PET imaging can help Hodgkin lymphoma patients avoid radiotherapy while still experiencing “excellent” outcomes, according to research set to be presented at the American Society of Clinical Oncology (ASTRO) annual meeting.
The classic bulky form of the disease—characterized by large tumors in the center of the chest—is tied to poorer prognoses and often treated with radiation. But this course can lead to toxic long-term effects, including heart problems and a higher risk of breast cancer, Dana-Farber Cancer Institute experts noted.
Researcher Ann LaCasce, MD, and colleagues’ investigation incorporated 94 patients with early-stage classic Hodgkin lymphoma and disease bulk greater than 10 cm on chest X-ray. Participants received two cycles of chemo followed by PET imaging. Those whose disease showed uptake less than liver on the interim PET scan (classified as PET2-) received four more cycles of chemo but no radiotherapy. Patients classified as PET2+ received intensified chemotherapy and radiation.
Progression-free survival was 93.1% among those who did not receive radiotherapy and 89.7% in the PET2+ group. And at a median follow-up of 5.5 years, estimated three-year overall survival rate was 98.6% for PET2- patients and 94.4% in the PET2+ group.
“The investigators said the PET-adapted approach achieved excellent [progression-free survival] outcomes that allowed omission of radiotherapy in 78 percent of patients,” Dana-Farber noted in a May 19 announcement, adding PET2+ patients who received radiotherapy “did not have inferior outcomes.”
LaCasce is set to present the findings during a session at the ASCO’s annual meeting June 7.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.