Zhenduanxue lilun yu shijian (Dec 2021)
The prognostic value of pretreatment 18F-FDG PET/CT in extranodal natural killer/T-cell lymphoma
Abstract
Objective: To assess use of pretreatment 18F-FDG PET/CT in prognosis prediction of extranodal natural killer/T-cell lymphoma(ENKTL). Methods: Sixty consecutive patients with newly diagnosed ENKTL underwent pretreatment 18F-FDG PET/CT were included and all patients received a pegaspargase-based regime. The maximum standardized uptake value (SUVmax), mean SUV (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG) of the tumor, and clinical parameters including gender, age, ENKTL stage, nasal lymphoma infiltration range, extranasal lymphoma infiltration, lymph node involvement, bone marrow involvement. Survival curves and log-rank test were performed, and Cox proportional hazards model was used to assess the independent risk factors for overall survival(OS) and progression-free survival (PFS). Results: Survival analysis showed that MTV (P<0.001), TLG (P<0.001), PET/CT-based Ann Arbor stage (P<0.001), extranasal lymphoma infiltration (P=0.006), lymph node involvement (P=0.031), and bone marrow involvement on PET/CT (P<0.001) were predictive factors for 2-year OS, while SUVmax (P=0.653), SUVmean (P=0.446), and nasal lymphoma infiltration range (P=0.308) were not. SUVmax (P=0.274), SUVmean (P=0.213), nasal lymphoma infiltration range (P=0.621), and lymph node involvement (P=0.069) were not predictive factors for 2-year PFS,and MTV (P=0.001), TLG (P=0.009), PET/CT-based Ann Arbor stage(P<0.001), extranasal lymphoma infiltration (P<0.001), and bone marrow involvement on PET/CT (P<0.001) were predictive factors. Multivariate analysis showed PET/CT-based bone marrow involvement and Ann Arbor stage were independent prognostic factors for 2-year OS (P=0.046 and 0.019, respectively) and PFS (P=0.033 and 0.015), respectively. Conclusions: It reveals that 18F-FDG PET/CT-based bone marrow involvement and Ann Arbor stage are independent prognostic factors for both OS and PFS of newly diagnosed ENKTL.
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