Hodgkin lenfoma hastalarında maksimum tümör çapı ve 18F-FDG PET/BT görüntüleme durumunun genel sağkalıma etkisi

Year 2023, Volume: 4 Issue: 5, 485 - 491, 27.10.2023

Vildan Gürsoy , Mehmet Refik Göktuğ , Fazıl Çağrı Hunutlu , İbrahim Ethem Pınar , Rıdvan Ali , Vildan Özkocaman , Fahir Özkalemkaş

https://doi.org/10.47582/jompac.1350661

Abstract

Amaç: Bu araştırma, tanı anındaki maksimum tümör çapının ve FDG PET BT durumunun sağkalım sonuçlarına etkisini belirlemeyi ve tedaviye yanıtı ve sağkalımı etkileyen prognostik faktörleri değerlendirmeyi amaçlamaktadır.
Yöntemler: Çalışmaya Hodgkin lenfoma tanısı alan 239 hasta katıldı. Sağkalımı etkileyen klinik özellikler, tedavi yanıtları ve prognostik faktörler, arşivlenmiş hasta tıbbi kayıtlarından retrospektif olarak analiz edildi.
Bulgular: Çalışmaya 136 (%56,1) erkek hasta ve 103 (%43,1) kadın hasta katıldı. Bu hastalardan 202'si (%84,5) hayatta kalırken, 37'si (%15,5) çalışma döneminde öldü. Hayatta kalan hastalar ile ölen hastalar karşılaştırıldığında, ölen hastaların ortalama yaşının daha yüksek (p = 0,003), dalak tutulumu ve B semptomlarının prevalansının daha yüksek olduğu (sırasıyla p = 0,011 ve p = 0,001), albümin düzeylerinin daha düşük olduğu (p = 0,008), daha yüksek beta-2 mikroglobulin düzeyleri (p = 0,001) ve daha fazla kemik iliği tutulumu (p = 0,006) görüldü. Beta-2 mikroglobulin düzeyi >2920 olan hastalarda mortalitede dört kat, dalak tutulumu olan hastalarda ise mortalitede 3.188 kat artış görüldü.
Sonuç: Sonuç olarak beta-2 mikroglobulin > 2920, dalak tutulumunun varlığı, nüks varlığı, ve FDG PET BT'de ilerleyici veya dirençli hastalığın varlığı, Hodgkin lenfoma hastalarında 1., 3. ve 5. yıllık sağkalım oranları açısından önemli prognostik faktörlerdi. Ek olarak hayatta kalma oranı ile FDG-PET veya CT ile ölçülen maksimum tümör çapı arasında bir korelasyon yoktu.

Keywords

Hodgkin lenfoma, prognostik faktörler, klinik göstergeler, FDG PET CT

The effect of maximum tumor diameter and 18F-FDG PET/CT imaging status on overall survival in Hodgkin lymphoma patients

Abstract

Aims: This research aims to determine the impact of maximum tumor diameter and FDG PET CT status at the time of diagnosis on survival outcomes and to identify prognostic factors that influence treatment response and survival.
Methods: 239 patients with a diagnosis of Hodgkin lymphoma participated in the study. Clinical characteristics, treatment responses, and prognostic factors influencing survival were retrospectively analyzed from patient medical records.
Results: There were 136 (56.9%) male patients and 103 (43.1%) female patients, who participated in the study. Of these patients, 202 (84.5%) survived, while 37 (15.5%) died during the study period. When surviving patients and non-survivor patients were compared, the deceased patients had a higher mean age (p = 0.003), a higher prevalence of spleen involvement and B symptoms (p = 0.011 and p = 0.001, respectively), lower albumin levels (p = 0.008), higher beta-2 microglobulin levels (p = 0.001), and more bone marrow involvement (p = 0.006). A fourfold increase in mortality was seen in patients with beta-2 microglobulin levels > 2920 mg/L, and a 3.188-fold increase in mortality was seen in patients with spleen involvement.
Conclusion: In conclusion, beta-2 microglobulin > 2920 mg/L, the presence of spleen involvement, the presence of relapse, and the presence of progressive or refractory disease in FDG PET CT were significant prognostic factors for 1st, 3rd, and 5th-year survival rates in patients with Hodgkin lymphoma. In addition, there was no correlation between survival rate and maximum tumor diameter as measured by FDG-PET or CT.

Keywords

Hodgkin lymphoma, prognostic factors, clinical indicators, FDG PET CT

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