Abstract：
Few data are known regarding the use of interim positron emission tomography (iPET) after the first two cycles (iPET2) of chemotherapy in treatment-naïve classical Hodgkin lymphoma (cHL) in routine clinical practice, and about the real-life adoption of intensification strategies for iPET positive patients. We conducted a multicenter retrospective study on cHL to investigate the use of iPET in the real-life setting, its prognostic role and outcomes of patients early shifted to intensification. Six hundreds and forty-one patients were enrolled (62% had advanced stage). iPET2 was positive in 89 patients (14%) including 8.7% and 17% early and advanced stage patients, respectively (p = 0.003). Among iPET 2 positive cases treatment was immediately modified in 19 cases; in 14 cases treatment was modified after an additional positive iPET4. Overall 56 iPET2 positive patients never received intensified therapies. Most frequently used intensified therapy was autologous stem cell transplantation followed by BEACOPP. After a median follow-up of 72 months, the 5-year progression-free survival (PFS) was 82% with iPET2 positive patients showing a worse PFS compared with iPET2 negative cases: 31% versus 85%. Focusing on advanced stage patients with a positive iPET2, the 5-year PFS was 59% for patients shifted to intensified therapy at any time point versus 61% for patients who never received intensified therapy. Our study confirmed the higher curability of naïve cHL patients in a real-world setting, and the prognostic role of iPET2 in this setting. A poor adherence to response-adapted strategy which however did not translate into a difference in patient outcomes.
摘要：
关于在常规临床实践中治疗初治经典霍奇金淋巴瘤（cHL）的前两个化疗周期（iPET2）后使用临时正电子发射断层扫描（iPET）的数据很少。以及iPET阳性患者强化策略的现实生活采用。我们对cHL进行了一项多中心回顾性研究，以调查iPET在现实生活中的使用情况。其预后作用和患者预后早期转向强化。招募了六百四十一名患者（62％的晚期）。iPET2阳性89例（14%），包括8.7%和17%的早期和晚期患者，分别(p=0.003)。在iPET2阳性病例中，有19例立即修改了治疗方法；在14例中，在额外的iPET4阳性后修改了治疗方法。共有56例iPET2阳性患者从未接受过强化治疗。最常用的强化治疗是自体干细胞移植，然后是BEACOPP。经过72个月的中位随访，与iPET2阴性病例相比,iPET2阳性患者的5年无进展生存期(PFS)为82%,PFS较差:31%对85%.针对iPET2阳性的晚期患者，在任何时间点转向强化治疗的患者的5年PFS为59％，而从未接受强化治疗的患者为61％。我们的研究证实了在现实世界中，幼稚的cHL患者的可固化性更高，以及iPET2在这种情况下的预后作用。对反应适应性策略的依从性较差，但并未转化为患者预后的差异。
