Introduction: To assess the role of interim positron emission tomography/computed tomography (PET/CT) and compare its with PET\CT results after the end of treatment the patients (pts) with advanced stages classical Hodgkin lymphoma (cHL).
Methods: 114 newly diagnosed cHL pts received 6 cycles EACOPP every 14 days (doxorubicin 50 mg\m2, cyclophosphamide, etoposide, procarbazine, vincristine, prednisone). Consolidation radiotherapy was given to 78 (68%) pts. Interim PET/CT (iPET) imaging after 2 cycles was done in 54 (48%) pts.
Results: With a median follow-up 35 months, 3-year progression-free survival (3-PFS) were 85%, overall survival - 92%. In 33 pts (61%) the iPET was negative - Deauville score 1-2 (DS 1-2). The residual uptake was higher than the mediastinal blood pool (MBP) uptake but below the liver uptake (DS 3) in 17 pts (31%) and 4 pts (8%) were PET-positive (DS 4-5). Сomplete metabolic response (CMR) after 2 cycles predicted higher 3-PFS compared PETpos (100% v 75%; p=0,0035 - figure 1). Patients with residual metabolic activity had equally good outcomes (100% v 92%; p=0,1). Of the 60 pts who not done iPET, 24 (40%) were performed PET\CT after the end of 6 EACOPP-14. There is not difference of outcome between 19 pts with CMR after the end of chemotherapy and 36 pts with CR\uCR according chest\abdominal\pelvic CT with contrast of diagnostic quality (3-PFS 78% v 91%; p<0,1).
Conclusion: The intensive EACOPP-14 program showed good and early response for pts with advanced stage cHL. Predictive value of metabolic response after 2 cycles was higher than PET-negativity after the end of chemotherapy.