| PART ONE:The value of 18F-FDG PET/CT in the prognosis of diffuse large B-cell lymphoma in the interim and later phase of chemotherapyObjective:To investigate the value of 18F-FDG PET/CT in the prognosis of diffuse large B-cell lymphoma in the interim and later phase of chemotherapy.Methods:A retrospective analysis of 18F-FDG PET/CT findings was conducted in 111 DLBCL patients from April 2013 to August 2017.All patients underwent R-CHOP chemotherapy.The patients who underwent PET/CT examination in the interim(2-4cycles)and later(6-8cycles)phase of chemotherapy were 52 cases and 67 cases respectively.(8 patients underwent 18F-FDG PET/CT in both interim and later phase of chemotherapy).18F-FDG PET/CT status were analyzed according to criteria of the Deauville.2-year progression free survival and 2-year overall survival was compared between the subjects with positive and negative PET/CT results.Kaplan-Meier analysis were used for data analysis.The rate was compared using ?2 test.Results:Of the 111 patients,25 cases progressed or recurred,and 11 patients died,the 2-year PFS rate and 2-year OS rate were 78.4%and 92.8%,respectively.There was no significant difference in 2-year PFS rate between positive and negative group in interim PET/CT(P>0.05),the difference in OS rate was statistically significant(P<0.05).There were statistically significant difference in PFS rate and OS rate between this two groups in the later phase of chemotherapy(P<0.05).Interim 18F-FDG PET/CT results were positive in 10 cases and negative in 42 cases.There was no statistically significant difference in PFS between the two groups(P>0.05),and there was statistically significant difference in OS(P<0.05).Post-thearpy 18F-FDG PET/CT results were positive in 7 cases and negative in 60 cases.There were statistically significant difference both in PFS and OS between the two groups.Conclusion:Both phase of PET/CT have value in predicting prognosis of patients with DLBCL.PET/CT in later phase of chemotherapy is more useful than interim PET/CT.PART TWO:The prognostic value of 18F-FDG PET/CT combined with an enhanced International Prognostic Index(NCCN-IPI)in diffuse large large-B cell lymphomaObjective:To investigate the prognostic stratification value of NCCN-IPI in patients with DLBCL who were negative at the end of treatment PET/CT.Methods:60 patients with DLBCL from April 2013 to August 2017 in our hospital were retrospectively analyzed.Basline characteristics were eollected,and all of these patients underwent 6-to 8-cycle R-CHOP regimen chemotherapy and were negative by 18F-FDG PET/CT.The risk stratification was performed by NCCN-IPI,and the differences in PFS and OS between groups were compared.Results:The main elinical features were as follows:median age was 51(range:16-81)years old,32 males and 28 females,46.7%were stage ?/? disease,8.3%were Eastern Cooperative Oncology Group Performance Status?2,and 20.0%had elevated lactate dehydrogenase level.with a median follow-up of 34 months(14-69 months),the 2-year PFS rate and the 2-year OS rate was 83.33%%96.67%.According to the NCCN-IPI risk categorization,35.0%,41.7%,18.3%,and 5.0%patients belonged to the four risk subgroups(low,low-intermediate,high-intermediate,and high).There was statistically significant difference in PFS between the low-risk group and the other groups(<0.05).There was statistieally significant difference in OS between the high-risk group and the other groups(P<0.05).The difference between PFS and OS of other components was not statistically significant(P>0.05).Conclusion:Further prognostic stratification can be performed by NCCN-IPI in patients with DLBCL who were negative at the end of treatment PET/CT. |
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