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Sample records for bone metastases potency

  1. Establishment of an experimental human lung adenocarcinoma cell line SPC-A-1BM with high bone metastases potency by {sup 99m}Tc-MDP bone scintigraphy

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    Yang Shunfang [Department of Nuclear Medicine, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China)], E-mail: yzyg@sh163.net; Dong Qianggang [Laboratory of Mol-diagnosis, Shanghai Cancer Institute of Shanghai Jiaotong University, Shanghai 200032 (China); Yao Ming [Laboratory of Pathology, Shanghai Cancer Institute of Shanghai Jiaotong University, Shanghai 200032 (China); Shi Meiping [Department of Pathology, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Ye Jianding [Department of Radiology, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Zhao Langxiang [Department of Pathology, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Su Jianzhong; Gu Weiyong [Shanghai Thoracic Tumor Institute, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Xie Wenhui [Department of Nuclear Medicine, Shanghai Chest Hospital of Shanghai Jiaotong University, Shanghai 200030 (China); Wang Kankan; Du Yanzhi [State Key Laboratory of Medical Genomics, Ruijin Hospital of Shanghai Jiaotong University, Shanghai 200025 (China); Li Yao [State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Science, Fudan University, Shanghai 200433 (China); Huang Yan [State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Science, Fudan University, Shanghai 200433 (China)], E-mail: huangyan@fudan.edu.cn

    2009-04-15

    Background: Bone metastasis is one of the most common clinical phenomena of late stage lung cancer. A major impediment to understanding the pathogenesis of bone metastasis has been the lack of an appropriate animal and cell model. This study aims to establish human lung adenocarcinoma cell line with highly bone metastases potency with {sup 99m}Tc-MDP bone scintigraphy. Methods: The human lung adenocarcinoma cancer cells SPC-A-1 were injected into the left cardiac ventricle of NIH-Beige-Nude-XID (NIH-BNX) immunodeficient mice. The metastatic lesions of tumor-bearing mice were imaged with {sup 99m}Tc-MDP bone scintigraphy on a Siemens multi-single photon emission computed tomography. Pinhole images were acquired on a GZ-B conventional gamma camera with a self-designed pinhole collimator. The mice with bone metastasis were sacrificed under deep anesthesia, and the lesions were resected. Bone metastatic cancer cells in the resected lesions were subjected for culture and then reinoculated into the NIH-BNX mice through left cardiac ventricle. The process was repeated for eight cycles to obtain a novel cell subline SPC-A-1BM. Real-time polymerase chain reaction (PCR) was used to compare the gene expression differences in the parental and SPC-A-1BM cells. Results: The bone metastasis sites were successfully revealed by bone scintigraphy. The established bone metastasis cell line SPC-A-1BM had a high potential to metastasize in bone, including mandible, humerus, thoracic vertebra, lumbar, femur, patella, ilium and cartilage rib. The expression level of vascular endothelial growth factor gene family, Bcl-2 and cell adhesion-related genes ECM1, ESM1, AF1Q, SERPINE2 and FN1 were examined. Gene expression difference was found between parental and bone-seeking metastasis cell SPC-A-1BM, which indicates SPC-A-1BM has metastatic capacity vs. its parental cells. Conclusion: SPC-A-1BM is a bone-seeking metastasis human lung adenocarcinoma cell line. Bone scintigraphy may be used as

  2. [Bone metastases treated with radiopharmaceuticals].

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    Giammarile, Francesco

    2013-11-01

    The administration of a radionuclide in unsealed source whose radiation will destroy cells that have selectively accumulated product is called radiometabolic therapy. The management of bone pain is a major problem, particularly in cases of breast or prostate where the presence of metastases can remain compatible with long-term survival of cancer patients. In this context, the radiometabolic therapy reduces the pain secondary to bone metastases, in association or not with analgesics. This technique is rarely prescribed as first-line. It can also be combined with external beam radiotherapy or chemotherapy, if clinical conditions permit (due to the increased risk of hematologic toxicity). In this setting, the currently used substances are Metastron® and Quadramet®. Recently, a new product, radium chloride (or Alpharadin®) has shown efficacy in bone metastases from prostate cancer, particularly in terms of bone pain palliation, but also of increased overall survival. In addition, this product has virtually no hematologic toxicity.

  3. New molecular targets in bone metastases.

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    Santini, D; Galluzzo, S; Zoccoli, A; Pantano, F; Fratto, M E; Vincenzi, B; Lombardi, L; Gucciardino, C; Silvestris, N; Riva, E; Rizzo, S; Russo, A; Maiello, E; Colucci, G; Tonini, G

    2010-11-01

    Bone metastases have a major impact on morbidity and on mortality in cancer patients. Despite its clinical relevance, metastasis remains the most poorly elucidated aspect of carcinogenesis. The biological mechanisms leading to bone metastasis establishment have been referred as "vicious circle," a complex network between cancer cells and the bone microenvironment. This review is aimed to underline the new molecular targets in bone metastases management other than bisphosphonates. Different pathways or molecules such as RANK/RANKL/OPG, cathepsin K, endothelin-1, Wnt/DKK1, Src have recently emerged as potential targets and nowadays preclinical and clinical trials are underway. The results from those in the advanced clinical phases are encouraging and underlined the need to design large randomised clinical trials to validate these results in the next future. Targeting the bone by preventing skeletal related events (SREs) and bone metastases has major clinical impact in improving survival in bone metastatic patients and in preventing disease relapse in adjuvant setting.

  4. Multiple fluid-filled bone metastases.

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    Frenzel, Laurent; Javier, Rose-Marie; Eichler, Francoise; Zollner, Goerg; Sibilia, Jean

    2010-03-01

    Bone metastases are usually seen on imaging studies as lytic lesions and less often as sclerotic or mixed lesions. We report an exceedingly unusual case of breast cancer identified after magnetic resonance imaging showed bone metastases with fluid-fluid levels in the spine and sacrum. Bone images containing fluid-fluid levels are usually solitary abnormalities produced by aneurismal bone cysts. The fluid-fluid level is due to bleeding within the tumor followed by layering of the blood components based on density differences. Only two other cases of bone metastases with multiple fluid-fluid levels have been reported. Although fluid-fluid levels are exceedingly rare, clinicians should be aware that they might indicate a malignancy, particularly when they are multiple.

  5. Renal Cell Carcinoma Metastasized to Pagetic Bone.

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    Ramirez, Ashley; Liu, Bo; Rop, Baiywo; Edison, Michelle; Valente, Michael; Burt, Jeremy

    2016-01-01

    Paget's disease of the bone, historically known as osteitis deformans, is an uncommon disease typically affecting individuals of European descent. Patients with Paget's disease of the bone are at increased risk for primary bone neoplasms, particularly osteosarcoma. Many cases of metastatic disease to pagetic bone have been reported. However, renal cell carcinoma metastasized to pagetic bone is extremely rare. A 94-year-old male presented to the emergency department complaining of abdominal pain. A computed tomography scan of the abdomen demonstrated a large mass in the right kidney compatible with renal cell carcinoma. The patient was also noted to have Paget's disease of the pelvic bones and sacrum. Within the pagetic bone of the sacrum, there was an enhancing mass compatible with renal cell carcinoma. A subsequent biopsy of the renal lesion confirmed renal cell carcinoma. Paget's disease of the bone places the patient at an increased risk for bone neoplasms. The most commonly reported sites for malignant transformation are the femur, pelvis, and humerus. In cases of malignant transformation, osteosarcoma is the most common diagnosis. Breast, lung, and prostate carcinomas are the most common to metastasize to pagetic bone. Renal cell carcinoma associated with Paget's disease of the bone is very rare, with only one prior reported case. Malignancy in Paget's disease of the bone is uncommon with metastatic disease to pagetic bone being extremely rare. We report a patient diagnosed with concomitant renal cell carcinoma and metastatic disease within Paget's disease of the sacrum. Further research is needed to assess the true incidence of renal cell carcinoma associated with pagetic bone.

  6. Radiotherapy for pain management of bone metastases

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    Rezende Junior, Ismar de; Mattos, Marcos Duarte de; Nakamura, Ricardo; Lemes Junior, Joaquim; Vanzelli, Talita Lozano, E-mail: rezende.med@terra.com.br [Radioterapia do Hospital de Cancer de Barretos, SP (Brazil)

    2011-07-01

    Purpose: This is the first Brazilian study intended to evaluate the response of pain relief with radiotherapy in three different fractionation and the clinical differences in managing pain in patients with painful bone metastases. Methods: Prospective study of patients with painful bone metastases referred to the Radiotherapy Sector of the Hospital de Cancer de Barretos for pain-relieving radiotherapy between March and December 2010. It is known that radiotherapy seems to alter the activation of osteoclast-mediated bone resorption, relieving pain in cases of painful bone metastases. Patients were assessed in relation to the status of pain intensity before and after the initiation of radiotherapy. Either a single fraction of 8Gy, five fractions of 4Gy or ten fractions of 3Gy were given. A visual analog scale (VAS) was applied by doctors, nurses and nursing technicians to assess pain intensity at each session of radiotherapy, and follow-up at 8, 30 and 90 days from the end of treatment. Results: We evaluated 92 consecutive patients, 48 male and 44 female, with a median age of 58 years. We found that 14% of patients referred from the Palliative Care or Clinical Oncology sectors need better pharmacological analgesia due to severe pain, compared with 40.5% of patients from the other sectors (p = 0.004). We also found that the onset of pain relief to patients receiving 10 fractions of 300cGy analgesia without changing the pre-radiotherapy analgesia occurred with significance after the fifth fraction. Improvement in pain experienced within 90 days of follow-up was found in eighty percent of patients, independent of fractionated radiotherapy, site of metastases and the clinical condition of the patient. Discussion/Conclusion: The Palliative Care and Clinical Oncology sectors expressed greater concern in regards to analgesia for the patient with painful bone metastases. Radiotherapy is an effective pain-relieving treatment in different fractionation studied, even though the

