The outcome of first line treatment in hodgkin lenfoma the effect of PET/CT on the treatment outcome

Treatment, treatment response and effects of treatment and prognostic factors on overall survival and progression-free survival were retrospectively evaluated in 106 patients who were managed with a diagnosis of Hodgkin lymphoma at Hematology Department of Gazi University, Medicine School between June, 1993 and June, 2012. The PET/CT scans for staging and interim analysis were reevaluated according to London and Dynamic visual scoring systems and the scores were retrospectively recorded. There is no sufficient data demonstrating the relationship between SUVmax values and tumor behavior in Hodgkin lymphoma. In the present study, it was aimed to evaluate SUVmax values in PET/CT scan for staging on treatment outcomes. In addition, it was also aimed to evaluate effects of London and Dynamic visual scores which are developed to assess treatment response in PET/CT scans on treatment outcomes. At the completion of treatment, complete response was achieved in 100% of the patients received MOPP, in 66.6% of the patients received ABVD, and in 93.3% in patients received BEACOPP. No significant difference was found among these treatment modality in terms of complete response (p>0.05). In 73 patients with advanced disease, overall survival was 77% and 85% in patients received ABVD and BEACOPP, respectively (p>0.05). There was a significant difference in progression-free survival favoring BEACOPP (34% vs. 90%; p<0.05). It was seen that rapid disease control and longer disease-free periods were achieved by BEACOPP regime as a first-line therapy; however, it had no effect on overall survival. It was found that, of the parameters consisting IPS, only stage IV had effect on overall survival (p<0.05). It was seen that SUVmax values in PET/CT scan at presentation were not significant in terms of IPS and complete response (p>0.05). However, baseline SUVmax values were found to be high in patients who failed to achieve complete response at the end of therapy (p>0.05). It was found that SUVmax values did not affect overall and progression-free survivals. In the present study, no significant correlation was found between scores of London and Dynamic visual scoring systems and stage, histological type, age, sex, hemoglobin, albumin, ECOG, PS, IPS values, sedimentation rate, leukocyte, lymphocyte or SUVmax value values at presentation (p>0.05). It may be possible to reduce false-positivity by using of London or Dynamic scoring systems during PET/CT assessment.