RESUMEN
PURPOSE: To determine the predictive value of gallium scans in patients with mediastinal Hodgkin's disease treated with chemotherapy or combined modality treatment. PATIENTS AND METHODS: A retrospective study was performed of 48 patients with mediastinal Hodgkin's disease treated with chemotherapy or combined modality therapy. Patients were monitored with whole-body planar scans (34 patients) or chest single-photon-emission computed tomography (SPECT) plus planar abdominal imaging studies (14 patients). Scans were performed at diagnosis, following three to eight cycles of chemotherapy, and after the end of treatment. The value of gallium scans in modifying treatment and predicting outcome was assessed. RESULTS: All patients studied at the time of diagnosis had abnormal gallium accumulation in the mediastinum. After chemotherapy, four patients had residual mediastinal activity; two patients with persistent activity on planar scans failed to enter remission and died of disease; two other patients with abnormal activity only seen on SPECT had therapy modified and remain in remission. After chemotherapy, 44 patients had a normal gallium scan. Twelve patients with negative scans relapsed, including nine patients with recurrence above the diaphragm. CONCLUSION: The use of gallium scans after several courses of chemotherapy resulted in a modification of treatment in four patients, including two patients who are apparently cured. However, after negative scans, 20% of patients relapsed above the diaphragm. These results suggest that gallium imaging, including SPECT, is of limited value in predicting disease sterilization, although the number of patients studied with SPECT was small. At present, the major value of gallium scans is to identify patients who may benefit from a modification of treatment.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Radioisótopos de Galio , Enfermedad de Hodgkin/diagnóstico por imagen , Enfermedad de Hodgkin/tratamiento farmacológico , Humanos , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
The mean concentration of total alpha-fetoprotein (AFP) measured in 51 primary breast cancer cytosols from postmenopausal women by radioimmunoassay after treatment with 0.4 M KCl was 87.2 IU AFP per ml. Little or no AFP was measured in these same cytosols before KCl treatment. After labeling KCl-treated human breast cancer cytosols with 125I, double immunodiffusion, immunoelectrophoresis, and autoradiography revealed that radiolabeled AFP codiffused and comigrated with alpha 1 electrophoretic mobility in a manner identical to that of added carrier cord serum AFP. These results indicate that human breast cancer cytosol contains appreciable amounts of a previously undetected AFP component that was initially nonimmunoreactive but became immunoreactive and measurable after KCl treatment. No positive correlation was found between the initial estrogen receptor content and AFP concentrations measured either before or after KCl treatment of breast cancer cytosols.