Comparative study of RECIL versus Lugano in the evaluation of curative effect and prognosis of lymphoma during mid-chemotherapy
10.3760/cma.j.cn321828-20220802-00251
- VernacularTitle:化疗中期RECIL与Lugano标准在淋巴瘤疗效及预后评价中的对比研究
- Author:
Qingqing YU
1
;
Ming ZHAO
;
Ling YUAN
;
Rongrong TIAN
;
Liping SU
;
Jie ZHOU
;
Yanmei LIN
Author Information
1. 山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院核医学科，太原 030013
- Keywords:
Lymphoma;
Treatment outcomes;
Response evaluation criteria in solid tumors;
Fluorodeoxyglucose F18;
Positron-emission tomography;
Tomography, X-ray compute
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2023;43(11):672-677
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy and prognostic evaluation of response evaluation criteria in lymphoma (RECIL) and Lugano classification in patients with 18F-FDG-avid Hodgkin′s lymphoma (HL) and non-HL (NHL) during mid-chemotherapy. Methods:From January 2015 to August 2021, 240 patients (149 males and 91 females, age 50.0(32.0, 62.0) years) with pathologically confirmed lymphoma in Shanxi Cancer Hospital were retrospectively analyzed. Pre-treatment and mid-treatment 18F-FDG PET/CT examinations were performed, and the differences of PET/CT imaging results among patients with different types of lymphoma were analyzed ( χ2 test or Kruskal-Wallis rank sum test). Efficacy evaluation was conducted during mid-chemotherapy, and the results were divided into complete remission (CR), partial remission (PR), stable disease (SD), progressive disease (PD) according to Lugano classification, which were divided into CR, PR, mild remission (MiR), SD, PD according to RECIL. For the better comparison with Lugano classification, MiR was included in PR group (recorded as RECIL-1) and SD group (recorded as RECIL-2) in this study. All patients were followed up, and the progression free survival (PFS) was analyzed. Kappa test, χ2 test or Fisher exact probability method were used to analyze the data, and ROC curve was used to compare the prediction efficiency of different standards. Results:Among 240 patients with different types of lymphoma (96 HL, 30 follicular lymphoma (FL), 114 diffuse large B-cell lymphoma (DLBCL)), there were statistically significant differences in baseline SUV max ( H=54.96, P<0.001) and the sum of longest diameters ( H=15.85, P<0.001). Patients were followed up for 12-89 months, and 26 patients (10.8%) were evaluated as MiR according to the RECIL. The consistency ( Kappa) was 0.84 between results of RECIL-1 and Lugano classification, which was 0.74 between RECIL-2 and Lugano classification (both P<0.001). According to Lugano classification, the PFS rates of patients evaluated as CR, PR, SD and PD were 91.4%(148/162), 57.1%(36/63), 1/3 and 3/12 respectively, which were 91.3%(136/149), 62.8%(49/78), 1/2 and 2/11 for RECIL-1, and 91.3%(136/149), 57.7%(30/52), 71.4%(20/28) and 2/11 for RECIL-2 respectively ( χ2 values: 46.64-52.44, all P<0.001). The AUC of Lugano classification for predicting PFS had a trend to be higher than AUCs of RECIL-1 and RECIL-2 (0.774, 0.758 and 0.746; z values: 1.28, 1.61, P values: 0.200, 0.107). Conclusion:RECIL and Lugano classification have similar efficacy and prognostic evaluation effect on patients with 18F-FDG-avid HL and NHL during mid-chemotherapy.
