal of Haematology·Kate CwynarskiUNKNOWN British Society for Haematology Guidelines
Aug 16, 2019·AJR. American Journal of Roentgenology·David PfauNikhil H Ramaiya
Feb 12, 2019·British Journal of Haematology·Charlotte LeesJay Gunawardana
May 22, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Sally F BarringtonJohn Radford
Jul 23, 2020·Clinical Case Reports·Cesar GentilleSai Ravi Pingali
Feb 8, 2021·British Journal of Haematology·Rahul Lakhotia, Mark Roschewski
Mar 18, 2021·Current Hematologic Malignancy Reports·Gabriela Llaurador, Lisa Giulino-Roth
Mar 29, 2021·International Journal of Radiation Oncology, Biology, Physics·Bradford S HoppeLouis S Constine
Aug 1, 2021·Clinical Lymphoma, Myeloma & Leukemia·Zahoor AhmedRaheel Iftikhar
Jul 9, 2021·Expert Review of Anticancer Therapy·Vincent CamusClémentine Sarkozy
Aug 21, 2021·The British Journal of Radiology·Sarah Allison MilgromAnne Berthelsen
Sep 15, 2021·The British Journal of Radiology·Elizabeth H PhillipsAndrew Wirth
Dec 29, 2020·The Lancet. Haematology·Sally F Barrington, Judith Trotman

❮ Previous
Next ❯

Methods Mentioned

BETA
biopsy

Software Mentioned

Osirix

Related Concepts

Related Feeds

B-Cell Lymphoma

B-cell lymphomas include lymphomas that affect B cells. This subtype of cancer accounts for over 80% of non-Hodgkin lymphomas in the US. Here is the latest research.