BACKGROUND: The role of [¹⁸F] fluorodeoxyglucose (FDG)-positron emission tomography (PET) in follicular lymphoma (FL) staging is not yet determined. PATIENTS AND METHODS: The aim of the present study was to investigate the role of PET in the initial staging of FL patients enrolled in the FOLL05-phase-III trial that compared first-line regimens (R-CVP, R-CHOP and R-FM). Patients should have undergone conventional staging and have available PET baseline to be included. RESULTS:A total of 142 patients were analysed. PET identified a higher number of nodal areas in 32% (46 of 142) of patients and more extranodal (EN) sites than computed tomography (CT) scan. Also, the Follicular Lymphoma International Prognostic Index (FLIPI) score increased in 18% (26 of 142) and decreased in 6% (9 of 142) of patients. Overall, the impact of PET on modifying the stage was highest in patients with limited stage. Actually, 62% (15 of 24) of cases with limited disease were upstaged with PET. CONCLUSIONS: The inclusion of PET among staging procedures makes the evaluation of patients with FL more accurate and has the potential to modify therapy decision and prognosis in a moderate proportion of patients. Further prospective clinical trials on FL should incorporate PET at different moments, and the therapeutic criteria to start therapy should be re-visited in the views of this new tool.
RCT Entities:
BACKGROUND: The role of [¹⁸F] fluorodeoxyglucose (FDG)-positron emission tomography (PET) in follicular lymphoma (FL) staging is not yet determined. PATIENTS AND METHODS: The aim of the present study was to investigate the role of PET in the initial staging of FL patients enrolled in the FOLL05-phase-III trial that compared first-line regimens (R-CVP, R-CHOP and R-FM). Patients should have undergone conventional staging and have available PET baseline to be included. RESULTS: A total of 142 patients were analysed. PET identified a higher number of nodal areas in 32% (46 of 142) of patients and more extranodal (EN) sites than computed tomography (CT) scan. Also, the Follicular Lymphoma International Prognostic Index (FLIPI) score increased in 18% (26 of 142) and decreased in 6% (9 of 142) of patients. Overall, the impact of PET on modifying the stage was highest in patients with limited stage. Actually, 62% (15 of 24) of cases with limited disease were upstaged with PET. CONCLUSIONS: The inclusion of PET among staging procedures makes the evaluation of patients with FL more accurate and has the potential to modify therapy decision and prognosis in a moderate proportion of patients. Further prospective clinical trials on FL should incorporate PET at different moments, and the therapeutic criteria to start therapy should be re-visited in the views of this new tool.
Authors: Joshua W D Tobin; Gabrielle Rule; Katherine Colvin; Lourdes Calvente; David Hodgson; Stephen Bell; Chengetai Dunduru; James Gallo; Erica S Tsang; Xuan Tan; Jonathan Wong; Jessica Pearce; Robert Campbell; Shao Tneh; Sophie Shorten; Melissa Ng; Tara Cochrane; Constantine S Tam; Emad Abro; Eliza Hawkes; Georgina Hodges; Roopesh Kansara; Dipti Talaulikar; Michael Gilbertson; Anna M Johnston; Kerry J Savage; Diego Villa; Kirk Morris; Sumi Ratnasingam; Wojt Janowski; Robert Kridel; Chan Y Cheah; Michael MacManus; Nicholas Matigian; Peter Mollee; Maher K Gandhi; Greg Hapgood Journal: Blood Adv Date: 2019-10-08
Authors: Connie L Batlevi; Fushen Sha; Anna Alperovich; Ai Ni; Katy Smith; Zhitao Ying; John F Gerecitano; Paul A Hamlin; Steve M Horwitz; Erel Joffe; Anita Kumar; Matthew J Matasar; Alison J Moskowitz; Craig H Moskowitz; Ariela Noy; Colette Owens; Lia M Palomba; David Straus; Gottfried von Keudell; Andrew D Zelenetz; Venkatraman E Seshan; Stefano Luminari; Luigi Marcheselli; Massimo Federico; Anas Younes Journal: Eur J Cancer Date: 2020-01-08 Impact factor: 9.162