Abstract
This study aimed to systematically review the value of end-of-treatment 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in improving overall survival (OS) of lymphoma patients. Medline was systematically searched for (1) randomized trials comparing the OS of patients who underwent end-of-treatment FDG-PET to those without and FDG-PET-based end-of-treatment evaluation and for (2) non-randomized studies comparing the OS of patients who underwent end-of-treatment FDG-PET to a (historical) cohort of patients without an FDG-PET-based end-of-treatment evaluation. The Medline search revealed 6284 articles. However, none of these reported data on the value of end-of-treatment FDG-PET in improving OS of lymphoma patients. In conclusion, the present systematic review reveals that there is currently no study at all that evaluates the value of end-of-treatment FDG-PET in improving OS of lymphoma patients. As a result, it remains unknown whether end-of-treatment FDG-PET increases OS and in which lymphoma subtype these examinations are of particular value. Future studies are required to demonstrate its value in this setting before it can be recommended as an evidence-based diagnostic tool by guidelines on the use of imaging in lymphoma.
Highlights
Lymphomas are the sixth most frequently occurring malignant tumors, comprise around 4.8% of cases of newly diagnosed cancer, and cause about 3.6% of all cancer-related deaths in the Western world [1]
The present systematic review revealed that, at present, there is no randomized controlled trial available evaluating whether performing end-of-treatment FDG-positron emission tomography (PET) imaging in lymphoma patients results in a better patient outcome than end-oftreatment evaluations by means of computed tomography (CT), laboratory values, or performing no routine end-of-treatment evaluation at all
This finding is of major importance, because international guidelines such as the Lugano classification [2, 3], the guidelines of the European Society of Medical Oncology (ESMO) [4, 5], and the guidelines of the National Comprehensive Cancer Network [6, 7] propose an end-of treatment evaluation using FDG-PET for all lymphomas that are FDG-avid at baseline
Summary
Lymphomas are the sixth most frequently occurring malignant tumors, comprise around 4.8% of cases of newly diagnosed cancer, and cause about 3.6% of all cancer-related deaths in the Western world [1] Current international guidelines, such as the Lugano classification [2, 3], the guidelines of the European Society of Medical Oncology (ESMO) [4, 5], and the guidelines of the National Comprehensive Cancer Network [6, 7] propose an end-of treatment evaluation using 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) for lymphomas that are FDG-avid at baseline. This may allow consolidation therapies to be applied at an earlier stage, and this may increase OS compared to an
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