The influence of Sm-153 therapy on bone marrow function.

AIM OF THE STUDY: Studies about possible risks connected with ß-emitterradiotherapy concentrate mainly on potential myelotoxicity. Results of previously published analysis based on white blood cells (WBC) and platelet (PLT) counts - before and after radionuclide treatment - are quite varied. The aim of our study was to present the greatest possible impact of Samarium-153 on bone marrow function in clinical practice. MATERIAL AND METHODS: The study included the blood test results of 175 patients with bone metastases treated with Sm-153 in the years 2012-2014. We compared levels of WBC, PLT, red blood cells (RBC), and haemoglobin (HGB) from two blood tests - one performed directly before the therapy and the other 2-6 weeks after isotope injection. RESULTS AND CONCLUSIONS: The study showed decreased mean level of WBC in a control test performed after therapy in comparison to output results at about 27.1%. In our study 1.1% of patients developed the third-grade toxicity in CTCAE (Common Terminology Criteria for Adverse Events). Mean decrease of PLT was about 18%. Three patients (1.7% of all) result qualified as third-grade toxicity in a control test, one as fourth-grade. Analysis of RBC level showed 5.7% reduction of output values. The same calculation was seen for HGB - 5.1%. The greatest but acceptable decrease in haematological parameters was observed in WBC and PLT. Analysis of changes in WBC and PLT level showed them to be similar or smaller than was proven in previously published studies.

[Evaluation of positron emission tomography by using F-18-fluorodeoxyglucose in diagnosis of recurrent colorectal cancer]. / Ocena pozytonowej tomografii emisyjnej z uzyciem F-18-fluorodeoksyglukozy w rozpoznawaniu wznowy raka jelita grubego.

UNLABELLED: Accurate detection of recurrent colorectal carcinoma remains a clinical challenge. 18-F-fluorodeoxyglucose-positron emission tomography is new imaging technique that allows direct evaluation of cellular metabolism. This method is mainly used in oncology, especially in fusion with computer tomography (FDG-PET/CT, PET/CT Fusion). The aim of the study was to evaluate the usefulness of FDG-PET/CT in diagnosis of recurrent colorectal cancer. MATERIAL AND METHODS: The results of FDG-PET/CT scan performed in 120 patients who had suspected recurrence disease were analyzed retrospectively. The definite diagnosis was established on the basis of histopathological examination or clinical follow-up. FDG-PET/CT results were compared with 76 computer tomography (CT), 30 magnetic resonance imaging (MRI), 81 ultrasonography (US), 75 chest roentgenogram (X-ray) and 91 carcinoembryonic antigen (CEA) test. RESULTS: Recurrence colorectal cancer was demonstrated on FDG-PET-CT in 69 patients (57.5%). In 24 patients local recurrence, 33 liver metastases, 23 pulmonary metastases and in 36 other metastases were found. A total of 116 suspicious lesions were identified. The final diagnosis of recurrence was obtained in 56 patients (46.6%). Sensitivity, specificity, and accuracy for malignant findings were: for FDG-PET/CT 98, 94 and 97%; for CEA test 68, 82 and 72%; for CT scan 85, 91 and 89%; for RMI scan 96, 86 and 93%; for ultrasound test 71, 96 and 82%; for X-ray 87, 96 and 92%, respectively. FDG-PET-CT influenced surgical decisions in 23.6% of cases. CONCLUSIONS: FDG-PET/CT is a very useful diagnostic method in case of patients with suspected recurrence of colorectal carcinoma. Its usefulness is higher than the serum level of CEA and other conventional imaging modalities (CT MRI, US, X-ray).

[Radionuclide therapy for painful bone metastases]. / Radioizotopy w leczeniu bolesnych przerzutów do kosci.

The paper presents the possibilities of therapy of painful bone metastases, which result from nuclear medicine development. Authors discuss fundamental problems connected with radionuclide therapy. The emphasis is put on the efficiency and safety of this treatment for patients and their environment.

Influence of the 6-month anemia therapy with erythropoietin on renal function and some hemodynamic parameters in predialysis patients.

OBJECTIVES: The aim of this study was to evaluate the influence of a 6-month anemia therapy with recombinant human erythropoietin (rHuEpo) on glomerular filtration rate (GFR) and renal blood flow related to hemoglobin (Hb) concentration, changes in heart function and total peripheral resistance in patients with chronic kidney disease (CKD) treated conservatively. PATIENTS AND METHODS: We evaluated 13 patients (9 women and 4 men) aged 64.8 +/- 8.9 years with serum creatinine of 3.82 +/- 1.30 mg/dl and Hb concentration of 10.02 +/- 0.45 g/dl. rHuEpo was given in the mean dose of 2296 +/- 673 U/week s.c. to achieve Hb 12 g/dl. At baseline and after 6 months of rHuEpo therapy echocardiography and renoscintigraphy were performed. RESULTS: After 6 months' therapy Hb increased significantly, while blood pressure did not change significantly. Renal anemia correction led to a decrease in left ventricular end-diastolic dimension index, left ventricular end-diastolic volume index, stroke volume index and cardiac index. Total peripheral vascular resistance index increased significantly. At the same time a significantly reduced left ventricular mass index was observed. Correction of renal anemia and changes in systemic hemodynamics did not exert unfavorable effect on renal hemodynamic parameters. GFR index, blood flow rate index, renal vascular resistance index and filtration fraction remained unchanged. During rHuEpo therapy decline in renal function expressed as 1/serum creatinine did not differ compared with a 6-month period before initiating rHuEpo therapy. CONCLUSIONS: Therapy with rHuEpo in patients with stage 3 and 4 CKD with correct blood pressure control does not result in worsening of renal function despite changes in left ventricular function and increase of total peripheral resistance.