Fine-Tuning the Treatment of Hodgkin’s Lymphoma
Menée sur 1 119 patients atteints d'un lymphome hodgkinien de stade avancé et inclus dans un essai évaluant une chimiothérapie ABVD par rapport à une chimiothérapie AVD (durée médiane de suivi : 41 mois), cette étude évalue l'intérêt d'une tomographie numérique par émission de positrons pour suivre la réponse au traitement et adapter le protocole thérapeutique afin de réduire sa toxicité et améliorer son efficacité
In 2007, Gallamini et al. published the dramatic results of a retrospective study describing the independent prognostic significance of an early interim positron-emission tomographic (PET) scan in advanced Hodgkin’s lymphoma. The 2-year progression-free survival among patients with a persistently positive PET scan after two cycles of chemotherapy was a dismal 12.8%, as compared with 95.0% among those with a negative interim PET scan. Investigators across the world saw this as the way forward, using a “response adapted” approach to eliminate potentially unnecessary treatment in patients with an early negative PET scan and to intensify treatment in those with a positive interim PET scan. In the context of nonbulky early-stage disease, this approach has been used to restrict the use of consolidative radiotherapy to patients with a positive early PET scan, thereby sparing this relatively young population the risk of late radiotherapy-associated effects
New England Journal of Medicine , éditorial en libre accès, 2015