SEGHI Study: Defining the Best Surveillance Strategy in Hodgkin Lymphoma after First-Line Treatment
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | N = 640 Patients |
---|---|
Age (median) | 45.5 years (r: 18.2–93.2) |
Histological Type | NSHL: 434 (67.8%) MCHL: 112 (17.5%) LRHL: 44 (6.9%) LDHL: 5 (0.8%) Not specified: 45 (7%) |
Stage | I–II: 375 (58.6%) III–IV: 262 (41%) Missing data: 3 (0.4%) |
Treatment Group | Favorable localized: 178 (27.8%) Unfavorable localized: 179 (28%) Advanced IPS 1–3: 166 (25.9%) Advanced IPS 4–7: 115 (18%) Missing data: 2 (0.3%) |
Type of treatment | Radiotherapy: 35 (5.5%) Radiotherapy + chemotherapy: 253 (39.5%) Chemotherapy: 350 (54.7%) Missing data: 2 (0.3%) |
Chemotherapy | ABVD: 564 (88.1%) BEACOPP: 37 (5.8%) Other: 29 (4.5%) Missing data: 10 (1.6%) |
Follow-up strategies | Clinical/analytical: 202 (31.6%) CT-Scan every 3 months: 58 (9.1%) CT- Scan every 6 months: 232 (36.3%) PET/CT every 3 months: 43 (6.7%) PET/CT every 6 months: 82 (12.8%) Missing data: 23 (3.5%) |
Follow-Up Strategy | ||||||
---|---|---|---|---|---|---|
Clinical/Analytical (n = 202) | CT-Scan Every 3 Months (n = 58) | CT-Scan Every 6 Months (n = 232) | PET/CT Every 3 Months (n = 43) | PET/CT Every 6 Months (n = 82) | ||
Age (median) | 46.9 (r:18.2–93.2) | 41.2 (r:20.7–84.7) | 45.6 (r:20.4–92.4%) | 44.2 (r:19.8–82.7) | 45.7 (r:20.1–90.2) | |
Histological Type | NSHL | 125 (63.5%) | 47 (81%) | 149 (64.8%) | 39 (90.7%) | 58 (75.3%) |
MCHL | 34 (17.3%) | 8 (13.8%) | 49 (21.3%) | 2 (4.7%) | 16 (20.8%) | |
LRHL | 20(10.2%) | 1 (1.7%) | 17 (7.4%) | 1 (2.3%) | 3 (3.9%) | |
LDHL | 1 (0.5%) | 0 (0%) | 3 (1.3%) | 0 (0%) | 0 (0%) | |
Not specified | 17 (8.5%) | 2 (3.4%) | 12 (5.2%) | 1 (2.3%) | 0 (0%) | |
Stage | I-II | 130 (64.7%) | 32 (55.1%) | 141 (60.8%) | 19 (44.2%) | 44 (54.3%) |
III-IV | 71 (35.3%) | 26 (44.8%) | 91 (39.2%) | 24 (55.8%) | 37 (45.7%) | |
Treatment Group | Favorable localized | 68 (33.8%) | 23 (39.7%) | 61 (26.3%) | 3 (7%) | 20 (24.4%) |
Unfavorable localized | 57 (28.4%) | 8 (13.8%) | 76 (32.8%) | 13 (30.2%) | 19 (23.2%) | |
Advanced IPI 1–3 | 46 (22.9%) | 10 (17.2%) | 68 (29.3%) | 17 (39.5%) | 17 (20.7%) | |
Advanced IPI 4–7 | 30 (14.9%) | 17 (29.3%) | 27 (11.6%) | 10 (23.3%) | 26 (31.7%) | |
Type of treatment | Radiotherapy | 6 (3%) | 13 (22.4%) | 15 (6.5%) | 1 (2.4%) | 0 (0%) |
Chemo+Radiotherapy | 74 (36.6%) | 28 (48.3%) | 112 (48.3%) | 7 (16.7%) | 24 (29.3%) | |
Chemotherapy | 122 (60.4%) | 17 (29.3%) | 105 (45.3%) | 34 (81%) | 58 (70.7%) | |
Type of chemotherapy | ABVD | 171 (86.8%) | 56 (98.2%) | 217 (94.3%) | 39 (92.9%) | 59 (72%) |
BEACOPP | 12 (6.1%) | 0 (0%) | 3 (1.3%) | 3 (7.1%) | 19 (23.2%) | |
Other | 14 (7.1%) | 1 (1.8%) | 10 (4.3%) | 0 (0%) | 4 (4.9%) |
Follow-Up Strategy | p-Value | |||||
---|---|---|---|---|---|---|
Clinical/Analytical (n = 202) | CT-Scan Every 3 Months (n = 58) | CT-Scan Every 6 Months (n = 232) | PET/CT Every 3 Months (n = 43) | PET/CT Every 6 Months (n = 82) | ||
