PET/CT-guided therapy improves survival in aggressive non-Hodgkin lymphoma patients

Authors of a recent study reported improved survival in patients with aggressive non-Hodgkin lymphoma (HL) whose first-line therapy was guided by PET/CT instead of CT alone.

In the study, published Dec. 4 in Radiology, researchers analyzed data from a prospective multicenter registry of 850 patients, with an average age of 54, who had either apparent limited-stage (LS) HL or aggressive non-HL (ANHL) based on clinical data and CT findings or equivocal CT in advanced stage cases. All were considered for curative-intent first-line therapy and recruited between May 2013 and December 31, 2015.

To-date, PET/CT is commonly thought of as the preferred imaging modality for staging patients with aggressive-histology lymphomas, wrote first author Ur Metser, MD, of Mount Sinai Hospital & Women’s College Hospital at the University of Toronto in Ontario, Canada, and colleagues. However, the authors noted, “there is a paucity of data regarding the effect of PET on patient treatment and more importantly on clinical outcomes in these patients.”

Comparing pre-PET/CT treatment with the treatment provided, Metser et al. found the nuclear imaging method helped upstage 150 of 850 (17.6 percent) patients and changed planned therapy in nearly 40 percent of participants after undergoing PET/CT.

Metser and colleagues also reported lower one-year mortality for patients with ANHL who received PET/CT versus CT. The same reduced mortality was found in patients with LS in the PET/CT group compared to those with LS who received CT. No one-year difference was observed in HL patients.

“This suggests that for participants with ANHL, PET-directed patient management may result in better overall outcomes,” the group wrote.

Overall, Metser et al. explained that their results provide evidence for the adoption of PET in staging aggressive lymphoma, confirming recommendations made during the International Conference on Malignant Lymphoma in Lugano, Switzerland.