  7. Bone metastases from differentiated thyroid carcinoma.

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    Muresan, M M; Olivier, P; Leclère, J; Sirveaux, F; Brunaud, L; Klein, M; Zarnegar, R; Weryha, G

    2008-03-01

    The presence of distant metastases from differentiated thyroid carcinoma decreases the 10-year survival of patients by 50%. Bone metastases represent a frequent complication especially of follicular thyroid cancer and severely reduce the quality of life causing pain, fractures, and spinal cord compression. Diagnosis is established by correlating clinical suspicion with imaging. Imaging is essential to detect, localize, and assess the extension of the lesions and should be used in conjunction with clinical evidence. Bone metastases are typically associated with elevated markers of bone turnover, but these markers have not been evaluated in differentiated thyroid cancer. Skeletal and whole-body magnetic resonance imaging and fusion 2-deoxy-2-[18F]fluoro-D-glucose whole-body positron emission tomography/computed tomography (PET/CT) are the best anatomic and functional imaging techniques available in specialized centers. For well-differentiated lesions, iodine-PET scan combined (124)I-PET/CT is the newest imaging development and (131)I is the first line of treatment. Bisphosphonates reduce the complications rate and pain, alone or in combination with radioiodine, radionuclides, or external beam radiotherapy and should be employed. Surgery and novel minimally invasive consolidation techniques demand an appropriate patient selection for best results on a multimodal approach. Basic research on interactions between tumor cells and bone microenvironment are identifying potential novel targets for future more effective therapeutic interventions for less differentiated tumors.

  8. The Surgical Treatment of Pelvic Bone Metastases

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    Daniel A. Müller

    2015-01-01

    Full Text Available Pelvic bone metastases are a growing concern in the field of orthopedic surgery. Patients with pelvic metastasis are individually different with different needs of treatment in order to attain the best possible quality of life despite the advanced stage of disease. A holistic collaboration among the oncologist, radiation therapist, and orthopedic surgeon is mandatory. Special attention has to be directed to osteolytic lesions in the periacetabular region as they can provoke pathological fractures and subsequent functional impairment. Different reconstruction techniques for the pelvis are available; the choice depends on the patient’s prognosis, size of the bone defect, and response of the tumor to adjuvant treatment. If all the conservative treatments are exhausted and the patient is not eligible for surgery, one of the various percutaneous ablation procedures can be considered. We propose a pelvic analogue to the treatment algorithm in long bone metastasis and a scoring system in pelvic metastasis. This algorithm aims to simplify the teamwork and to avoid under- or overtreatment of pelvic bone metastases.

  9. Radiation therapy for long-bone metastases

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    Wadasaki, Kouichi; Tomiyoshi, Hideki; Ooshima, Yoshie; Urashima, Masaki; Mori, Masaki (Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital (Japan))

    1992-09-01

    Efficacy of palliative and prophylactic radiotherapies for metastatic bone pain and pathological fracture was investigated in 14 patients with long bone metastases. Irradiation sites were the femur in 10 patients, the humerus in 2, the radius in one, and the tibia in one. Radiographs showed osteolytic lesion in 13 patients and osteoblastic lesion in one. A total dose of 48.6 Gy to 87.3 Gy was delivered in daily fractional doses of 2 Gy (one patient), 2.5 Gy (3), 3 Gy (6), 4 Gy (2) and 5 Gy (2), 5 days a week. For 13 patients, except for one death within one month after the completion of irradiation, pain relief was attained. Of these patients, 7 (54%) had complete pain relief. In one patient, pathological fracture occurred as early as 10 days after the beginning of irradiation when irradiation efficacy was not attained. In none of the 13 others, was pathological fracture encountered. No side effects were seen at all during or after irradiation. Radiation therapy was an extremely effective means for managing patients with long bone metastases in terms of its palliative and prophylactic role. (N.K.).

  10. MULTIVARIATE ANALYSIS OF BONE METASTASES IN BREAST CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To investigate the risk factors of bone metastases in breast carcinoma. Methods: By cross sectional study, the data of 225 breast cancer patients who were inpatients in four hospitals in Hangzhou were analyzed. All patients underwent total body bone scan with single photon emission computed tomography (SPECT) at least once during 1995 to 2000. Results: All patients were followed-up to 294 months after operation, bone metastases were found in 113 cases, suspected bone metastases 3 cases, with a bone metastases rate of 50.9% (113/222). Multivariate analysis by Cox's proportional hazards regression model showed that there were four risk factors of bone metastases in breast cancer: (1) clinical stage, I(IV stages with a hazard ratio of bone metastases of 1.945, 95% confidence interval 1.396(2.710; (2) number of invaded axillary lymph nodes, with a hazard ratio of 1.039, 95% confidence interval 1.0142(1.068; (3) skeletal complications (yes vs. no), with a hazard ratio of bone metastases of 1.722, 95% confidence interval 1.060(2.796; (4) age at the time of surgery or diagnosis, with a hazard ratio of 2.048, 95% confidence interval 1.123(3.876 for patients of age 40(50 y versus patients bellow 40 y of age and 2.837, 95% confidence interval 1.473(5.465 for patients of age above 50 y versus patients of ages between 40 and 50. Kaplan-Meier curves showed that for patients with more than 5 invasive axillary lymph nodes, compared with those with 1(5, the bone metastasis rates increased significantly ((2 =6.3319, P=0.012). Conclusion: The clinical stage, number of metastatic axillary lymph nodes, age at the time of operation and skeletal complications are essential risk factors of bone metastases.

  11. Bone and brain metastases from ampullary adenocarcinoma

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    Ioannis A Voutsadakis; Stergios Doumas; Konstantinos Tsapakidis; Maria Papagianni; Christos N Papandreou

    2009-01-01

    Ampullary carcinoma is the second most common cancer of the peri-ampullary area after pancreatic carcinoma and metastasizes mostly intra-abdominally and to the liver. Extra-abdominal metastases are less frequent. In this report we describe the case of a patient with resected adenocarcinoma of the ampulla of Vater who developed skeletal metastases in the lower extremity and brain metastases. We briefly discuss aspects of this comparatively rare gastrointestinal malignancy.

  12. Percutaneous radiofrequency ablation in painful bone metastases

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    German Garabano

    2015-09-01

    Full Text Available Backgraund There are different treatment for painful bone metastases (mtts, with different results. CT-guided Percutaneous Radiofrequency Ablation (CT-PRA is one of them. The pupose of this retrospective study was to assess the initial results using this methods, focusing on pain relief, showing details of the surgical technique. Methods 18 patients with an average age of 59.2 years and 15 months follow-up were treated. Nine mtts were located in the femur, 4 dorsal / lumbar spine, 3 in scapula and 2 in Iliac. The Mtts origin were Breast Ca 7 cases, lung in 4, Kidney in 4 and 3 in Thyroid. The rachis mtts were found at more than 10mm of the medullary cavity and mtts of long bones showed low risk of fracture. Lesions >3cm were treated whit CT-PRA  using Valleylab Rita needle and these <3cm with CoolTip needle. Pain was assessed by Visual Analog Scale (VAS preoperatively, at 2, 7 and 30 days, and then at 3 and 6 months. Results Preoperative pain score was 8.33 on average. At 7 days of ablatión de VAS score was 5 on average and at 30 days was 2 points. After at 3 and 6 months de VAS average was 1. This method had excellent patients tolerance and no complications. There were two recurrences which underwent endoprosthesis unconventional proximal femur and knee respectively, evolving favorably. Conclusion CT-guided APRF impresses a promising, simple and effective tool in the treatment of painfull bone mtts, achieving excellent pain control with good tolerance by the patient.

  13. Quality of life measurement in bone metastases: A literature review

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    Sukirtha Tharmalingam

    2008-12-01

    Full Text Available Sukirtha Tharmalingam, Edward Chow, Kristin Harris, Amanda Hird, Emily SinclairRapid Response Radiotherapy Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, CanadaAbstract: Quality of life (QOL has become an important consideration in the care of patients with bone metastases as prevalence, incidence and patient survival are on the rise. As a result, more interventional studies now measure patient’s QOL as a meaningful endpoint. However, well-developed bone metastases specific quality of life instruments are lacking. A literature review was conducted to better understand the nature of QOL instruments used in bone metastases trials. A total of 47 articles evaluating QOL in patients with bone metastases were identified. Twenty-five different instruments were used to evaluate QOL with study-designed questionnaires and the EORTC QLQ-C30 being most commonly employed. Many studies used more than one scale or instrument to measure QOL. This makes it difficult to compare QOL in bone metastases patients across studies and come to any formal conclusions. Therefore, this review demonstrates the need to develop a bone module that can be used across countries in future clinical trials.Keywords: bone metastases, quality of life, QOL instrument, review

  14. Prevention and Treatment of Bone Metastases in Breast Cancer

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    Ripamonti Carla

    2013-09-01

    Full Text Available In breast cancer patients, bone is the most common site of metastases. Medical therapies are the basic therapy to prevent distant metastases and recurrence and to cure them. Radiotherapy has a primary role in pain relief, recalcification and stabilization of the bone, as well as the reduction of the risk of complications (e.g., bone fractures, spinal cord compression. Bisphosphonates, as potent inhibitors of osteoclastic-mediated bone resorption are a well-established, standard-of-care treatment option to reduce the frequency, severity and time of onset of the skeletal related events in breast cancer patients with bone metastases. Moreover bisphosphonates prevent cancer treatment-induced bone loss. Recent data shows the anti-tumor activity of bisphosphonates, in particular, in postmenopausal women and in older premenopausal women with hormone-sensitive disease treated with ovarian suppression. Pain is the most frequent symptom reported in patients with bone metastases, and its prevention and treatment must be considered at any stage of the disease. The prevention and treatment of bone metastases in breast cancer must consider an integrated multidisciplinary approach.

