The role of radiotherapy in the treatment of stage III non-small cell lung cancer: a survey of clinical practices in Lombardy, Italy, by the Airo*-Lombardia Cooperative Group.

AIMS AND BACKGROUND: The role of radiotherapy in the treatment of stage III non-small cell lung cancer is controversial. The aim of this survey was to investigate the use of this modality in current clinical practice in Lombardy, a highly industrialized region of northern Italy. METHODS: A questionnaire was sent to all 13 radiotherapy centers in Lombardy, covering statistical, clinical, technical and strategical aspects, and the responses were analyzed. RESULTS: A wide range of attitudes was observed among participating radiation oncologists; the percentage of cases treated with curative intent varied largely between centers (4-100%), as did the proportion of patients given to radiation only rather than combined modality treatment (5-100% vs 0-90%). CONCLUSIONS: An urgent need exists for better cooperation between all clinicians involved in lung cancer treatment, pursuing the goals of a more uniform clinical practice and a more aggressive clinical research attitude.

The role of radiotherapy in the treatment of carcinoma of the prostate: a survey of clinical practices in Lombardy, Italy, by the AIRO-Lombardia Cooperative Group. Italian Association for Radiation Oncology.

AIMS AND BACKGROUND: We report the results of a survey performed in 1994 by the AIRO-Lombardia Cooperative Group, on the clinical patterns of radiation treatment for prostatic carcinoma in Lombardy, Italy, involving all radiotherapy centers serving an overall local population of about 8,800,000 people. METHODS: A questionnaire was sent to all 13 radiotherapy centers throughout Lombardy, asking for demographic and treatment details concerning the local population of patients with a localized (T1-4, N0-1, M0) carcinoma of the prostate treated with radiotherapy; 12 centers responded, making the basis for the present report. RESULTS: Analysis of collected data showed that in Lombardy: a) approximately 400 patients per year are irradiated for a localized carcinoma of the prostate, accounting for less than 30% of the total expected number of patients with this disease presentation; b) a complete staging (with PSA, transrectal ultrasonography, abdomino-pelvic CT or MRI scan and total-body bone scan) is performed in over 95% of patients before initiating radiotherapy; c) significant differences exist between radiotherapy centers as regards treatment planning and delivery. CONCLUSIONS: An urgent need exists for implementing procedures aimed at standardizing radiotherapy procedures within Lombardy.

[Right atrial myxoma: echocardiographic diagnosis and review of the literature. Description of a clinical case]. / Mixoma atriale destro: diagnosi ecocardiografica e revisione della letteratura. Descrizione di un caso clinico.

Two-dimensional echocardiography is the method of first choice for diagnosing right atrial myxoma. A case of right atrial myxoma, documented by two-dimensional echocardiography, is here presented. Two-dimensional echocardiography allows accurate assessment of, tumor size, site of attachment, mobility and consistency. This non-invasive technique has replaced angiocardiography in the routine preoperative evaluation of these cases. The myxomatous nature of the mass was confirmed at surgery.

[Analysis of diastolic heart function. Principles and considerations on the use of 2 harmonics]. / Analisi della funzione cardiaca diastolica. Principi e considerazioni sull'uso di due armoniche.

In this study the authors have briefly exposed the mathematical bases about the application of the Fourier transform in cardiac radioisotopic examinations. It has pointed out the usefulness of two harmonics for clinical applications.

[Equilibrium radioisotope angiocardioscintigraphy in noninvasive diagnosis of chronic respiratory insufficiency]. / L'angiocardioscintigrafia radio-isotopica all'equilibrio nella diagnostica non invasiva dell'insufficienza respiratoria cronica.

The role and utility of equilibrium radionuclide angiocardiography was estimated in non-invasive diagnosis of patients with Chronic Obstructive Pulmonary Disease (COPD). In 26 healthy subjects the average value of Right Ventricular Ejection Fraction (RVEF) was 54.8 +/- 7.2, versus 40.89 +/- 7.85 in 37 patients with COPD. Right heart catheterization was performed on 9 patients with COPD, randomly chosen, to analyze the correlation between RVEF values and average Pulmonary Artery Pressure (PAP) values: the correlation index was significantly high (r = 0.80). Moreover, an important agreement was observed between RVEF and PaCO2 values (r = 0.77).

[Ultrasonography in the preoperative staging of carcinoma of the breast]. / L'ecotomografia nella stadiazione preoperatoria del carcinoma mammario.

Data relative to 51 patients operated for breast carcinoma were retrospectively reviewed. All patients had undergone US and mammographic evaluation of max diameter of the neoplastic nodule. The above data were correlated with pathologic measurements of the surgical specimens. US-pathologic correlation coefficient was extremely high (r = 0.94). US proved especially helpful in those cases where mammography had failed to visualize the mass-namely in patients with dense breasts. Nearly all evaluated carcinomas had a typical US pattern: a hypoechoic lesion with irregular outline. US is recommended in evaluating tumor response to nonsurgical conservative treatment.

[A comparative evaluation of iodine-131 OIH and technetium-99m MAG3 in the study of renal function]. / Valutazione comparata di Iodio-131 OIH e Tecnezio-99m MAG3 nello studio della funzionalità renale.

A new renal imaging agent, 99mTc mercaptoacetyltriglycine (MAG3), has been recently proposed in the nuclear medicine evaluation of renal function. Just like 131 orthoiodohippurate (OIH), 99mTc MAG3 is removed mainly by the renal tubules. An heterogeneous group of 39 patients underwent a radioisotopic study with the simultaneous injection of OIH (131I) and 99mTc MAG3. Image quality was found to be better with 99mTc MAG3 than with OIH (131I), because the former always allowed renal regions of interest (ROI) to be clearly demonstrated, even in case of severe renal impairment. A quantitative analysis was also carried out: effective renal plasma flow (ERPF) values were compared with renographic peak times evaluated by using both radiotracers. Our results demonstrate a firm correlation to exist between the informative content yielded by 99mTc MAG3 and by OIH (131I). Absolute ERPF value was higher with MAG3, but the correlation index (r = 0.98) allowed a simple correction factor to be introduced. In conclusion, MAG3 appears to be a good alternative to OIH.

[SPECT with 99m-TC HM PAO in the study of classical hemicrania]. / La SPET con 99mTc-HM PAO nello studio dell'emicrania classica.

Five patients presenting with migraine attacks underwent Electroencephalography (EEC), Computed Tomography (CT) and Single Photon Emission Tomography (SPECT) with 99mTc-HM PAO. EEG and SPECT were subsequently repeated in the intercritical period. We observed that: two patients only showed non-specific abnormalities in EEG; scans were normal in all patients; all subjects exhibited diffuse cortical hypoperfusion. A strong correlation was always found between clinical presentation and hemispheric impairment. One patient exhibited asymmetrical perfusion between cerebellum hemispheres; intercritical SPECT showed homogeneous distribution of the radio-tracer in four patients. In the last one minimal residual hypoperfusion was observed, although less marked than in the acute phase. Therefore SPECT with 99mTc-HM PAO can be reasonably employed as the examination of choice when a migraine attack is clinically suspected, because of its reproducibility and reliability. It can be easily performed in every nuclear medical center supplied with modern tomographic gamma-cameras.