Ga-67 citrate imaging in malignant lymphoma: final report of cooperative group.

In a large cooperative study of Ga-67 uptake in non-Hodgkin's malignant lymphoma, 76% of untreated patients showed positive uptake in one or more lesions. The percentage of known individual lesions seen on scan was significantly lower; thus, negative findings at any one site may have much less significance than positive findings. After treatment, the number of lesions seen decreases sharply, but the role of Ga-67 in evaluating response to therapy is uncertain, especially in view of the fairly large number of lesions undetectable before therapy. Histologic type plays a role in Ga-67 uptake. Large lesions are much more effectively detected than small ones. In spite of numerous false-negative results, Ga-67 scanning is a useful method in evaluating the extent of untreated disease and the presence of lesions posttherapy.

Chemotherapy drug dose alteration due to radiation therapy in an adjuvant situation in breast cancer.

Fifty-six patients with T1-T3 and T2-T3 N0 medial lesions of breast carcinoma were randomized after modified radical mastectomy to receive either cytoxan, methotrexate, 5-fluorouracil (5-Fu) (CMF) chemotherapy for 1 year (group A) or CMF for 1 year and postoperative radiation therapy (group B). Thirty-two patients received chemotherapy alone and 25 patients received both chemotherapy and radiation therapy. Twenty-five of 32 group A patients (median age 52) and 20/24 group B patients (median age 50) were evaluable. Leukopenia was the major cause of drug dose reduction in both groups. In group A, 4/25 patients (16%) had leukopenia at less than the 2500 level, whereas 8/20 (40%) group B patients had leukopenia at the same level. If 70% of all three drug dosages are considered as adequate chemotherapy, 21/25 (84%) patients received adequate chemotherapy in group A, and 10/20 (50%) in group B (p approximately equal to 0.029 from contingency table). It appears that radiation therapy in postmastectomy patients hinders adequate drug dose delivery in an adjuvant setting.

Intraoral extranodal Hodgkin's disease.

A case of extranodal Hodgkin's disease that was limited to the maxillary alveolus has been presented. A team approach was used to diagnose and treat the lesion. After appropriate staging procedures, treatment consisted of local excision and cobalt teletherapy. Follow-up examinations for the past three years have failed to disclose recurrent or new disease.

Improved survival in the treatment of advanced Hodgkin's disease at a nonuniversity institution (1970-1979).

From 1970 through 1979, 89 patients with Hodgkin's disease were treated at the Marshfield Clinic/St. Joseph's Hospital. After the pathologic material was reviewed, the patients were analyzed to compare Group I (1970-1973) with Group II (1974-1979). Demographic characteristics in the two groups were similar. In the decade, 76% of patients achieved complete remission. In advanced-stage disease, 50% of patients achieved complete remission in Group I compared with 68% in Group II. At 5 years, 50% of patients were alive without COPP (cyclophosphamide, vincristine, procarbazine, prednisone) chemotherapy; with this treatment, 75% of patients survived (P = 0.02). There was improved survival comparing Group I (56% at 5 years) with Group II (76% at 5 years) patients with advanced disease (P = 0.004). More aggressive combination chemotherapy (COPP) was related to the improvement in survival (P less than 0.001). The advances in treatment made by cooperative groups and universities are being transferred to nonuniversity institutions, with appropriate improvement in survival of Hodgkin's disease.