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• W2107876993 abstract "Primary lymphoma of bone (PLB) is one of the rarest primary bone malignancies [1.Hicks D.G. Gokan T. O'Keefe R.J. et al.Primary lymphoma of bone.Cancer. 1995; 75: 973-980Crossref PubMed Scopus (78) Google Scholar, 2.Heyning F.H. Hogendoorn P.C.W. Kramer M.H.H. et al.Primary non-Hodgkin's lymphoma of bone: a clinicopathological investigation of 60 cases.Leukemia. 1999; 13: 2094-2098Crossref PubMed Scopus (113) Google Scholar]. Prognosis depends on the response to systemic chemotherapy, and, according to the response to primary treatment, subsequent treatment could be different; therefore, proper evaluation for treatment effectiveness is essential. However, evaluation of treatment effectiveness is more difficult than for other lymphomas owing to the characteristics of bone lesions [3.Barr J. Burkes R.L. Bell R. et al.Primary non-Hodgkin's lymphoma of bone.Cancer. 1994; 73: 1194-1199Crossref PubMed Scopus (123) Google Scholar, 4.Mulligan M.E. McRae G.A. Murphey M.D. Imaging features of primary lymphoma of bone.AJR Am J Roentgenol. 1999; 173: 1691-1697Crossref PubMed Scopus (174) Google Scholar]. Evaluation for the viability of a residual tumor after chemotherapy is very important, but difficult, since viable tumors cannot easily be differentiated from bone fibrosis and remodeling lesions. Therefore, it is not easy to accurately determine complete response (CR). A survey of 1422 non-Hodgkin's lymphoma (NHL) patients who were diagnosed at the Korea Institute of Radiological & Medical Sciences between 1989 and 2004 identified 28 patients with PLB (2%). In 18 of these cases, fluorodeoxyglucose positron emission tomography (FDG-PET) was used for evaluation of diagnosis and response, and for recurrence cases. All 18 cases were reviewed and confirmed with bone biopsy by an experienced hematopathologist. The clinical data and imaging findings of these 18 patients were monitored during treatment and follow-up period for changes in the imaging findings. All study findings were retrospectively interpreted jointly and in consensus by one radiologist and two nuclear physicians. All computed tomography (CT) or magnetic resonance imaging (MRI) scans of the involved lesions were timed to coincide with the PET images. We analyzed the clinical relevance of the separate imaging findings. The effects in staging, response and recurrence evaluation were determined according to the final clinical decisions. The study population is summarized in Table 1. The number of patients in whom PET findings would contribute to treatment decisions in addition to clinical findings was 15 out of 18 patients. PET contributed in the staging of 12 PBLs with polyostotic lesions. Five patients in whom there were difficulties in evaluating the response turned out to have CR during the follow-up period. The lesion finding resolved on a subsequent PET scan, with rapid decline of FDG uptake, indicating successful chemotherapy, although MRI findings were little changed. Four patients who had newly developed lesion on PET during the follow-up period showing CR turned out to have recurred, with rapid increase of FDG uptake. Those cases who were detected to have recurred resumed salvage high-dose chemotherapy with autologous hematopoietic stem-cell transplantation.Table 1Patient characteristicsPatientsSexAge (years)StagingSymptomFocalityNumber of sitesTreatmentResponseOutcome1Male24IVPain and swellingPolyostotic3ChemotherapyPRDOD2Female45IPainUnifocal1ChemotherapyCRAlive in CR3Male37IPainUnifocal1Chemotherapy plus radiationCRAlive in CR4Female31IPain and swellingMultifocal1Chemotherapy plus radiationCRAlive in CR5Male16IVPain and swellingPolyostotic4ChemotherapyPRAlive in PD6Female67IVPainPolyostotic4Chemotherapy plus radiationCRDOD7Female65IVPainPolyostotic4Chemotherapy plus radiationCRAlive in CR8Male24IVPainPolyostotic2Chemotherapy plus radiationCRAlive in CR9Female59IVPainPolyostotic4ChemotherapyCRAlive in CR10Female74IVPain and fracturePolyostotic4Chemotherapy plus radiationNADOD11Male22IVPainPolyostotic2Chemotherapy plus radiationCRAlive in CR12Female57IVPainPolyostotic3ChemotherapyCRAlive in CR13Male67IPain and fractureMultifocal1ChemotherapyPRAlive in PD14Male69IIPainUnifocal1ChemotherapyCRAlive in CR15Female23IVPainPolyostotic4ChemotherapyCRAlive in CR16Female73IVPain and swellingPolyostotic4Chemotherapy plus radiationNADOD17Male20IVPainPolyostotic4ChemotherapyCRAlive in CR18Male40IPainUnifocal1ChemotherapyCRAlive in CRCR, complete response; PR, partial response; PD, progressive disease; DOD, dead of disease; NA, not evaluable. Open table in a new tab CR, complete response; PR, partial response; PD, progressive disease; DOD, dead of disease; NA, not evaluable. This study showed the usefulness of PET scan in PBL. Compared with CT and MRI findings before and after treatment as well as at relapse, PET scanning was found to be superior for the evaluation of response. Consequently, both over- and under-treatment can be avoided. In cases of CR, PET scanning after treatment showed no hypermetabolic lesion, with a rapid decline of FDG uptake. However, follow-up MRI showed persistent bone lesion after partial response, suggesting that PET scanning was more sensitive in evaluation of response. Our results suggested that PET scanning is a useful method in treatment evaluation of PBL. FDG-PET will provide major contribution in the decision-making of further management in PBL. This abstract was presented at the 29th ESMO Congress and published in Abstract Book of the 29th ESMO Congress, Vienna, Austria, October 29 to November 2, 2004. A travel grant (ESMO Congress Committee) was awarded to enable attendance of the Meeting." @default.
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• W2107876993 title "Clinical impact of whole-body FDG-PET for evaluation of response and therapeutic decision-making of primary lymphoma of bone" @default.
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• W2107876993 doi "https://doi.org/10.1093/annonc/mdi234" @default.
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