  15. Spinal cord compression secondary to bone metastases from hepatocellular carcinoma

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    Dinesh Chandra Doval; Komal Bhatia; Ashok Kumar Vaid; Keechelat Pavithran; Jai Bhagwan Sharma; Digant Hazarika; Amarnath Jena

    2006-01-01

    Bone metastases are rare in primary hepatocellular carcinoma (HCC). Spinal cord compression (SCC) due to bone metastases occur commonly in patients with lung and breast carcinomas, and metastatic HCC is an unusual cause of SCC. Spinal cord compression is an oncologic emergency and treatment delays can lead to irreversible consequences. Thus, the awareness that SCC could be a potential complication of bone metastases due to HCC is of significance in initiation of early treatment that can improve the quality of life and survival of the patients, if diagnosed earlier. This paper describes four cases of primary HCC with varied manifestations of SCC due to bone metastases. The first patient presented primarily with the symptoms of bone pains corresponding to the bone metastases sites rather than symptoms of associated hepatic pathology and eventually developed SCC. The second patient, diagnosed as having HCC, developed extradural SCC leading to paraplegia during the course of illness, for which he underwent emergency laminectomy with posterior fixation. The third patient developed SCC soon after the primary diagnosis and had to undergo emergency laminectomy. Post laminectomy he had good neurological recovery. The Fourth patient presented primarily with radicular pains rather than frank paraplegia as the first manifestation of SCC.

  16. Papillary thyroid carcinoma presenting as an asymptomatic pelvic bone metastases

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    Siddiq S

    2010-05-01

    Full Text Available Thyroid carcinoma is rare comprising 1% of all malignancies and commonly presents as a neck lump. Papillary thyroid carcinoma unlike follicular thyroid carcinoma tends not to metastasise to distant sites.We present a case of papillary thyroid carcinoma presenting as a solitary asymptomatic pelvic bone metastases and highlight current management of bone metastases. A 59-year old female was found on abdominal computerised tomography to have an incidental finding of a 4.5 cm soft tissue mass in the right iliac bone. Biopsy of the lesion confirmed metastatic thyroid carcinoma. There was no history of a neck lump, head and neck examination was normal. Further imaging confirmed focal activity in the right lobe of the thyroid. A total thyroidectomy and level VI neck dissection was performed and histology confirmed follicular variant of papillary carcinoma.Early detection of bone metastases have been shown to improve prognosis and thyroid carcinoma should be considered as a potential primary malignancy.

  17. Unexplained Bone Pain Is an Independent Risk Factor for Bone Metastases in Newly Diagnosed Prostate Cancer

    DEFF Research Database (Denmark)

    Zacho, Helle D; Mørch, Carsten D; Barsi, Tamás;

    2017-01-01

    OBJECTIVE: To determine the relationship between bone pain and bone metastases in newly diagnosed prostate cancer. PATIENTS AND METHODS: This prospective study of bone scintigraphy enrolled 567 consecutive patients with newly diagnosed prostate cancer. The presence of all-cause bone pain, known b......: Unexplained bone pain was a strong independent risk factor for bone metastasis. Guidelines should recommend staging bone scintigraphy in patients with unexplained bone pain, regardless of other risk factors....

  18. Biochemical parameters of bone metabolism in bone metastases of solid tumors (Review)

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    Meijer, Wilhelmus; van der Veer, E; Willemse, P H

    1998-01-01

    The role of biochemical markers of bone metabolism in the diagnosis and monitoring of bone metastases in solid tumors is reviewed. Emphasis is on the recently developed markers, which may provide a more accurate quantitation of bone metabolism. In metastatic bone disease, bone formation and resorpti

  19. Multimodal imaging of bone metastases: From preclinical to clinical applications

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    Stephan Ellmann

    2015-10-01

    Full Text Available Metastases to the skeletal system are commonly observed in cancer patients, highly affecting the patients' quality of life. Imaging plays a major role in detection, follow-up, and molecular characterisation of metastatic disease. Thus, imaging techniques have been optimised and combined in a multimodal and multiparametric manner for assessment of complementary aspects in osseous metastases. This review summarises both application of the most relevant imaging techniques for bone metastasis in preclinical models and the clinical setting.

  20. Optimal management of bone metastases in breast cancer patients

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    Wong MH

    2011-05-01

    Full Text Available MH Wong, N PavlakisDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, AustraliaAbstract: Bone metastasis in breast cancer is a significant clinical problem. It not only indicates incurable disease with a guarded prognosis, but is also associated with skeletal-related morbidities including bone pain, pathological fractures, spinal cord compression, and hypercalcemia. In recent years, the mechanism of bone metastasis has been further elucidated. Bone metastasis involves a vicious cycle of close interaction between the tumor and the bone microenvironment. In patients with bone metastases, the goal of management is to prevent further skeletal-related events, manage complications, reduce bone pain, and improve quality of life. Bisphosphonates are a proven therapy for the above indications. Recently, a drug of a different class, the RANK ligand antibody, denosumab, has been shown to reduce skeletal-related events more than the bisphosphonate, zoledronic acid. Other strategies of clinical value may include surgery, radiotherapy, radiopharmaceuticals, and, of course, effective systemic therapy. In early breast cancer, bisphosphonates may have an antitumor effect and prevent both bone and non-bone metastases. Whilst two important Phase III trials with conflicting results have led to controversy in this topic, final results from these and other key Phase III trials must still be awaited before a firm conclusion can be drawn about the use of bisphosphonates in this setting. Advances in bone markers, predictive biomarkers, multi-imaging modalities, and the introduction of novel agents have ushered in a new era of proactive management for bone metastases in breast cancer.Keywords: breast cancer, bone metastases, bisphosphonates, denosumab, biomarkers, optimal management

  1. Imaging response to systemic therapy for bone metastases

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    Baeuerle, Tobias; Semmler, Wolfhard [German Cancer Research Center, Department of Medical Physics in Radiology, Heidelberg (Germany)

    2009-10-15

    In patients with osteotropic primary tumours such as breast and prostate cancer, imaging treatment response of bone metastases is essential for the clinical management. After treatment of skeletal metastases, morphological changes, in particular of bone structure, occur relatively late and are difficult to quantify using conventional X-rays, CT or MRI. Early treatment response in these lesions can be assessed from functional imaging techniques such as dynamic contrast-enhanced techniques by MRI or CT and by diffusion-weighted MRI, which are quantifiable. Among the techniques within nuclear medicine, PET offers the acquisition of quantifiable parameters for response evaluation. PET, therefore, especially in combination with CT and MRI using hybrid techniques, holds great promise for early and quantifiable assessment of treatment response in bone metastases. This review summarises the classification systems and the use of imaging techniques for evaluation of treatment response and suggests parameters for the early detection and quantification of response to systemic therapy. (orig.)

  2. TGF-β in cancer and bone: implications for treatment of bone metastases.

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    Juárez, Patricia; Guise, Theresa A

    2011-01-01

    Bone metastases are common in patients with advanced breast, prostate and lung cancer. Tumor cells co-opt bone cells to drive a feed-forward cycle which disrupts normal bone remodeling to result in abnormal bone destruction or formation and tumor growth in bone. Transforming growth factor-beta (TGF-β) is a major bone-derived factor, which contributes to this vicious cycle of bone metastasis. TGF-β released from bone matrix during osteoclastic resorption stimulates tumor cells to produce osteolytic factors further increasing bone resorption adjacent to the tumor cells. TGF-β also regulates 1) key components of the metastatic cascade such as epithelial-mesenchymal transition, tumor cell invasion, angiogenesis and immunosuppression as well as 2) normal bone remodeling and coupling of bone resorption and formation. Preclinical models demonstrate that blockade of TGF-β signaling is effective to treat and prevent bone metastases as well as to increase bone mass.

  3. TGFβ and Hypoxia Drive Breast Cancer Bone Metastases through Parallel Signaling Pathways in Tumor Cells and the Bone Microenvironment

    Institute of Scientific and Technical Information of China (English)

    Lauren K. DUNN; Pierrick G.J. FOURNIE; Khalid S. MOHAMMAD; C. Ryan MCKENNA; Holly W. DAVIS; Maria NIEWOLNA; Xianghong PENG; John M. CHIRGWIN; Theresa A.GUISE

    2009-01-01

    @@ Breast cancers frequently metastasize to bone, a site of hypoxia and high concentrations of active TGFβ. Skeletal metastases involve interactions between tumor and bone cells driven by locally secreted proteins, many of which are increased by hypoxia and TGFβ.

  4. Efficacy of Radiotherapy for Painful Bone Metastases During the Last 12 Weeks of Life

    NARCIS (Netherlands)

    Meeuse, Jan J.; van der Linden, Yvette M.; van Tienhoven, Geertjan; Gans, Rijk O. B.; Leer, Jan Willem H.; Reyners, An K. L.

    2010-01-01

    BACKGROUND: Radiotherapy is an effective treatment for painful bone metastases. Whether this applies also in patients with limited survival remains to be investigated. This study analyzed the effect of radiotherapy for painful bone metastases in patients with a survival

  5. SURGICAL TREATMENT FOR KIDNEY CANCER METASTASES TO THE LONG TUBULAR BONES

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    S. V. Kostritsky

    2013-01-01

    Full Text Available The data of 35 kidney cancer patients with metastases in long bones, who had been operated, were retrospectively analyzed. The role of surgery in patients with long bones metastases of kidney cancer was assessed and application of surgical treatment was ascertained to yield satisfactory results in improving the quality of life and duration of life in patients with solitary bone metastases.

