Prognostic utility of interim 18F-FDG PET/CT after two cycles of ABVD in response assessment in Hodgkin’s lymphoma patients : single-center preliminary experience

Articles in Press

Document Type : Original Article

Authors

1 Hanoi Medical University Vietnam National Cancer Hospital

2 Hanoi Medical University

3 Viet Duc Hospital, Hanoi, Vietnam

4 108 Military Hospital, Hanoi, Vietnam

5 Vietnam National Cancer Hospital

10.22038/aojnmb.2025.89081.1644

Abstract

ABSTRACT

Purpose: This study evaluates the utility of interim 18F-FDG PET/CT (iPET)-guided therapy in a Southeast Asian population, addressing gaps in region-specific data. Key outcomes included treatment response rates and progression-free survival (PFS) stratified by iPET results (Deauville score (DS) 1–3 vs. 4–5). Findings will inform optimal risk-adapted strategies in resource-aware settings.

Material and Methods: A prospective study was conducted of 100 patients with Hodgkin Lymphoma (HL) at the Vietnam National Cancer Hospital from March 2020 to March 2024. All patients underwent baseline clinical assessment and imaging (CT and/or PET/CT), followed by two cycles of ABVD chemotherapy. IPET was performed for early response assessment using Deauville scores (DS), with subsequent treatment adjusted according to NCCN guidelines.

Results: A total of 100 patients with classical Hodgkin lymphoma (mean age: 32 ± 13.8 years; range: 9–73) were analyzed. Bulky disease and extranodal involvement were observed in 10.0% and 15.0% of cases, respectively. Early-stage disease (stage I–II) was present in 72.0%, and advanced-stage (stage III–IV) in 28.0%. After two cycles of ABVD, iPET showed a negative response (DS 1–3) in 78.0% of patients of whom 88.5% were DS 1 and a positive response (DS 4–5) in 22.0%, with DS 4 comprising 72.7% of these cases. Among favorable-risk patients (IPS 0–2), 61.5% achieved complete metabolic response (CMR), whereas 54.5% of high-risk patients (IPS 4–7) showed partial or no metabolic response (PMR/NMR). The 3-year progression-free survival (PFS) was significantly higher in the iPET-negative group compared to the iPET-positive group (93.6% vs. 40.9%, p < 0.0001). The sensitivity, specificity, negative predictive value, positive predictive value, and overall accuracy of iPET for predicting treatment outcome were 72.3%, 89.0%, 93.6%, 59.0%, and 86.0%, respectively. In both univariate and multivariate analyses, iPET was identified as an independent predictor of PFS (p < 0.05).

Conclusion: In a real-world Vietnamese cohort with Hodgkin lymphoma, interim PET/CT guided by Deauville scoring after two cycles of ABVD chemotherapy showed strong predictive value for treatment response. The results advocate for broader integration of NCCN-consistent risk-adapted strategies in Southeast Asia.

Keywords: Interim 18F-FDG PET/CT, Early response treatment, Progression-Free Survival, Hodgkin’s Lymphoma.

Keywords

Main Subjects

Asia Oceania Journal of Nuclear Medicine and Biology

Articles in Press, Accepted Manuscript
Available Online from 08 November 2025

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