Using PET scanning to predict treatment outcomes for older patients with Hodgkin lymphoma

This study evaluated whether PET scanning during treatment can help predict outcomes for older patients with Hodgkin’s lymphoma (HL). This study concluded that PET scanning during treatment was highly predictive of outcomes for these patients.

Medical imaging is used during treatment (interim) to evaluate how well a patient is responding to therapy. Depending on the imaging results, treatment can be decreased, increased, or changed to a different therapy. Interim PET-CT scanning (iPET) is usually done after 2 to 3 cycles of chemotherapy.  This type of scanning can help predict treatment outcomes and plan further treatments.

After scanning, the iPET scans are scored. A higher score means that cancer cells are still present. A lower score means that cancer is not present. iPET has been helpful in predicting long-term outcomes for young patients with HL. However, the role of iPET in treating patients older than 60 with HL is unclear.

This study had 78 patients of 60 years and older with HL. 72% of patients had advanced-stage disease. After 2 cycles of chemotherapy, all patients received iPET. Patients were followed-up for an average of 5 years.

Overall, 86% of patients had a complete disappearance of all signs of cancer (complete response). 4% of patients had tumor shrinkage (partial response). 75% of patients were still alive 5 years later, with 65% of patients not having tumor growth or spread.

Overall, 83% of patients had iPET scores of 1, 2, or 3. 17% of patients had iPET scores of 4 or 5. Significantly more patients with scores of 1 – 3 were still alive 5 years later compared to patients with scores of 4 – 5 (82% vs. 45%). Also, significantly more of these patients were still alive 5 years later without tumor growth or spread (72% vs. 25%).

67% of patients received ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy. After treatment, 72% of these patients had an iPET score of 1. Significantly more of these patients with iPET scores of 1 – 3 were still alive 5 years later compared to patients with scores of 4 – 5 (87% vs. 57%). Also, significantly more of these patients were still alive 5 years later without tumor growth or spread (69% vs. 14%).

This study concluded that older patients with lower iPET scores had significantly better outcomes than patients with higher iPET scores. The authors suggest that iPET can help guide therapy for these patients to improve treatment outcomes.

This was a small study. Larger studies are needed to confirm the role of iPET scanning in the treatment of elderly patients with HL.

Talk to your oncologist about the potential benefits of iPET scanning.