Is Radiotherapy Cost-effective in the PET/CT-era for Early-Stage Favorable Hodgkin's Lymphoma with Alternative Payment Models?

Author(s):  
Hayeon Kim ◽  
Adam Richman ◽  
Kenneth J Smith ◽  
Parvez M Shaikh ◽  
Sushil Beriwal ◽  
...  
Author(s):  
Volkan Bas ◽  
Elif Gulsum Umit ◽  
Ulku Korkmaz ◽  
Mehmet Baysal ◽  
Sedanur Karaman Gulsaran ◽  
...  

2010 ◽  
Vol 363 (23) ◽  
pp. 2267-2267
Author(s):  
Michele Bibas ◽  
Andrea Antinori

2022 ◽  
pp. 7-15
Author(s):  
T. I. Bogatyreva ◽  
A. O. Afanasov ◽  
A. Yu. Terekhova ◽  
N. A. Falaleeva

Rationale. In the early stages of classical Hodgkin’s lymphoma (cHL), the cure rate reaches 85–95 %, but the long-term effects of therapy can worsen overall survival. Current trials for early stages of Hodgkin’s lymphoma with favorable prognosis address the task of maintaining cure rates while reducing sequelae. For early unfavorable stages, the challenge is to improve cure rate without increasing toxicity.Purpose. To assess the potential significance of individual risk factors for optimal choice of the first line chemotherapy in early-stage Hodgkin lymphoma.Materials and methods. This single-center retrospective study included 290 patients with early stage cHL who had received ABVD – based (n = 249; 86 %) or BEACOPP‑21 – based (n = 41; 14 %) combined modality therapy from 2000 to 2017. Progression-free survival (PFS) and overall survival (OS) were assessed in Cox regression analysis including 12 clinical parameters.Main results. At a median follow up of 60 months for the entire group, OS was 95 % and PFS was 89 %. In a multivariate analysis PFS, at 5 years, was significantly inferior in patients with mediastinal bulk, baseline lymphocytopenia (≤ 0.6 × 109/L, р = 0.002; < 1.0 × 109/L, р = 0.000) and male gender; OS was inferior only in patients with an absolute lymphocytopenia (AL). In patients with AL, PFS after ABVD-based regimen was, respectively, 12 % in the high-risk group with mediastinal bulk and 56 % without it. PFS of patients without AL when treated with ABVD did not differ compared to BEACOPP‑21 within the same prognostic group: 95.2 % vs. 92.3 % for non-bulky and 86.4 % vs. 84.2 % for bulky disease. In the absence of AL, mediastinal bulk remained the main and only risk factor in multivariate analysis.Conclusions. The ABVD regimen is highly effective in the first line of chemotherapy for cHL, except for cases with baseline lymphocytopenia, in which the early usage of the BEACOPP regimen in the escalated or 14-day variants might be justified. In patients with mediastinal bulk, standard chemotherapy is not effective enough even in the absence of AL; therefore, if an intermediate PET/CT scan is available, it seems more appropriate to use a milder ABVD regimen on the first line and leave intensive therapy for patients with proven refractory disease. Prospects for improving the efficiency are opened with the new N-AVD and A-AVD schemes, the benefits of which should be evaluated, first of all, in patients with AL and mediastinal bulk.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sally Mahmoud Abdel-Aziz Abdel-Aziz ◽  
Safaa Kamal Mohamed BadrElden ◽  
Asmaa Magdy Mohamed Salama

Abstract Aim of the study to evaluate the role of PET/CT in initial diagnosis and staging of lymphoma, and to determine the predictive value of 18F-FDG PET by monitoring the early response and final response after completion of chemotherapy in patients with non-Hodgkin's lymphoma. Patient and Methods our prospective study included 25 patients with pathologically confirmed nonHodgkin Lymphoma diffuse large B cell lymphoma selected from Department of Radiology at Ain Shams University Hospital from January 2019 to March 2020. The patients included in this study performed the followings: Initial PET/CT for staging, interim PET/CT and end of the treatment PET/CT. We performed low dose non enhanced CT scan first, then a whole body PET study followed by diagnostic enhanced whole body CT scan. The whole study took approximately 20-30 minutes. Results PET/CT has greater sensitivity 100% and specificity 68.8% than CT alone for detecting sites of nodal and extra-nodal involvement and for assessment of therapeutic response in non-Hodgkin lymphoma. Conclusion PET / CT is an accurate method for evaluating tumor viability in the post-therapy setting of Non-Hodgkin lymphomas. PET / CT has a significant advantage for the diagnosis of diffusely infiltrating organs without mass lesions or contrast enhancement compared to contrast enhanced CT.


The Lancet ◽  
2017 ◽  
Vol 390 (10114) ◽  
pp. 2744-2745 ◽  
Author(s):  
Maja V Maraldo

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