Recently published studies demonstrated very high event free survival for patients with a normal interim PET/CT and a high hazard ratio for progression of an interim positive (pathological)study. These findings strongly support the integration of interim PET as a decision point for adjustment of chemotherapy.This study use the minimal therapy considered safe according to the predefined risk factors for patients with interim negative PET. Those with pathologic interim study considered as higher risk patients will have dose escalation of therapy.remission rate ,event free survival and overall survival will be evaluated.
study aim is to tailor the therapy in order to administer the lowest cumulative dose of therapy yet considered safe in order to reduce both early and late therapy related complications. patients will be divided according to risk factors to sub groups of early favorable, early unfavorable, advanced disease with score less then 3 points or higher then 3 points. Early Interim PET will be carried out Further therapy will be based on the study results.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
365
sintigraphy with PET/CT following 2 cycles of chemotherapy on day 12-14 following chemotherapy
RAMBAM health care campus
Haifa, Israel
Event Free survival in various risk groups of patients
Time frame: five years
Event Free Survival
Time frame: 5 years
overall survival5 years
Time frame: 5 years
event free survival 5 years
Time frame: five years
Disease free survival 5 years
Time frame: five years
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