  6. SURGICAL TREATMENT FOR KIDNEY CANCER METASTASES TO THE LONG TUBULAR BONES

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    S. V. Kostritsky

    2014-07-01

    Full Text Available The data of 35 kidney cancer patients with metastases in long bones, who had been operated, were retrospectively analyzed. The role of surgery in patients with long bones metastases of kidney cancer was assessed and application of surgical treatment was ascertained to yield satisfactory results in improving the quality of life and duration of life in patients with solitary bone metastases.

  7. Characterization of bone quality in prostate cancer bone metastases using Raman spectroscopy

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    Bi, Xiaohong; Patil, Chetan; Morrissey, Colm; Roudier, Martine P.; Mahadevan-Jansen, Anita; Nyman, Jeffry

    2010-02-01

    Prostate cancer is the most common primary tumor in men, with a high propensity to metastasize to bone. Bone metastases in prostate cancer are associated with active pathologic bone remodeling, leading to increased mortality and morbidity. Detailed characterization of bone metastases is important in the management of prostate cancer. Raman spectroscopy was applied in this study to investigate the structure and composition of metastatic bone in prostate cancer with the ultimate goal of identifying spectral features that are related to the alterations in bone quality as the bone metastases develop. Osteoblastic-, osteolytic- and tumor-absent bone specimens from prostate cancer patients were investigated using bench-top Raman microspectroscopy. Raman derived measurements of collagen mineralization, mineral crystallinity, and carbonate substitution were calculated. The osteolytic lesions demonstrated significantly lower collagen mineralization, determined by phosphate ν1/proline, and higher carbonate substitution than normal and osteoblastic bones. Mineral crystallinity was significantly lower in both blastic and lytic specimens. In addition, a significant increase in the ratio of hydroxyproine: proline was observed in the osteoblastic specimen, indicating an increase in the content of hydroxyproline at the blastic lesions. This study demonstrate that Raman spectroscopy shows promise in determining alterations in osteoblastic and osteolytic bone metastases as well as assessing the response of metastatic bone to therapies.

  8. How to irradiate bone metastases?; Radiotherapie des metastases osseuses: quel est le meilleur schema de radiotherapie?

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    Pradier, O.; Bouchekoua, M.; Albargach, N.; Muller, M.; Malhaire, J.P. [Centre Hospitalier Universitaire, Service de Radiotherapie, Institut de Cancerologie et d' Hematologie, 29 - Brest (France)

    2008-12-15

    Radiotherapy for bone metastases represents an important part of daily practice in our departments of radiotherapy. Majority of treatments deliver either one fraction (6 to 10 Gy) or multi-fractions mainly using 30 Gy in ten fractions. In the past decade, several randomized trials aimed to determine the optimal scheme of radiotherapy in this setting. In the present review, the efficacy of radiotherapy on bone metastases will be evaluated using the following parameters: the partial or complete responses on pain, the reduction of antalgic intake, bone re-calcification, and need for reirradiation. Other parameters must also be considered, such as the primary site, number of metastasis, performance status, overall prognosis and side effects of radiotherapy. (authors)

  9. Thrombotic Microangiopathy Revealing Bone Metastases from an Ethmoid Sinus Carcinoma

    Directory of Open Access Journals (Sweden)

    Mony Chenda Morisse

    2016-08-01

    Full Text Available Cancer-related thrombotic microangiopathy (TMA is a rare entity whose clinical and biological characteristics have been described in various tumors. Here we describe the first case of cancer-related TMA revealing diffuse bone metastases from an ethmoid sinus carcinoma.

  10. Cold metastases detected by bone scintigraphy in aggressive lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Carsi, C.; Perales Vila, A. [Servei de Medicina Nuclear de l`Hospital 9 d`Octubre, Valencia (Spain); Ruiz Hernandez, G. [Servei de Medicina Nuclear de l`Hospital Clinic Universitari, Valencia (Spain); Sanchez Marchori, C.; Oro Camps, J. [Servei de Traumatologia de l`Hospital 9 d`Octubre, Valencia (Spain)

    1998-12-31

    A case of a 55-year-old man was remitted to Traumatology Department to present back pain of two weeks of evolution. The results of bone scintigraphy and the patient`s evolution allowed the diagnosis. This case report and a literature review showed the importance of using a routine bone scan in diagnosis of bone metastases. (orig.) [Deutsch] Ein 55jaehriger Mann mit seit zwei Wochen andauernden lumbalen Schmerzen wurde in der orthopaedischen Klinik untersucht. Die Evolution des klinischen Bildes und eine Knochenszintigraphie ermoeglichten die Diagnose. Dieser klinische Fall und das wissenschaftliche Schrifttum zeigten, wie wichtig eine routinemaessige Knochenszintigraphie in der Diagnostik von Knochenmetastasen ist. (orig.)

  11. Prostate cancer cells metastasize to the hematopoietic stem cell niche in bone

    Institute of Scientific and Technical Information of China (English)

    Evan T Keller

    2011-01-01

    @@ The majority of men with advanced prostate cancer develop bone metastases as opposed to metastases at other sites.1 It has been unclear why prostate cancer selectively metastasizes to and proliferates in bone.Recently, Shiozawa et al.Delineated a mechanism that may account for the establishment of prostate cancer in bone.2 Specifically, they identified that prostate cancer cells compete with hematopoietic stem cells (HSC) for the osteoblast in the HSC niche of the bone.Defining the mechanisms through which prostate cancer cells establish themselves in bone is critical towards developing effective therapeutic strategies to prevent or target bone metastases.

  12. Radiotherapy of bone metastases of a spinal meningeal hemangiopericytoma

    Energy Technology Data Exchange (ETDEWEB)

    Sakata, K. [Tokyo Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology]|[Sapporo Medical Univ. (Japan). Dept. of Radiology; Aoki, Y.; Tago, M.; Karasawa, K.; Nakagawa, K.; Hasezawa, K.; Muta, N.; Terahara, A.; Onogi, Y.; Sasaki, Y. [Tokyo Univ. School of Medicine, Tokyo (Japan). Dept. of Radiology; Hareyama, M. [Sapporo Medical Univ. (Japan). Dept. of Radiology

    1998-04-01

    Hemangiopericytoma is a rare tumor arising from pericapillary cells or pericytes of Zimmerman, and can occur anywhere capillaries are found. We describe a patient with a meningeal hemangiopericytoma who was treated with primary surgical resection and experienced multiple bone metastases 20 years after the first treatment. This patient with multiple bone metastases was treated with multiple courses of irradiation and good palliation was achieved. (orig.) [Deutsch] Das Haemangioperizytom ist ein seltener Tumor, der seinen Ausgang von perikapillaeren Zellen oder Zimmermannschen Perizyten nimmt. Es kann ueberall dort entstehen, wo sich Kapillaren befinden. Wir berichten ueber einen Patienten mit meningealem Haemangioperizytom, der zunaechst radikal operiert wurde und 20 Jahre nach der Primaerbehandlung multiple Knochenmetastasen entwickelte. Der Patient wurde mit gutem palliativen Ergebnis mehrfach bestrahlt. (orig.)

  13. Radiologic aspects of metastatic bone disease; Imagerie des metastases osseuses

    Energy Technology Data Exchange (ETDEWEB)

    Proust, C.; Maubon, A. [Hopital Universitaire Dupuytren, Dept. de Radiologie et d' Imagerie Medicale, 87 - Limoges (France); Proust, J. [Hopital Universitaire Dupuytren, Dept. d' Orthopedie Traumatologie, 87 - Limoges (France)

    2006-03-15

    In the human body, metastases are the most frequently found bone tumors. We can distinguish between lytic, blastic and mixed forms. The authors recall the radiologic aspects of these last ones, and describe even so the imagery with magnetic resonance. they also recall that major differences between a compressive benign osteoporotic tumor and a malignant one remains an every day diagnostic problem. Finally, magnetic resonance is proven to be a better diagnostic tool in comparison with the radiologic standard examination. (author)

  14. Bone Metastases in carcinoid tumors : Clinical features, imaging characteristics, and markers of bone metabolism

    NARCIS (Netherlands)

    Meijer, WG; van der Veer, E; Jager, PL; van der Jagt, EJ; Piers, BA; Kema, IP; de Vries, EGE; Willemse, PHB

    2003-01-01

    The purpose of this study was to describe the clinical presentation of bone metastases in patients with carcinoid tumors and to determine the diagnostic value of imaging techniques and markers of bone metabolism. Methods: This retrospective study was performed on the entire group of patients with ca

  15. Detection of bone metastases in thyroid cancer patients : Bone scintigraphy or F-18-DG PET?

    NARCIS (Netherlands)

    Phan, Ha T. T.; Jager, Pieter L.; Plukker, John T. M.; Wolffenbuttel, Bruce H. R.; Dierckx, Rudi A.; Links, Thera P.

    2007-01-01

    Background Similar to the situation in other tumour types, it is currently unclear whether fluorodeoxyglucose (FDG) positron emission tomography (PET) is adequate in the detection of bone metastases of thyroid cancer. The purpose of this retrospective study was to evaluate the performance of bone sc

  16. Treatment with bone-seeking radionuclides for painful bone metastases in patients with lung cancer

    DEFF Research Database (Denmark)

    Zacho, Helle D; Karthigaseu, Nita Nishanthiny; Fuglsang, Randi

    2017-01-01

    Treatment with bone-seeking radionuclides may provide palliation from pain originating from bone metastases. However, most studies have been conducted in patients with prostate cancer and patients with breast cancer. We aimed to perform a systematic review of the use of radionuclide treatment...

