Hodgkin disease: Prediction of outcome with Ga-67 scintigraphy after one cycle of chemotherapy

PURPOSE: To investigate gallium 67 scintigraphy performed early during trea tment as a means to predict outcome and thus to optimize treatment of Hodgk in disease (HD) in the future. MATERIALS AND METHODS: Ninety-eight patients with HD were examined. Thirty- one patients underwent Ga-67 scintigraphy after one chemotherapy cycle and 83 patients after a mean 3.5 cycles (range, 2-5 cycles). Sixteen patients u nderwent Ga-67 scintigraphy both after one cycle and at midtreatment. Patie nts underwent whole-body scintigraphy and single photon emission computed t omography of the torso. Torso computed tomography (CT) was performed after a mean 3.5 cycles (range, 2-6 cycles). Failure-free survival was compared b etween patients with positive and patients with negative test findings (Kap lan-Meier method), and the significance of the difference was calculated. T he association of failure-free survival with various prognostic clinical fa ctors before treatment was compared (log-rank test univariate analysis). RESULTS: Failure-free survival differed significantly (P < .002) between pa tients with positive and patients with negative Ga-67 scintigrams after one chemotherapy cycle but not at midtreatment. Failure-free survival was not significantly different between patients with positive and patients with ne gative CT scans at midtreatment. Twenty-two (92%) of 24 patients with negat ive Ga-67 scintigrams after one cycle and 64 (82%) of 78 patients with nega tive scintigrams at midtreatment remained in complete response. In four (57 %) of seven patients with positive Ga-67 scintigrams after one cycle, treat ment failed. CONCLUSION: Ga-67 scintigraphy after one cycle of chemotherapy is a good ea rly predictor of outcome of HD.