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    腫瘤學

    2015-10-31 01:25:14
    中國學術期刊文摘 2015年9期
    關鍵詞:腫瘤學出版物來源

    腫瘤學

    來源出版物:Chinese Journal of Cancer,2015,34(2): 70-78

    封面介紹:This cover art shows the image of a diffuse large B-cell lymphoma patient who underwent ET/CT at the time of diagnosis and after 2 cycles of rituximab,cyclophosphamide,doxorubicin,vincristine,and prednisone. These patients who have a positive PET/CT result after 2 cycles of induction chemotherapy are thought to have a poorer prognosis than those patients who have a negative result.(The original cover art is provided by Wei Fan and Xu Zhang.)

    Use of subsequent PET/CT in diffuse large B-cell lymphoma patients in complete remission following primary therapy

    Xu Zhang,Wei Fan,Zhong-Jun Xia,et al.

    Interim18F-fluorodeoxyglucose(FDG)positron emission tomography/computed tomography(I-PET/CT)is a powerful tool for monitoring the response to therapy in diffuse large B-cell lymphoma(DLBCL). This retrospective study aimed to determine when and how to use I-PET/CT in DLBCL. A total of 197 patients treated with rituximab,cyclophosphamide,doxorubicin,vincristine,and prednisone(R-CHOP)were enrolled between October 2005 and July 2011; PET/CT was performed at the time of diagnosis(PET/CT0),after 2 and 4 cycles of chemotherapy(PET/CT2 and PET/CT4,respectively),and at the end of treatment(F-PET/CT). According to the International Harmonization Project for Response Criteria in Lymphoma,110 patients had negative PET/CT2 scans,and 87 had positive PET/CT2 scans. The PET/CT2-negative patients had significantly higher 3-year progression-free survival rate(75.8% vs. 38.2%)and 3-year overall survival rate(93.5% vs. 55.6%)than PET/CT2-positive patients. All PET/CT2-negative patients remained negative at PET/CT4,but 3 were positive at F-PET/ CT. Among the 87 PET/CT2-positive patients,57 remained positive at F-PET/CT,and 32 progressed during chemotherapy(15 at PET/CT4 and 17 at F-PET/CT). Comparing PET/CT4 with PET/CT0,7 patients exhibited progression,and 8 achieved partial remission. Comparing FPET/CT with PET/CT0,10 patients exhibited progression,and 7 achieved partial remission. In conclusion,our results indicate that I-PET/CT should be performed after 2 rather than 4 cycles of immunochemotherapy in DLBCL patients. There is a limited role for subsequent PET/CT in the detection of relapse in PET/CT2-negative patients,but repeat PET/CT is required if the PET/CT2 findings are positive.

    Inte rim PET/CT; diffuse large B-celllymphoma; predictive value

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