  17. Prevention of Bone Metastases in Breast Cancer Patients. Therapeutic Perspectives

    Directory of Open Access Journals (Sweden)

    Philippe Beuzeboc

    2014-05-01

    Full Text Available One in four breast cancer patients is at risk of developing bone metastases in her life time. The early prevention of bone metastases is a crucial challenge. It has been suggested that the use of zoledronic acid (ZOL in the adjuvant setting may reduce the persistence of disseminated tumor cells and thereby might improve outcome, specifically in a population of patients with a low estrogen microenvironment. More recently, the results of a large meta-analysis from 41 randomized trials comparing a bisphosphonate (BP to placebo or to an open control have been presented at the 2013 San Antonio Breast Cancer Meeting. Data on 17,016 patients confirm that adjuvant BPs, irrespective of the type of treatment or the treatment schedule and formulation (oral or intra-venously (IV, significantly reduced bone recurrences and improved breast cancer survival in postmenopausal women. No advantage was seen in premenopausal women. BPs are soon likely to become integrated into standard practice. Published data on the mechanisms involved in tumor cell seeding from the primary site, in homing to bone tissues and in the reactivation of dormant tumor cells will be reviewed; these might offer new ideas for innovative combination strategies.

  18. Pathogenesis and pharmacological treatment of bone pain in skeletal metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ripamonti, C. [National Cancer Institute, Rehabilitation, Pain Therapy and Palliative Care Division, Milan (Italy); Fulfaro, F. [Societa' per l' Assistenza al Malato Oncologico Terminale, Palermo (Italy)

    2001-03-01

    Sixty-five percent of patients with advanced cancer present bone metastases and most of them present a rather slow clinical course characterized by pain, mobility deficiencies and skeletal complications such as fractures and spinal cord compression. Metastatic involvement of the bone is one of the most frequent causes of pain in cancer patients and represents one of the firs signs of widespread neoplastic disease. The pain may originate directly from the plastic disease. The pain may originate directly from the bone, from nerve root compression or from muscle spasms in the area of the lesions. The mechanism of metastatic bone pain is mainly somatic (nociceptive) even though, in some cases, neuropathic and visceral stimulations may overlap. The conventional symptomatic treatment of metastatic bone pain requires the use of multidisciplinary therapies such as radiotherapy in association with systemic treatment (hormonotherapy, chemotherapy, radioisotopes) with the support of analgesic therapy. Recently, studies have indicated the use of bisphosphonates in the treatment of pain and in the prevention of skeletal complications in patients with metastatic bone disease. In some patients pharmacological treatment, radiotherapy, radioisotopes administered alone or in association are not able to manage pain adequately. The role of neuroinvasive techniques in treating metastatic bone pain is debated. The clinical conditions of the patient, his life expectancy and quality of life must guide the physician in the choice of the best possible therapy.

  19. The role of radioisotopes for the palliation of bone pain from bone metastases

    Institute of Scientific and Technical Information of China (English)

    YANG Ji-gang; LI Chun-lin

    2006-01-01

    Bone metastasis occurs as a result of a complex pathophysiologic process between host and tumor cells leading to cellular invasion, migration adhesion, and stimulation of osteoclastic and osteoblastic activity. Several sequences occur as a result of osseous metastases and resulting bone pain can lead to significant debilitation. Pain associated with osseous metastasis is thought to be distinct from neuropathic or inflammatory pain. Several mechanisms, such as invasion of tumor cells, spinal cord astrogliosis,and sensitization of nervous system, have been postulated to cause pain. Pharmaceutical therapy of bone pain includes nonsteroidal analgesics and opiates. These drags are associated with side effects, and tolerance to these agents necessitates treatment with other modalities. Bisphosphonates act by inhibiting osteoclast-mediated resorption and have been increasingly used in treatment of painful bone metastasis. While external beam radiation therapy remains the mainstay of pain palliation of solitary lesions, bone-seeking radiopharmaceuticals have entered the therapeutic armamentarium for the treatment of multiple painful osseous lesions. 32p has been used for over 3 decades in the treatment of multiple osseous metastases. The myelosuppression caused by this agent has led to the development of other bone-seeking radiopharmaceuticals, including 89SrCl, and 153Sm-ethylenediaminetetramethylene phosphonic acid (153Sm-EDTMP). 89Sr is a bone-seeking radionuclide, whereas 153Sm-EDTMP is a bone-seeking tetraphosphonate; both have been approved by the Food and Drug Administration for the treatment of painful osseous metastases. While both agents have been shown to have efficacy in the treatment of painful osseous metastases from prostate cancer, they may also have utility in the treatment of painful osseous metastases from breast cancer and perhaps from non-small cell lung cancer. This article illustrates the salient features of these radiopharmaceuticals, including the

  20. Cementoplasty for managing painful bone metastases outside the spine

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Gang; Jin, Peng; Liu, Xun-wei; Li, Min; Li, Li [Jinan Military General Hospital, Department of Medical Imaging, Jinan, Shandong Province (China)

    2014-03-15

    To illustrate the effect of treatment with cementoplasty in patients with painful bone metastases in the extraspinal region. A retrospective study was conducted to review 51 consecutive patients who underwent cementoplasty under CT or fluoroscopic guidance, a total of 65 lesions involving the ilium, ischium, pubis, acetabulum, humeral, femur and tibia. In 5 patients with a high risk of impending fracture in long bones based on Mirels' scoring system, an innovative technique using a cement-filled catheter was applied. The clinical effects were evaluated using the visual analogue scale (VAS) preoperatively and postoperatively. All patients were treated successfully with a satisfying resolution of painful symptoms at 3 months' follow-up. Cement leakage was found in 8 lesions without any symptoms. VAS scores decreased from 8.19 ± 1.1 preoperatively to 4.94 ± 1.6 at 3 days, 3.41 ± 2.1 at 1 month and 3.02 ± 1.9 at 3 months postoperatively. There was a significant difference between the mean preoperative baseline score and the mean score at all of the postoperative follow-up points (P < 0.01). Cementoplasty is an effective technique for treating painful bone metastases in extraspinal regions, which is a valuable, minimally invasive, method that allows reduction of pain and improvement of patients' quality of life. (orig.)

  1. Comparative study of whole-body MRI and bone scintigraphy for the detection of bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Balliu, E., E-mail: eballiu@gmail.co [Department of Magnetic Resonance, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Boada, M.; Pelaez, I. [Department of Magnetic Resonance, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Vilanova, J.C. [Department of Magnetic Resonance, Clinica Girona - Hospital Sta Caterina, Girona (Spain); Barcelo-Vidal, C. [Department of Computer Science and Applied Mathematics, University of Girona (Spain); Rubio, A.; Galofre, P. [Department of Nuclear Medicine, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Castro, A. [Department of Internal Medicine, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Pedraza, S. [Department of Magnetic Resonance, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain)

    2010-12-15

    Aim: To assess and compare the diagnostic accuracy of whole-body magnetic resonance imaging (MRI) and bone scintigraphy in the detection of metastases to bone. Material and methods: Forty randomly selected patients with known malignant tumours were prospectively studied using bone scintigraphy and whole-body MRI. Two patients were excluded. Symptoms of bone metastasis were present in 29 (76%) patients and absent in nine (24%). Findings were classified into four categories according to the probability of bone metastasis: (1) negative, (2) probably negative, (3) probably positive, and (4) positive. Diagnostic accuracy was determined according to the area under the receiver operating characteristic (ROC) curve. The definitive diagnosis was reached using other imaging techniques, biopsy, or 12 months clinical follow-up. Results: Metastases were present in 18 patients. The sensitivity, specificity, and diagnostic accuracy were 94, 90, and 92%, respectively, for whole-body MRI and 72, 75, and 74%, respectively, for bone scintigraphy. Diagnostic accuracy measured by the area under the ROC curve was significantly higher for whole-body MRI (96%) than for bone scintigraphy (77%; p<0.05). Interobserver agreement measured by the kappa index was significantly higher for whole-body MRI (0.895) than for bone scintigraphy (0.524; p<0.05). Whole-body MRI detected lesions in tissues other than bone in 17 (45%) patients. Conclusions: Whole-body MRI is more accurate and more objective than bone scintigraphy for the detection of bone metastases. Whole-body MRI can also detect lesions in tissues other than bone.

  2. [State of the art in nuclear imaging for the diagnosis of bone metastases].

    Science.gov (United States)

    Ouvrier, Matthieu-John; Vignot, Stéphane; Thariat, Juliette

    2013-11-01

    Cancers prone to spread to bone include prostate, lung, kidney, breast and thyroid cancers. While bone scanner has been widely used in the past decades, PET-based imaging modalities are increasingly used. Current modalities of PET imaging of bone metastases include tumor and inflammatory targeting with FDG-PET, bone imaging with NaF-PET, and direct cancer-specific markers such as FDOPA-PET or PET using choline. The cancer-specific metastatic patterns and the relative prognosis conferred by osseous metastases (versus visceral metastases) may determine the need for bone scan, FDG-PET for the detection of bone metastases. Because some cancers have a mixed skeletal and visceral, cocktails PET radiopharmaceuticals may also be discussed in the future. The cancer-specific context and performances of bone scan and PET imaging are discussed.

  3. SEOM guidelines for the treatment of bone metastases from solid tumours.

    Science.gov (United States)

    Cassinello Espinosa, Javier; González Del Alba Baamonde, Aránzazu; Rivera Herrero, Fernando; Holgado Martín, Esther

    2012-07-01

    Bone metastases are a common and distressing effect of cancer, being a major cause of morbidity in many patients with advanced stage cancer, in particular in breast and prostate cancer. Patients with bone metastases can experience complications known as skeletal-related events (SREs) which may cause significant debilitation and have a negative impact on quality of life and functional independence. The current recommended systemic treatment for the prevention of SREs is based on the use of bisphosphonates: ibandronate, pamidronate and zoledronic acid- the most potent one- are approved in advanced breast cancer with bone metastases, whereas only zoledronic acid is indicated in advanced prostate cancer with bone metastases. The 2011 ASCO guidelines on breast cancer, recommend initiating bisphosphonate treatment only for patients with evidence of bone destruction due to bone metastases. Denosumab, a fully human antibody that specifically targets the RANK-L, has been demonstrated in two phase III studies to be superior to zoledronic acid in preventing or delaying SREs in breast and prostate cancer and non-inferior in other solid tumours and mieloma; it's convenient subcutaneous administration and the fact that does not require dose adjustment in cases of renal impairment, make this agent an attractive new therapeutic option in patients with bone metastases. Finally, in a phase III study against placebo, denosumab significantly increased the median metastasis-free survival in high risk non-metastatic prostate cancer, arising the potential role of these bone-modifying agents in preventing or delaying the development of bone metastases.

