RT Journal Article
SR Electronic
T1 What to do and when? Comparison of clinical, PET and PET-CT surveillance in detection of relapsed Hodgkin’s disease (HD) and aggressive non-Hodgkin’s lymphoma (ANHL)
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 591
OP 591
VO 51
IS supplement 2
A1 Klein, Martine
A1 Goldschmidt, Neta
A1 Or, Omer
A1 Savitsky, Bella
A1 Chisin, Roland
A1 Paltiel, Ora
YR 2010
UL http://jnm.snmjournals.org/content/51/supplement_2/591.abstract
AB 591 Objectives In HD and ANHL, relapse most often occurs in the 2 years following initial therapy. Follow-up (F/U) strategies for these curable diseases aim to detect relapse at an early stage when tumor burden is low. We set out to define the optimal F/U method -clinical vs PET/PET-CT - for the detection of relapse of HD and of ANHL and the eventual impact on survival. Methods We retrospectively reviewed the files of 79 patients (pts) (26 HD, 53 ANHL) diagnosed after 1.2001 who had a first relapse after end of treatment and were followed at least 1 year post-relapse. Clinic visits are scheduled every 3 months (mth) in the first 2 years and PET/PET-CT every 4-6 mth the first year and every 6 mth later on. PET stand alone was performed until PET-CT became available in 2004. Clinical detection of relapse (CDR) was based on symptoms or physical signs and asymptomatic relapse was detected via routine imaging (PET/PET-CT) (IDR). We evaluated the influence of time to relapse, stage, B symptoms, prognostic score, site of relapse and extra-nodal involvement on the diagnostic mode of relapse. Survival was assessed by Kaplan Meier curves. Results Relapse was detected by IDR in 18/26 (69%) HD and in 19/53 (36%) ANHL, p=0.008. Detection of relapse by IDR or CDR was independent of the disease characteristics. In HD, IDR was associated with improved survival albeit statistically non-significant and risk of death was more than twice for CDR. For ANHL survival did not differ by mode of relapse detection. Conclusions These preliminary results show that IDR by routine PET-CT is more common in HD compared to ANHL and suggest that survival in HD might be improved by IDR. However larger series are required for further validation of the findings and will then impact on the choice and the timing of the appropriate surveillance in these diseases