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Lymphoma and Pets
Study Challenges Value of Routine CT Scans Following Treatment for DLBCL
A new study calls into question the value of CT scans in routine monitoring of post-treatment patients with diffuse large B-cell lymphoma (DLBCL).
The standard of care in DLBCL following immunochemotherapy involves computed tomography (CT) every six months for two years, among other things. The point of the CT scan is to catch relapse early, if relapse is to occur, and the earlier relapse is caught the better it can be treated.
Patients can detect relapse better than CT scans
However, Mayo Clinic researchers have carried out a study examining the usefulness of these routine CT scans and found that they are not nearly as good at detecting potential relapse as the patients themselves. Put another way, more often than not, clinical signs appeared before CT scans caught signs of relapse.
Specifically, the study followed 537 patients for a median of 59 months. Of those patients, 109 – or 20 percent – experienced relapse. Among them, routine CT scans detected relapse before any clinical signs appeared in just eight of the patients. More often, it was patient symptoms that indicated relapse.
CT scans increase risk of secondary cancer
Because CT scans expose patients to high levels of radiation and therefore make them more likely to develop secondary cancers, it is important to reevaluate the value of such scans.
Said the study's lead author Carrie Thompson, MD, a hematologist at the Mayo Clinic, Rochester, Minnesota:
Our results were surprising because the current standard of care is to include scans for the follow-up of this disease. We found that scans detected relapse in only a handful of patients who didn't have any of those other signs or symptoms.
Because this study is being presented as an abstract at the annual meeting of the American Society of Clinical Oncology, its findings should be considered preliminary until published in a peer reviewed journal.
Photo by Jacopo Werther