Abstract
Positron emission tomography-computed tomography (PET/CT) is widely used for initial staging and monitoring treatment responses in Hodgkin and diffuse large B-cell lymphoma. However, its prognostic value in extranodal natural killer (NK)/T-cell lymphoma (ENKL) remains unclear. Here, we conducted a retrospective study to determine the impact of PET/CT in ENKL. Fifty-two patients newly diagnosed with ENKL were enrolled. Baseline maximum standardized uptake values (SUVmax), whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG) were recorded. Additionally, interim PET/CT (I-PET) and end-of-treatment PET/CT (E-PET) results were scored using a 5-point scale. Patients were divided into groups using baseline parameter cut-off values; significant differences were found in overall survival (OS) and progression-free survival (PFS) between the high and low WBMTV and WBTLG groups and in OS between the two SUVmax groups. Positive I-PET and E-PET results predicted inferior PFS and OS. A multivariate analysis showed that baseline WBTLG, I-PET and E-PET results were associated with PFS and OS, and baseline SUVmax was an independent predictor of OS. Thus, baseline WBTLG, I-PET and E-PET results are good predictors of PFS and OS in ENKL patients who received L-asparaginase/pegaspargase in their first-line treatment, and baseline SUVmax is a valuable tool for assessing OS.
Highlights
Extranodal natural killer/T-cell lymphoma, nasal type (ENKL) has been recognized as a distinct clinicopathologic type with an aggressive clinical course and a remarkable geographical prevalence in Asia and South America[1,2]
Among patients who underwent baseline PET/CT (B-PET) scans, we found that the Korean prognostic index (KPI) (P = 0.015), baseline whole-body metabolic tumor volume (WBMTV) (P = 0.018), baseline whole-body total lesion glycolysis (WBTLG) (P = 0.012) and baseline SUVmax (P = 0.005) significantly influenced overall survival (OS) and that the first three associated with inferior progression-free survival (PFS) (P = 0.036, P < 0.001 and P < 0.001, respectively)
There is no definitely evidence that adjusting treatment based on interim PET/CT (I-PET) results could improve a prognosis, our findings show that I-PET results could be used as a chemosensitivity index to predict PFS and OS in extranodal natural killer (NK)/T-cell lymphoma (ENKL)
Summary
Extranodal natural killer/T-cell lymphoma, nasal type (ENKL) has been recognized as a distinct clinicopathologic type with an aggressive clinical course and a remarkable geographical prevalence in Asia and South America[1,2]. It is the most common peripheral T-cell lymphoma (PTCL) in Asia, accounting for 22.4% of PTCL3,4. In these limited previous studies included CHOP, CHOP-like or L-asparaginase/pegaspargase-based regimens, and the criteria for interpreting the PET/CT results varied[16,17,18]. In this study, we investigated the prognostic value of baseline, interim and end-of-treatment PET/ CT results in ENKL in a single-center study
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
