FDG PET in response evaluation of bulky masses in paediatric Hodgkin’s lymphoma (HL) patients enrolled in the Italian AIEOP-LH2004 trial

• Published in: European journal of nuclear medicine and molecular imaging 2019, Vol.46 (1), p.97-106
• Main Authors: Lopci, Egesta, Mascarin, Maurizio, Piccardo, Arnoldo, Castello, Angelo, Elia, Caterina, Guerra, Luca, Borsatti, Eugenio, Sala, Alessandra, Todesco, Alessandra, Zucchetta, Pietro, Farruggia, Piero, Cistaro, Angelina, Buffardi, Salvatore, Bertolini, Patrizia, Bianchi, Maurizio, Moleti, Maria Luisa, Bunkheila, Feisal, Indolfi, Paolo, Fagioli, Franca, Garaventa, Alberto, Burnelli, Roberta
• Format: Article
• Language: English
• Subjects: Adolescent; Antineoplastic Agents - therapeutic use; Cardiology; Chemotherapy; Child; Child, Preschool; Clinical Trials as Topic; Computed tomography; Data processing; Evaluation; Female; Fluorodeoxyglucose F18; Hodgkin Disease - diagnostic imaging; Hodgkin Disease - drug therapy; Hodgkin Disease - pathology; Humans; Imaging; Lymphoma; Male; Medicine; Medicine & Public Health; Morphology; Multivariate analysis; Nuclear Medicine; Oncology; Original Article; Orthopedics; Patients; Positron emission; Positron emission tomography; Positron-Emission Tomography - methods; Positron-Emission Tomography - standards; Predictive Value of Tests; Radiology; Radiopharmaceuticals; Rank tests; Statistical analysis; Subgroups; Treatment Outcome
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-018-4155-4

Purpose We present the results of an investigation of the role of FDG PET in response evaluation of bulky masses in paediatric patients with Hodgkin’s lymphoma (HL) enrolled in the Italian AIEOP-LH2004 trial. Methods We analysed data derived from 703 patients (388 male, 315 female; mean age 13 years) with HL and enrolled in 41 different Italian centres from March 2004 to September 2012, all treated with the AIEOP-LH2004 protocol. The cohort comprised 309 patients with a bulky mass, of whom 263 were evaluated with FDG PET at baseline and after four cycles of chemotherapy. Responses were determined according to combined functional and morphological criteria. Patients were followed up for a mean period of 43 months and for each child we calculated time-to-progression (TTP) and relapse rates considering clinical monitoring, and instrumental and histological data as the reference standard. Statistical analyses were performed for FDG PET and morphological responses with respect to TTP. Multivariate analysis was used to define independent predictive factors. Results Overall, response evaluation revealed 238 PET-negative patients (90.5%) and 25 PET-positive patients (9.5%), with a significant difference in TTP between these groups (mean TTP: 32.67 months for negative scans, 23.8 months for positive scans; p