Abstract：
BACKGROUND: Hodgkin lymphoma (HL) in pediatric populations has a high survival rate but poses risks for long-term morbidities. Although [18F]fluoro‑2‑deoxy‑2‑d‑glucose positron emission tomography ([18F]FDG PET) scans offer potential for improved risk stratification, the definitive prognostic value of quantitative [18F]FDG PET parameters remains unclear for pediatric HL.
METHODS: A single-center, retrospective study included pediatric patients diagnosed with HL between 2016 and 2023 treated according to EuroNet-PHL-C1 and DAL/GPOH-HD protocols. Patients underwent baseline and interim PET/CT scans after two chemotherapy cycles. Event-free survival (EFS) was the primary endpoint, Deauville score was the secondary endpoint. Quantitative [18F]FDG PET parameters included SUVmax, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) that were evaluated using two segmentation methods (SUV 2.5, 41% SUVmax). Survival outcomes were assessed using Cox regression analysis.
RESULTS: A total of 115 patients (50 males, median age 14.2 years) were studied, with a median follow-up period of 35 months. During this period, 16 cases (13.9%) of relapse or progression were noted. Baseline and interim MTV 2.5, MTV 41%, TLG 2.5, and TLG 41%, along with interim SUVmax, were significantly associated with worse EFS and correlated with post-treatment Deauville scores. In multivariable analysis, interim MTV 2.5 > 0 ml (adj. hazard ratio, HR: 3.89, p = 0.009) and interim TLG 41% ≥ 30 g (adj. HR: 7.98, p = 0.006) were independent risk factors for EFS.
CONCLUSIONS: Baseline and interim [18F]FDG PET parameters can serve as significant prognostic indicators for EFS and treatment response in pediatric HL. These quantitative measures could enhance individualized, risk-adapted treatment strategies for children and adolescents with HL.
METHODS: A single-center, retrospective study included pediatric patients diagnosed with HL between 2016 and 2023 treated according to EuroNet-PHL-C1 and DAL/GPOH-HD protocols. Patients underwent baseline and interim PET/CT scans after two chemotherapy cycles. Event-free survival (EFS) was the primary endpoint, Deauville score was the secondary endpoint. Quantitative [18F]FDG PET parameters included SUVmax, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) that were evaluated using two segmentation methods (SUV 2.5, 41% SUVmax). Survival outcomes were assessed using Cox regression analysis.
RESULTS: A total of 115 patients (50 males, median age 14.2 years) were studied, with a median follow-up period of 35 months. During this period, 16 cases (13.9%) of relapse or progression were noted. Baseline and interim MTV 2.5, MTV 41%, TLG 2.5, and TLG 41%, along with interim SUVmax, were significantly associated with worse EFS and correlated with post-treatment Deauville scores. In multivariable analysis, interim MTV 2.5 > 0 ml (adj. hazard ratio, HR: 3.89, p = 0.009) and interim TLG 41% ≥ 30 g (adj. HR: 7.98, p = 0.006) were independent risk factors for EFS.
CONCLUSIONS: Baseline and interim [18F]FDG PET parameters can serve as significant prognostic indicators for EFS and treatment response in pediatric HL. These quantitative measures could enhance individualized, risk-adapted treatment strategies for children and adolescents with HL.
摘要：
背景：儿童人群中的霍奇金淋巴瘤（HL）具有较高的生存率，但存在长期发病率的风险。尽管[18F]氟代-2-脱氧-2-d-葡萄糖正电子发射断层扫描（[18F]FDGPET）扫描提供了改善风险分层的潜力，定量[18F]FDGPET参数对小儿HL的确切预后价值尚不清楚.
方法：单中心，回顾性研究纳入2016-2023年间诊断为HL的儿科患者,根据EuroNet-PHL-C1和DAL/GPOH-HD方案治疗.患者在两个化疗周期后接受基线和临时PET/CT扫描。无事件生存期（EFS）是主要终点，多维尔评分是次要终点。定量[18F]FDGPET参数包括SUVmax，使用两种分割方法（SUV2.5，41％SUVmax）评估的代谢性肿瘤体积（MTV）和总病变糖酵解（TLG）。使用Cox回归分析评估生存结果。
结果：共有115名患者（50名男性，中位年龄14.2岁)进行了研究，中位随访期为35个月。在此期间,16例（13.9%）复发或进展。基线和临时MTV2.5，MTV41%，TLG2.5和TLG41%，以及临时SUVmax，与较差的EFS显着相关，并与治疗后的Deauville评分相关。在多变量分析中，临时MTV2.5>0毫升（调整。危险比，HR：3.89，p=0.009）和临时TLG41%≥30g（调整。HR：7.98，p=0.006）是EFS的独立危险因素。
结论：基线和临时[18F]FDGPET参数可作为小儿HL的EFS和治疗反应的重要预后指标。这些量化措施可以增强个性化，儿童和青少年HL的风险适应治疗策略。
方法：单中心，回顾性研究纳入2016-2023年间诊断为HL的儿科患者,根据EuroNet-PHL-C1和DAL/GPOH-HD方案治疗.患者在两个化疗周期后接受基线和临时PET/CT扫描。无事件生存期（EFS）是主要终点，多维尔评分是次要终点。定量[18F]FDGPET参数包括SUVmax，使用两种分割方法（SUV2.5，41％SUVmax）评估的代谢性肿瘤体积（MTV）和总病变糖酵解（TLG）。使用Cox回归分析评估生存结果。
结果：共有115名患者（50名男性，中位年龄14.2岁)进行了研究，中位随访期为35个月。在此期间,16例（13.9%）复发或进展。基线和临时MTV2.5，MTV41%，TLG2.5和TLG41%，以及临时SUVmax，与较差的EFS显着相关，并与治疗后的Deauville评分相关。在多变量分析中，临时MTV2.5>0毫升（调整。危险比，HR：3.89，p=0.009）和临时TLG41%≥30g（调整。HR：7.98，p=0.006）是EFS的独立危险因素。
结论：基线和临时[18F]FDGPET参数可作为小儿HL的EFS和治疗反应的重要预后指标。这些量化措施可以增强个性化，儿童和青少年HL的风险适应治疗策略。
