Predictive value of baseline <sup>18</sup>F‑FDG PET/CT and interim treatment response for the prognosis of patients with diffuse large B‑cell lymphoma receiving R‑CHOP chemotherapy

Zhu,Lili; Meng,Yankai; Guo,Lili; Zhao,Hanqing; Shi,Yue; Li,Shaodong; Wang,Anming; Zhang,Xiaojun; Shi,Jing; Zhu,Jie; Xu,Kai

doi:10.3892/ol.2020.12393

Predictive value of baseline ¹⁸F‑FDG PET/CT and interim treatment response for the prognosis of patients with diffuse large B‑cell lymphoma receiving R‑CHOP chemotherapy

Authors:
- Lili Zhu
- Yankai Meng
- Lili Guo
- Hanqing Zhao
- Yue Shi
- Shaodong Li
- Anming Wang
- Xiaojun Zhang
- Jing Shi
- Jie Zhu
- Kai Xu
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Affiliations: The First School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China, Department of Radiology, Afﬁliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China, Department of Radiology, Huaihai Hospital Affiliated with Xuzhou Medical University, Xuzhou, Jiangsu 221004, P.R. China
Published online on: December 18, 2020 https://doi.org/10.3892/ol.2020.12393
Article Number: 132
Copyright: © Zhu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to investigate the prognostic value of baseline ¹⁸F‑FDG PET/CT quantitative parameters and interim treatment response, and to assess whether the combination of these could improve the predictive efficacy in patients with diffuse large B‑cell lymphoma (DLBCL) receiving R‑CHOP chemotherapy. PET/CT images and clinical data of 64 patients with DLBCL who had undergone ¹⁸F‑FDG PET/CT scan before and after 3 or 4 cycles of R‑CHOP chemotherapy were retrospectively reviewed. The quantitative parameters including standardized uptake value (SUV), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum diameter of the maximum lesion (Dmax) were measured on baseline PET/CT images. Cox proportional hazards model was used to evaluate the influence of baseline PET/CT parameters, clinical indicators and interim treatment response on prognosis. Survival analysis was performed using Kaplan‑Meier method. Receiver operating characteristic (ROC) curve analysis was performed to estimate the predictive efficacy of the combination of baseline PET/CT parameters and interim treatment response. Ann Arbor stage, International Prognostic Index (IPI), lactate dehydrogenase (LDH), necrosis, MTVmax, TLGmax, Dmax and interim treatment response showed association with 2‑year progression‑free survival (PFS, P<0.05). LDH, necrosis, MTVmax, MTVsum, TLGmax, TLGsum, Dmax and interim treatment response showed association with 2‑year overall survival (OS, P<0.05). Ann Arbor stage, Dmax and interim treatment response were found to be independent predictors of 2‑year PFS (P<0.05), while Dmax and interim treatment response were found to be independent predictors of 2‑year OS (P<0.05). The PFS and OS curves of Dmax <5.7 cm group and Dmax ≥5.7 cm group, complete response (CR) group and non‑CR group were significantly different, respectively (P<0.05). The baseline ¹⁸F‑FDG PET/CT parameters and interim treatment response have important prognostic values in DLBCL patients who received R‑CHOP chemotherapy. Combined application of Dmax and interim treatment response improved the predictive efficacy of 2‑year PFS. It may be helpful to identify patients who are at high‑risk of relapse and to guide early clinical intervention of these patients.

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