Abstract
Background: The use of PET CT has become instrumental in the management of Hodgkin's lymphoma (HL), with multiple studies favoring PET adapted therapies. Current guidelines recommend using the Deauville score (DS) for assessment of end therapy PET-CT scans. We looked at the predictive ability of end therapy PET CT DS in a cohort of HL.
Methods: Adult patients diagnosed with, and treated for, Hodgkin's lymphoma between 2007 and 2015 with end-of-treatment PET CT scans were included in this retrospective analysis.
Results: One hundred and ninety-eight patients [median age- 35 (18-74) years, advanced disease: 147 (74%); bulky disease: 54 (27%)] underwent end-of-therapy PET CT scanning with Deauville scoring. The chemotherapy regimens used were as follows: ABVD in 167 patients (84%); COPP/AVD in 20 patients (10%) and other regimens in 11 patients (6%). The end of therapy Deauville score (DS) was 1 or 2 in 160 patients (81%), 3 in 9 patients (5%) and 4 or 5 in 29 patients (14%). The median follow-up was 62 months. The 5-year DFS for patients with DS 1 or 2 was 85%, DS 3 was 65% and DS 4 or 5 was 40% (p<0.05). The 5-year overall survival for DS 1 and 2 combined was 91%, for DS 3 was 76% and for DS 4 and 5 combined was 70% (p=0.001).
Based on this analysis, the positive and negative predictive values for predicting treatment outcome on the basis of end of therapy PET CT by Deauville scoring were 0.48 and 0.85 respectively.
Conclusions: DS 1 and 2 were highly predictive of excellent survival while DS 4 and 5 were predictive for treatment failure. However, the positive predictive value was overall lower than reported from other studies. DS score of 3 was seen in very few patients at end therapy. Further modification of this is required for clear interpretation.
No relevant conflicts of interest to declare.
This feature is available to Subscribers Only
Sign In or Create an Account Close Modal