• Int. J. Radiat. Oncol. Biol. Phys. · Mar 2011

    Multicenter Study

    Impact of 18F-fluoro-2-deoxyglucose positron emission tomography on treatment strategy and radiotherapy planning for stage I-II Hodgkin disease: a prospective multicenter study.

    • Pascal Pommier, Sophie Dussart, Théodore Girinsky, Sylvie Chabaud, Jean Leon Lagrange, Tan Dat Nguyen, Véronique Beckendorff, Anne D'Hombres, Xavier Artignan, Pierre Yves Bondiau, Christian Carrie, and Francesco Giammarile.
    • Department of Radiation Oncology, Lyon University-Centre Léon Bérard, Lyon, France. pommier@lyon.fnclcc.fr
    • Int. J. Radiat. Oncol. Biol. Phys. 2011 Mar 1; 79 (3): 823-8.

    PurposeTo quantify the impact of preradiotherapy 18F-fluoro-2-deoxyglucose positron-emission tomography (FDG-PET) on treatment strategy and radiotherapy planning for patients with Stage I/II Hodgkin disease included in a large prospective multicenter study.Patients And MethodsConventional computed tomography and FDG-PET were performed just before the planned radiotherapy. The radiotherapy plan was first elaborated under blinded conditions for FDG-PET data. Then, the medical staff was asked to confirm or not confirm the treatment strategy and, if appropriate, to modify the radiotherapy plan based on additional information from FDG-PET.ResultsBetween January 2004 and January 2006, 137 patients were included (124 were available for analysis) in 11 centers (108 adults, 16 children). All but 1 patient had received chemotherapy before inclusion. Prechemotherapy work-up included FDG-PET for 61 patients, and data were available for elaboration of the first radiotherapy plan. Based on preradiotherapy FDG-PET data, the radiotherapy was cancelled in 6 patients (4.8%), and treatment plan modifications occurred in 16 patients (12.9%): total dose (11 patients), CTV volume (5 patients), number of beam incidences (6 patients), and number of CTV (6 patients). The concordance between the treatment strategies with or without preradiotherapy FDG-PET was 82.3%. Concordance results were not significantly different when prechemotherapy PET-CT information was available.ConclusionPreradiotherapy FDG-PET for treatment planning in Hodgkin lymphoma may lead to significant modification of the treatment strategy and the radiotherapy planning in patients with Stage I or II Hodgkin disease, even in those who have undergone FDG-PET as part of the prechemotherapy work-up.Copyright © 2011 Elsevier Inc. All rights reserved.

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