Visits/year (median) | 4 (0–10) | 4 (2–12) | 4 (1–15) | 6 (2–21) | 4 (1–12) | <0.001 * |
Median number of CT-scans (2y) (n = 579) | 1 (0–6) | 6 (2–10) | 3 (2–8) | 2 (0–4) | 0 (0–4) | 0.001 * |
Median number of CT-scans (5y) (n = 319) | 3 (0–17) | 7 (3–14) | 5 (2–11) | 3 (0–7) | 0 (0–5) | <0.001 * |
Median number of PET/CT (2y) (n = 579) | 0 (0–8) | 1 (1–6) | 0 (0–6) | 6 (1–10) | 3 (1–9) | <0.001 * |
Median number of PET/CT (5y) (n = 319) | 0 (0–5) | 1 (1–7) | 0 (0–6) | 8 (3–16) | 6 (2–9) | <0.001 * |
2-year Cumulative Radiation Exposure (msV) (median) (n = 579) | 19.9 (0–140) | 126.68 (46.68–240.08) | 59.94 (0–200.04) | 80.16 (6.7–187.12) | 20.1 (13.4–140.22) | <0.001 * |
5-year Cumulative Radiation Exposure (msV) (median) (n = 319) | 40.1 (0–339.7) | 146.56 (66.64–326.62) | 99.9 (39.9–259.98) | 113.54 (20.1–206.86) | 40.2 (13.4–160.2) | <0.001 * |
Findings that Identified Relapse | Relapse (n = 68) |
---|---|
Clinical History | 9 (13.2%) |
Physical Examination | 10 (14.7%) |
Laboratory abnormalities | 2 (2.9%) |
Clinical History + Physical Examination | 5 (7.4%) |
Clinical History + Physical Examination + Laboratory abnormalities | 8 (11.8%) |
Clinical/ analytical + image | 8 (11.8%) |
42 (61.7%) | |
CT-SCAN | 17 (25.1%) |
PET/CT | 9 (13.1%) |
26 (38.2%) | |
Type of laboratory finding | |
Blood cell counts | 6 (33.3%) |
ESR | 7 (38.8%) |
LDH | 4 (22.2%) |
Other | 1 (5.6%) |
Surveillance Strategies | PFS at 12 Months | PFS at 24 Months | PSF at 60 Months | Median Time to Relapse (Month) |
---|---|---|---|---|
Clinical/analytical (n = 202) | 96% | 94% | 86% | 16.2 |
CT-Scan every 3 months (n = 58) | 85% | 82% | 82% | 9.4 |
CT-Scan every 6 months (n = 232) | 96% | 96% | 87% | 18.4 |
PET/CT every 3 months (n = 43) | 97% | 92% | 92% | 19.2 |
PET/CT every 6 months (n = 82) | 95% | 90% | 90% | 13.2 |
CT-Scan, total (n = 290) | 95% | 92% | 92% | 14.2 |
PET/CT, total (n = 125) | 95% | 92% | 88% | 16.5 |
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Bastos Oreiro, M.; Martín, R.; Gomez, P.; López Muñoz, N.; Rodriguez, A.; Liébana, M.; Navarro, B.; Sánchez-González, B.; Marí, P.; Pérez de Oteiza, J.; et al. SEGHI Study: Defining the Best Surveillance Strategy in Hodgkin Lymphoma after First-Line Treatment. Cancers 2021, 13, 2412. https://doi.org/10.3390/cancers13102412
Bastos Oreiro M, Martín R, Gomez P, López Muñoz N, Rodriguez A, Liébana M, Navarro B, Sánchez-González B, Marí P, Pérez de Oteiza J, et al. SEGHI Study: Defining the Best Surveillance Strategy in Hodgkin Lymphoma after First-Line Treatment. Cancers. 2021; 13(10):2412. https://doi.org/10.3390/cancers13102412
Chicago/Turabian StyleBastos Oreiro, Mariana, Reyes Martín, Pilar Gomez, Nieves López Muñoz, Antonia Rodriguez, Marta Liébana, Belén Navarro, Blanca Sánchez-González, Pilar Marí, Jaime Pérez de Oteiza, and et al. 2021. "SEGHI Study: Defining the Best Surveillance Strategy in Hodgkin Lymphoma after First-Line Treatment" Cancers 13, no. 10: 2412. https://doi.org/10.3390/cancers13102412