  4. Comparison of FDG-PET/CT and bone scintigraphy for detection of bone metastases in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Steffen; Heusner, Till; Forsting, Michael; Antoch, Gerald (Dept. of Diagnostic and Interventional Radiology and Neuroradiology, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)), email: steffen.hahn@uk-essen.de; Kuemmel, Sherko; Koeninger, Angelika (Dept. of Gynecology and Obstetrics, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)); Nagarajah, James; Mueller, Stefan; Boy, Christian; Bockisch, Andreas; Stahl, Alexander (Dept. of Nuclear Medicine, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany))

    2011-11-15

    Background Bone scintigraphy is the standard procedure for the detection of bone metastases in breast cancer patients. FDG-PET/CT has been reported to be a sensitive tool for tumor staging in different malignant diseases. However, its accuracy for the detection of bone metastases has not been compared to bone scintigraphy. Purpose To compare whole-body FDG-PET/CT and bone scintigraphy for the detection of bone metastases on a lesion basis in breast cancer patients. Material and Methods Twenty-nine consecutive women (mean age 58 years, range 35-78 years) with histologically proven breast cancer were assessed with bone scintigraphy and whole-body FDG-PET/CT. Twenty-one patients (72%) were suffering from primary breast cancer and eight patients (28%) were in aftercare with a history of advanced breast cancer. Both imaging procedures were assessed for bone metastases by a radiologist and a nuclear medicine physician. Concordant readings between bone scintigraphy and FDG-PET/CT were taken as true. Discordant readings were verified with additional MRI imaging in all patients and follow-up studies in most patients. Results A total of 132 lesions were detected on bone scintigraphy, FDG-PET/CT or both. According to the reference standard, 70/132 lesions (53%) were bone metastases, 59/132 lesions (45%) were benign, and three lesions (2%) remained unclear. The sensitivity of bone scintigraphy was 76% (53/70) compared to 96% (67/70) for FDG-PET/CT. The specificity of bone scintigraphy and FDG-PET/CT was 95% (56/59) and 92% (54/59), respectively. According to the reference standard bone metastases were present in eight out of the 29 patients (28%), whereas 20 patients (69%) were free of bone metastases. One (3%) patient had inconclusive readings on both modalities as well as on MRI and follow-up studies. Bone scintigraphy and FDG-PET/CT correctly identified seven out of eight patients with bone metastases and 20 out of 20 patients free of metastases. Conclusion On a lesion

  5. A definition of “uncomplicated bone metastases” based on previous bone metastases radiation trials comparing single-fraction and multi-fraction radiation therapy

    Directory of Open Access Journals (Sweden)

    Paul M. Cheon

    2015-03-01

    “Uncomplicated” bone metastases can be defined as: presence of painful bone metastases unassociated with impending or existing pathologic fracture or existing spinal cord or cauda equina compression. Therefore, MF and SF have equal efficacy in patients with such bone metastases.

  6. Bone marrow metastases from alveolar rhabdomyosarcoma with impressive FDG PET/CT finding but less-revealing bone scintigraphy.

    Science.gov (United States)

    Yang, Jigang; Zhen, Lishi; Zhuang, Hongming

    2013-12-01

    An 18F-FDG PET/CT scan was performed in a 26-year-old man with a known alveolar rhabdomyosarcoma for staging. The PET/CT scan showed abnormally increased FDG activity involving almost all bones in the imaged regions. In contrast, 99mTc-MDP whole-body bone scan demonstrated only very limited bone metastases.

  7. Gastric carcinoma presenting with extensive bone metastases and marrow infiltration causing extradural spinal haemorrhage.

    Science.gov (United States)

    Hussain, S; Chui, S

    2006-03-01

    Gastric carcinoma is the third most common gastrointestinal (GI) malignancy after colon and pancreatic carcinoma. A Japanese study showed that the incidence of bone metastases of gastric cancer was 13.4% among autopsies. It is very rare for the primary presentation of a gastric malignancy to be with bone metastases. This case report is of a 46-year-old female patient, who presented with a thoracic vertebral wedge fracture and was subsequently found to have widespread vertebral metastatic deposits with marrow infiltration. The infiltration and suppression of marrow function was complicated by an acute bleed into the extradural space causing spinal cord compression. This case demonstrates two important features. First, that gastric cancer, although far less common than breast, kidney, thyroid, prostate and bronchial cancer, is a cause of metastases to bone. Second, it highlights the complications of bone metastases, marrow suppression, leukoerythroblastic anaemia, spinal canal haematoma and cord compression. The case is illustrated by axial and sagittal MRI slices.

  8. Half body irradiation of patients with multiple bone metastases: A phase II trial

    DEFF Research Database (Denmark)

    Berg, Randi; Yilmaz, Mette; Høyer, Morten

    2009-01-01

    AIM OF STUDY: The primary aim of this study was to evaluate the effect of half-body irradiation (HBI) on pain and quality of life in cancer patients with multiple bone metastases. The secondary aim was to evaluate side effects of the treatment. PATIENTS AND METHODS: A total of 44 patients received...... on the patients' global quality of life. CONCLUSION: Single fraction HBI is safe and effective providing long lasting pain reduction in 76% of patients with multiple bone metastases....

  9. Three cases of bone metastases in patients with gastrointestinal stromal tumors

    Directory of Open Access Journals (Sweden)

    Maurizio Zompatori

    2011-04-01

    Full Text Available Gastrointestinal stromal tumors (GISTs are rare, but represent the most common mesenchymal neoplasms of the gastrointestinal tract. Tumor resection is the treatment of choice for localized disease. Tyrosine kinase inhibitors (imatinib, sunitinib are the standard therapy for metastatic or unresectable GISTs. GISTs usually metastasize to the liver and peritoneum. Bone metastases are uncommon. We describe three cases of bone metastases in patients with advanced GISTs: two women (82 and 54 years of age, and one man (62 years of age. Bones metastases involved the spine, pelvis and ribs in one patient, multiple vertebral bodies and pelvis in one, and the spine and iliac wings in the third case. The lesions presented a lytic pattern in all cases. Two patients presented with multiple bone metastases at the time of initial diagnosis and one patient after seven years during the follow-up period. This report describes the diagnosis and treatment of the lesions and may help clinicians to manage bones metastases in GIST patients.

  10. Clinical features and prognostic factors for patients with bone metastases from prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Jian He; Zhao-Chong Zeng; Ping Yang; Bing Chen; We Jiang; Shi-Suo Du

    2012-01-01

    To identify the clinical features and independent predictors of survival in patients with bone metastases from prostate cancer (PCa).We retrospectively analysed 115 PCa patients with bone metastases between 1997 and 2009.The overall survival rate after bone metastases was calculated using the Kaplan-Meier method.The prognostic factors were identified by univariate analysis using a log-rank test and by multivariate analysis using Cox proportional hazards regression models.The follow-up rate was 100%,the follow-up cases during 1,3 and 5 years were 103,79 and 55,respectively.The 1-,3- and 5-year survival rates were 89.1%,60.9% and 49.8%,respectively,with a median survival time of 48.5 months for patients with bone metastases from PCa.In univariate analysis,age,Gleason score,clinical stage,the number of bone lesions,alkaline phosphatase (ALP) level,invasion of neighbouring organs and non-regional lymph node metastases were correlated with prognosis.By multivariate analysis using Cox regression,ALP level,Gleason score and non-regional lymph node metastases were independent prognostic factors.These prognostic factors will help us to determine the appropriate dose and fraction of radiotherapy for these patients.

  11. Radium-223 treatment of bone metastases from castration-resistant prostate cancer

    DEFF Research Database (Denmark)

    Mortensen, Jann; Højgaard, Liselotte

    2014-01-01

    The alpha emitter Radium-223 ((22)3Ra-Cl2) is a bone-seeking radionuclide studied as a new treatment for patients with bone metastases from hormone refractory prostate cancer. More than 1,000 patients have been included in clinical phase I-III tests showing significant reduction in alkaline...

  12. Pain relief by palliative radiotherapy in patients with advanced bone metastases

    Institute of Scientific and Technical Information of China (English)

    BU Jun-guo; YUAN Ya-wei

    2001-01-01

    To compare 3 local field radiation therapies for bone metastases to determine the strategy producing the best results. Methods: Among 104 patients with bone metastases, 30 patients were given 8 Gy in single fraction, 31 given 20 Gy in 5 fractions, 43 given 40Gy in 20 fractions. Results and Conclusion: The method of 40 Gy in 20 fractions had a higher pain relief rate and a lower pain relapse rate, suggesting that large-dose fractioned treatment regimen is more appropriate for patients with bone metastasis.

  13. Bisphosphonate use in patients with lung cancer and bone metastases: recommendations of a European expert panel

    DEFF Research Database (Denmark)

    De Marinis, Filippo; Eberhardt, Wilfried; Harper, Peter G

    2009-01-01

    INTRODUCTION: Bisphosphonates (BPs) are effective in preventing, reducing the incidence, and delaying the onset of skeletal-related events in patients with bone metastases in a variety of solid tumors, including lung cancer. The purpose of this article is to review the current evidence for the use...... of BPs in lung cancer and to provide specific European recommendations to support the clinical practice of using BPs to treat patients with lung cancer with bone metastases. METHODS: An expert panel of European clinical oncologists and lung cancer specialists convened for two face-to-face meetings...... designed to review available evidence on the efficacy of BPs in lung cancer and to develop recommendations based on published literature and clinical practice experiences. RESULTS: The panel recommends screening patients with lung cancer for bone metastases at the initial staging of disease to assess...

