| Surveillance imaging of Hodgkin lymphoma patients in first remission: a clinical and economic analysis. | |
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MedLine Citation:
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PMID: 20564135 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The majority of patients with Hodgkin lymphoma (HL) achieve disease remission after primary therapy. To the best of the authors' knowledge, no consensus exists for postremission surveillance imaging. METHODS: Retrospectively analyzed were 192 adult patients with classic HL in first remission. Events were defined as recurrent HL or secondary malignancies. Primary outcome was positive predictive value (PPV) of surveillance positron emission tomography/computed tomography (PET/CT) and CT scans in event detection. Secondary outcomes were costs and radiation exposures of surveillance scans. RESULTS: Sixteen events (12 recurrent HL cases and 4 secondary malignancies) were detected during a median follow-up of 31 months. The PPV of surveillance PET/CT was 22.9% compared with 28.6% for CT (P=.73). Factors that were found to significantly improve the PPV of scans in detecting recurrent HL included PET and CT concordance, involvement of a prior disease site, or the occurrence of a radiographic abnormality within 12 months. There were too few events to determine whether event detection by PET/CT versus CT or the presence of symptoms at the time of event detection affected overall outcomes. The cost to detect a single event was approximately $100,000. Radiation exposure to detect a single event was 146.6 millisieverts per patient for each of 9 patients. CONCLUSIONS: For patients with HL in first disease remission, surveillance radiography appears to be expensive, with limited clinical impact. Surveillance CT is generally adequate. |
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Authors:
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Alfred Ian Lee; Dan S Zuckerman; Annick D Van den Abbeele; Suzanne L Aquino; Diane Crowley; Christiana Toomey; Ann S Lacasce; Yang Feng; Donna S Neuberg; Ephraim P Hochberg |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Cancer Volume: 116 ISSN: 0008-543X ISO Abbreviation: Cancer Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-10 Completed Date: 2010-10-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0374236 Medline TA: Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 3835-42 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 American Cancer Society. |
Affiliation:
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Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02114, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Female Fluorodeoxyglucose F18 / diagnostic use Hodgkin Disease / economics*, radiography*, radionuclide imaging* Humans Male Middle Aged Neoplasms, Second Primary / diagnosis Positron-Emission Tomography* Predictive Value of Tests Recurrence Remission Induction Retrospective Studies Tomography, X-Ray Computed* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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