Relationship Between the Response to Treatment and the Prognosis of Patients with Aggressive Lymphomas Treated with Chemotherapy Followed by Involved-field Radiotherapy: Radiographic Assessment

Objective We examined the relationship between the response to treatment and prognosis of patients with aggressive lymphoma. Methods We reviewed 33 patients with aggressive lymphoma treated with chemotherapy consisting of the CHOP regimen followed by radiotherapy. Twelve patients had Stage I, 13 had Stage II, 6 had Stage III and 2 had Stage IV disease. According to the International Prognostic Index (IPI), 13 had low, 15 had low-intermediate, 2 had high-intermediate and 3 had high IPI. After three to six cycles of chemotherapy, involved-field radiotherapy was performed. We evaluated the response to treatment by computed tomography (CT), magnetic resonance imaging (MRI) and gallium scintigraphy (Ga-67) at the time of completion of chemotherapy and at the time of completion of radiation therapy. The median follow-up period was 48 months (4–80). Results The 2-year progression-free survival rates of the patients with Ga-67 positive uptake and Ga-67 negative uptake after completion of chemotherapy were 78 and 26% (P = 0.009), respectively. However, there were no statistically significant correlations between progression-free survival and the response after completion of chemotherapy determined by CT (P = 0.75) or MRI (P = 0.19). The response to treatment at the time of completion of overall treatment was not useful for prediction of prognosis. Conclusions Ga-67 positive uptake at the completion of chemotherapy before radiotherapy may be associated with poor prognosis.