  14. Samarium lexidronam (153Sm-EDTMP): skeletal radiation for osteoblastic bone metastases and osteosarcoma.

    Science.gov (United States)

    Anderson, Pete; Nuñez, Rodolfo

    2007-11-01

    Radiation therapy can be an effective means to treat bone metastases, which occur in more than 50% of cancer patients. (153)Samarium lexidronam ((153)Sm-EDTMP; Quadramet, Cytogen) is a radiopharmaceutical designed for deposition into bone metastases. Bone scans can identify patients that may benefit from targeted radiation therapy with (153)Sm-EDTMP. As an unsealed source of radiation therapy, (153)Sm-EDTMP is simple to administer: 1 mCi/kg is given in a similar fashion to a bone scan injection ((99m)Tc-MDP bone scan injection is given at 0.2-0.35 mCi/kg. Therefore, both are administered intravenously. However, the radiation-absorbed dose and radiopharmaceutical energy are different). Nevertheless, despite simplicity of administration, (153)Sm-EDTMP is underutilized for improving cancer pain in the skeleton. Repeated cycles and combined treatment with other modalities such as bisphosphonates, chemotherapy and/or external beam radiation are possible. (153)Sm-EDTMP combined with bisphosphonates, chemotherapy and/or radiation may provide better palliation of bone metastases and also in bone-forming tumors (osteosarcoma). Encouraging experience using high-dose (153)Sm-EDTMP for total marrow irradiation in hematologic malignancies involving the bones (e.g., myeloma or acute leukemia) is also reviewed.

  15. Cost of palliative radiation to the bone for patients with bone metastases secondary to breast or prostate cancer

    Directory of Open Access Journals (Sweden)

    Hess Gregory

    2012-10-01

    Full Text Available Abstract Background To estimate the costs (paid amounts of palliative radiation episodes of care (REOCs to the bone for patients with bone metastases secondary to breast or prostate cancer. Methods Claims-linked medical records from patients at 98 cancer treatment centers in 16 US states were analyzed. Inclusion criteria included a primary neoplasm of breast or prostate cancer with a secondary neoplasm of bone metastases; ≥2 visits to ≥1 radiation center during the study period (1 July 2008 through 31 December 2009 on or after the metastatic cancer diagnosis date; radiation therapy to ≥1 bone site; and ≥1 complete REOC as evidenced by a >30-day gap pre- and post-radiation therapy. Results The total number of REOCs was 220 for 207 breast cancer patients and 233 for 213 prostate cancer patients. In the main analysis (which excluded records with unpopulated costs the median number of fractions per a REOC for treatment of metastases was 10. Mean total radiation costs (i.e., radiation direct cost + cost of radiation-related procedures and visits per REOC were $7457 for patients with breast cancer and $7553 for patients with prostate cancer. Results were consistent in sensitivity analyses excluding patients with unpopulated costs. Conclusions In the US, current use of radiation therapy for bone metastases is relatively costly and the use of multi-fraction schedules remains prevalent.

  16. Suppression of NADPH Oxidase Activity May Slow the Expansion of Osteolytic Bone Metastases

    Directory of Open Access Journals (Sweden)

    Mark F. McCarty

    2016-08-01

    Full Text Available Lysophosphatidic acid (LPA, generated in the microenvironment of cancer cells, can drive the proliferation, invasion, and migration of cancer cells by activating G protein-coupled LPA receptors. Moreover, in cancer cells that have metastasized to bone, LPA signaling can promote osteolysis by inducing cancer cell production of cytokines, such as IL-6 and IL-8, which can stimulate osteoblasts to secrete RANKL, a key promoter of osteoclastogenesis. Indeed, in cancers prone to metastasize to bone, LPA appears to be a major driver of the expansion of osteolytic bone metastases. Activation of NADPH oxidase has been shown to play a mediating role in the signaling pathways by which LPA, as well as RANKL, promote osteolysis. In addition, there is reason to suspect that Nox4 activation is a mediator of the feed-forward mechanism whereby release of TGF-beta from bone matrix by osteolysis promotes expression of PTHrP in cancer cells, and thereby induces further osteolysis. Hence, measures which can down-regulate NADPH oxidase activity may have potential for slowing the expansion of osteolytic bone metastases in cancer patients. Phycocyanin and high-dose statins may have utility in this regard, and could be contemplated as complements to bisphosphonates or denosumab for the prevention and control of osteolytic lesions. Ingestion of omega-3-rich flaxseed or fish oil may also have potential for controlling osteolysis in cancer patients.

  17. Incidence and imaging characteristics of skeletal metastases detected by bone scintigraphy in lung cancer patients

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    Jauković Ljiljana

    2006-01-01

    Full Text Available Background/Aim. Detection of metastatic bone disease by skeletal scintigraphy is a classical application of nuclear medicine in cancer patients. Detection of bone metastases in patients with lung cancer is necessary for an appropriate treatment modality. The aim of this study was to report the frequency and imaging characteristics of bone metastases detected by bone scintigraphy (BS using technetium-99m phosphonates in patients with lung cancer. Methods. We retrospectively analyzed a total of one hundred patients (78 males and 22 females, mean age of 63.3 years, with the diagnosis of lung cancer, who underwent BS during a three-year period (2003−2005. Scintiscans were classified as positive, negative and suspicious with regard to the presence of bone metastases. Results. The incidence of positive, negative and suspicious findings were 57%. 32% and 11%, respectively. Out of 57 patients with bone metastases, 51 had multiple asymmetric foci of increased tracer activity localized in the ribs, spine, extremities, pelvis, sternum, scapula and skull in 72%, 54%, 49%, 37%, 12%, 9% and 5% of scans, respectively. BS revealed solitary metastases in 6 of the patients. The lesions were located in the lower limbs in three patients and in the upper limbs, pelvis and sternum in the remaining three patients. Conclusion. Bone scintigraphy plays a significant role in staging and selecting of patients for curative lung surgery. Due to the fact that metastatic involvment of the extremities was frequently shown, our study suggests that systematic inclusion of the limbs in BS acquisition should be obligatory.

  18. Zoledronic acid treatment for cancerous bone metastases: a phase IV study in Taiwan

    Directory of Open Access Journals (Sweden)

    Po-Hui Chiang

    2013-01-01

    Full Text Available Aim of study: To investigate the features, adverse effects, bone marker changes in patients with breast cancer, prostate cancer, and multiple myeloma with bone metastases under Zometa® therapy. Materials and Methods: This post-marketing study included 414 Taiwanese patients with bone metastases secondary to breast cancer, prostate cancer, or multiple myeloma who received Zometa® for 48 weeks. The patients′ characteristics, medication and adverse events were recorded, meanwhile changes in four serum bone metabolic markers and pain reduction were assessed every three months for one year. Results: A total of 3,711 doses of Zometa® were infused, accounting for 294.5 patient-years. Adverse events occurred in 9.4% of patients, with bone pain, insomnia, constipation, and pyrexia as the most frequently reported. There was no osteonecrosis of the jaw. The incidence of skeletal-related events decreased significantly from 44.9% to 18.8%. Serum NTx, BAP, and TRACP5b steadily decreased to nadir at six months, but serum OPG was persistently elevated until the end of one year. The average decrease in pain score was 14.1, 14.3, and 16.7 for prostate cancer, breast cancer, and multiple myeloma patients, respectively. Conclusion: Zometa® can be safely administered in Taiwanese patients with bone metastases secondary to breast cancer, prostate cancer, and multiple myeloma. There are concomitant decreases in skeletal-related events and bone pain.

  19. Serum bone turnover markers (PINP and ICTP) for the early detection of bone metastases in patients with prostate cancer : A longitudinal approach

    NARCIS (Netherlands)

    Koopmans, N.; de Jong, I. J.; van der Veer, E.; Breeuwsma, J.

    2007-01-01

    Purpose: An increase in bone turnover markers in patients with prostate cancer may predict bone metastases but it can also reflect the effects of androgen deprivation treatment. To assess the diagnostic efficacy of early detection of skeletal metastases we retrospectively performed serial measuremen

  20. Isolated Femoral Muscle and Bone Metastases Rarely Encountered in Testicular Seminoma

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    Serkan Degirmencioglu

    2013-01-01

    Full Text Available Isolated muscle and bone metastases are rarely encountered in patients with testicular seminomas. In the present study, a patient who was admitted with pain, loss of motion, and swelling in the right leg 20 months following surgery for stage I seminoma was presented. Hypermetabolic lesion was detected in the right femoral muscle and bone via positron emission tomography. After the presence of metastasis from seminoma was confirmed by biopsy, bleomycin, cisplatin, and etoposide, combination chemotherapy was administered to the patient.

  1. An easy tool to predict survival in patients receiving radiation therapy for painful bone metastases

    NARCIS (Netherlands)

    Westhoff, P.G.; Graeff, A. de; Monninkhof, E.M.; Bollen, L.; Dijkstra, S.P.; Steen-Banasik, E.M. van der; Vulpen, M. van; Leer, J.W.H.; Marijnen, C.A.; Linden, Y.M. van der; Study, G.

