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The prognostic value of PET/CT evaluation with Deauville score on the recurrence and survival in diffuse large B-cell lymphoma: a multi-institutional study of KROG 17-02

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Abstract

The Korean Radiation Oncology Group (KROG) assessed the value of Deauville score (DS) on 18F-fluorodeoxyglucose Positron emission tomography-computed tomography (FDG PET/CT) as a predictor of recurrence and survival after rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy in diffuse large B-cell lymphoma (DLBCL). A total of 512 patients with stage I–III DLBCL who received six cycles of R-CHOP with or without radiation therapy (RT) and obtained treatment responses according to PET-CT imagings after R-CHOP ± RT were included. Patients were sorted into two arms; DS 4–5 arm (n = 24) was matched at a 1:2 ratio with DS 1–3 arm (n = 48) using propensity score matching method. After a median follow-up time of 37.2 months, the recurrence-free survival rate (86.6% vs. 66.8%, P = 0.041) and overall survival rate (86.9% vs. 62.2%, P = 0.009) at 5 years were significantly different between the DS 1–3 and DS 4–5 arms. DS 4–5 arm showed higher 5-years locoregional recurrence-free survival (88.8% vs. 74.3%, P = 0.155) and distant failure-free survival (91.1% vs. 84.3%, P = 0.333) than DS 1–3 arm. In the multivariate analysis, DS was still a significant factor for recurrence-free survival [hazard ratio (HR), 3.840 and confidence interval (CI), 1.068–13.806; P = 0.039] and overall survival rates (HR 4.453 and CI 1.274–15.562; P = 0.019). This study showed and validated that Deauville score of 4–5 of PET-CT imaging taken after full-course of R-CHOP chemotherapy with or without RT could predict recurrence-free survival and overall survival in DLBCL patients.

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Abbreviations

CI:

Confidence interval

DLBCL:

Diffuse large B-cell lymphoma

DS:

Deauville score

ECOG:

Eastern Cooperative Oncology Group

EOT:

End-of-treatment

FDG:

18F-fluorodeoxyglucose

HR:

Hazard ratio

IPI:

International prognostic index

LRR:

Locoregional recurrence

PET/CT:

Positron emission tomography-computed tomography

R-CHOP:

Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone

RT:

Radiotherapy

RFS:

Recurrence-free survival

OS:

Overall survival

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Acknowledgements

The statistical analyses performed in this article were advised by Catholic Medical Center Clinical Research Coordinating Center.

Funding

There is no funding relevant to this work to be declared.

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Authors and Affiliations

  1. Department of Radiation Oncology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea

    Jeong Won Lee

  2. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Dongryul Oh

  3. Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    Keun-Yong Eom

  4. Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea

    Jin Hee Kim

  5. Department of Radiation Oncology, Inha University Hospital, Inha University of Medicine, Inchon, Republic of Korea

    Woo Chul Kim

  6. Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea

    Mi Joo Chung

  7. Department of Radiation Oncology, College of Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea

    Jong Hoon Lee

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  1. Jeong Won Lee
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Correspondence to Jong Hoon Lee.

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This study was approved by the Institutional Review Board (VC17RESI0046).

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Lee, J.W., Oh, D., Eom, KY. et al. The prognostic value of PET/CT evaluation with Deauville score on the recurrence and survival in diffuse large B-cell lymphoma: a multi-institutional study of KROG 17-02. Clin Exp Metastasis 37, 125–131 (2020). https://doi.org/10.1007/s10585-019-09992-z

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