    2014-01-01

    PURPOSE: Patients with bone metastases have a widely varying survival. A reliable estimation of survival is needed for appropriate treatment strategies. Our goal was to assess the value of simple prognostic factors, namely, patient and tumor characteristics, Karnofsky performance status (KPS), and p

  2. Embolization in combination with radioiodine therapy for bone metastases from differentiated thyroid carcinoma

    NARCIS (Netherlands)

    van Tol, KM; Hew, JM; Jager, PL; Vermey, A; Dullaart, RPF; Links, TP

    2000-01-01

    BACKGROUND The outcome for patients with bone metastases from differentiated thyroid carcinoma is worse compared to the overall prognosis of patients with differentiated thyroid carcinoma. The aim of this study is to evaluate the effect of embolization with concomitant radioiodine treatment on the s

  3. Efficacy and time course of palliative radiotherapy for pain relief in 70 patients with bone metastases

    Institute of Scientific and Technical Information of China (English)

    Peng Zhang; Chen Gong; Huihua Xiong

    2016-01-01

    Objective The aim of this study was to evaluate the ef icacy and time course of radiotherapy for pain relief in patients with bone metastases. Methods A total of 70 patients with painful bone metastases were investigated between January 2013 and August 2015. The patients were divided into 3 groups and each group was treated with radiotherapy using 30 Gy in 10 fractions, 20 Gy in 5 fractions, or a single dose of 8 Gy. The pain over the irradiated site was assessed using a numerical rating scale (NRS) ranging from 0 to 10. Pain relief was assessed every 5 days based on a pain questionnaire. Results Complete pain relief was achieved in 14.3% (10/70) patients; partial pain relief in 74.3% (52/70); and no response in 11.4% (8/70). The overal response rate was 88.6%. No significant dif erence was observed between single fraction radiotherapy and multifraction radiotherapy. There was no relationship between the pain relief and treated sites. The pain score gradual y decreased and most patients reached a moderate pain score (NRS Conclusion Local radiotherapy is a very rapid and ef ective pal iative treatment for painful bone metas-tases; however, the optimal dose and fractionation regimen remain debatable. Individualized therapy for painful bone metastases should be considered according to the patient’s condition and life expectancy.

  4. EpCAM Expression in Lymph Node and Bone Metastases of Prostate Carcinoma : A Pilot Study

    NARCIS (Netherlands)

    Campos, Anna K.; Hoving, Hilde D.; Rosati, Stefano; van Leenders, Geert J. L. H.; de Jong, Igle J.

    2016-01-01

    There is an urgent need for new imaging modalities in prostate carcinoma staging. A non-invasive modality that can assess lymph node and bone metastases simultaneously is preferred. Epithelial cell adhesion molecule (EpCAM) is a membranous protein of interest as an imaging target since it is overexp

  5. EpCAM expression in lymph node and bone metastases of prostate carcinoma: A pilot study

    NARCIS (Netherlands)

    Campos, A.K. (Anna K.); Hoving, H.D. (Hilde D.); S. Rosati (Stefano); G.J.H.L. Leenders (Geert); I.J. de Jong (Igle)

    2016-01-01

    textabstractThere is an urgent need for new imaging modalities in prostate carcinoma staging. A non-invasive modality that can assess lymph node and bone metastases simultaneously is preferred. Epithelial cell adhesion molecule (EpCAM) is a membranous protein of interest as an imaging target since i

  6. Update of the International Consensus on Palliative Radiotherapy Endpoints for Future Clinical Trials in Bone Metastases

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    Chow, Edward, E-mail: Edward.Chow@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Hoskin, Peter [Mount Vernon Centre for Cancer Treatment, Mount Vernon Hospital, Northwood, Middlesex (United Kingdom); Mitera, Gunita; Zeng Liang [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON (Canada); Lutz, Stephen [Department of Radiation Oncology, Blanchard Valley Regional Cancer Center, Findlay, OH (United States); Roos, Daniel [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia (Australia); Hahn, Carol [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Linden, Yvette van der [Radiotherapeutic Institute Friesland, Leeuwarden (Netherlands); Hartsell, William [Department of Radiation Oncology, Advocate Good Samaritan Cancer Center, Downers Grove, IL (United States); Kumar, Eshwar [Department of Oncology, Atlantic Health Sciences Cancer Centre, Saint John Regional Hospital, Saint John, NB (Canada)

    2012-04-01

    Purpose: To update the international consensus on palliative radiotherapy endpoints for future clinical trials in bone metastases by surveying international experts regarding previous uncertainties within the 2002 consensus, changes that may be necessary based on practice pattern changes and research findings since that time. Methods and Materials: A two-phase survey was used to determine revisions and new additions to the 2002 consensus. A total of 49 experts from the American Society for Radiation Oncology, the European Society for Therapeutic Radiology and Oncology, the Faculty of Radiation Oncology of the Royal Australian and New Zealand College of Radiologists, and the Canadian Association of Radiation Oncology who are directly involved in the care of patients with bone metastases participated in this survey. Results: Consensus was established in areas involving response definitions, eligibility criteria for future trials, reirradiation, changes in systemic therapy, radiation techniques, parameters at follow-up, and timing of assessments. Conclusion: An outline for trials in bone metastases was updated based on survey and consensus. Investigators leading trials in bone metastases are encouraged to adopt the revised guideline to promote consistent reporting. Areas for future research were identified. It is intended for the consensus to be re-examined in the future on a regular basis.

  7. Occipital condyle syndrome secondary to bone metastases from rectal cancer.

    Science.gov (United States)

    Marruecos, J; Conill, C; Valduvieco, I; Vargas, M; Berenguer, J; Maurel, J

    2008-01-01

    Skull-base metastases are very unfrequent. Occipital condyle syndrome (OCS) is usually underdiagnosed. Until now few cases have been reported in the literature. We present a 71-year-old woman with metastatic rectum adenocarcinoma, with right occipital headache and ipsilateral hypoglossal palsy, diagnosed by computed tomography and magnetic resonance imaging of OCS due to a skull-base metastasis and treated with radiation therapy.

  8. Palliative external-beam radiotherapy for bone metastases from hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Shinya; Hayashi; Hidekazu; Tanaka; Hiroaki; Hoshi

    2014-01-01

    The incidence of bone metastases(BMs)from hepatocellular carcinoma(HCC)is relatively low compared to those of other cancers,but it has increased recently,especially in Asian countries.Typically,BMs from HCC appear radiologically as osteolytic,destructive,and expansive components with large,bulky soft-tissue masses.These soft-tissue masses are unique to bone metastases from HCC and often replace the normal bone matrix and exhibit expansive growth.They often compress the peripheral nerves,spinal cord,or cranial nerves,causing not only bone pain but also neuropathic pain and neurological symptoms.In patients with spinal BMs,the consequent metastatic spinal cord compression(MSCC)causes paralysis.Skull base metastases(SBMs)with cranial nerve involvement can cause neurological symptoms.Therefore,patients with bony lesions often suffer from pain or neurological symptoms that have a severe,adverse effect on the quality of life.External-beam radiotherapy(EBRT)can effectively relieve bone pain and neurological symptoms caused by BMs.However,EBRT is not yet widely used for the palliative management of BMs from HCC because of the limited number of relevant studies.Furthermore,the optimal dosing schedule remains unclear,despite clinical evidence to support single-fraction ra-diation schedules for primary cancers.In this review,we outline data describing palliative EBRT for BMs from HCC in the context of(1)bone pain;(2)MSCC;and(3)SBMs.

  9. [Preliminary application of strontium-89 for the treatment of bone metastases from prostate cancer].

    Science.gov (United States)

    Zhao, Weiwei; Deng, Houfu; Jie, Peng; Qing, Chun; Zhang, Xiying

    2010-12-01

    Bone metastases are a major problem in the clinical management of patients with prostate cancer. Despite the use of analgesic for the relief of such pain, the outcomes are not often satisfactory. Strontium-89 (89Sr) is a pure beta-emitting radioisotope to be avidly concentrated in the areas of high osteoblastic activity. The aim of this study was to evaluate the efficacy of 89Sr in the therapy for bone metastases of prostate carcinoma. 116 patients received intravenous injection of 89Sr at the dose of 3mCi (111MBq). All patients underwent physical examination and Karnofsky's Performance Score (KPS) evaluation before and after administration; the analgesic effects were evaluated by scores of pain. The complete response (CR) was defined as scores of pain > 75%; no response (NR) was defined as scores of pain bone metastases were screened by CT, MRI and 99mTc-MDP bone scintigraphy according to the standards of WHO. After the treatment with 89Sr, the total response rate was 80.2%. In the 116 cases, 21 cases (18.1%) displayed complete response and 72 cases (62.1%) displayed partial response, but 23 cases (19.2%) showed no response. The mean score on Karnfsky's performance status (KPS) was 20.0% higher. About 1/3 cases exhibited an obvious decrease in the number of metastases, and some foci disappeared. Thirteen cases (12%) showed a greater decrease in prostate-specific antigen (PSA) value. 89Sr chloride is an effective and safe therapy of the bone metastases from prostate cancer.

  10. Systemic Delivery of an Oncolytic Adenovirus Expressing Decorin for the Treatment of Breast Cancer Bone Metastases.

    Science.gov (United States)

    Yang, Yuefeng; Xu, Weidong; Neill, Thomas; Hu, Zebin; Wang, Chi-Hsiung; Xiao, Xianghui; Stock, Stuart R; Guise, Theresa; Yun, Chae-Ok; Brendler, Charles B; Iozzo, Renato V; Seth, Prem

    2015-12-01

    The development of novel therapies for breast cancer bone metastasis is a major unmet medical need. Toward that end, we have constructed an oncolytic adenovirus, Ad.dcn, and a nonreplicating adenovirus, Ad(E1-).dcn, both containing the human decorin gene. Our in vitro studies showed that Ad.dcn produced high levels of viral replication and the decorin protein in the breast tumor cells. Ad(E1-).dcn-mediated decorin expression in MDA-MB-231 cells downregulated the expression of Met, β-catenin, and vascular endothelial growth factor A, all of which are recognized decorin targets and play pivotal roles in the progression of breast tumor growth and metastasis. Adenoviral-mediated decorin expression inhibited cell migration and induced mitochondrial autophagy in MDA-MB-231 cells. Mice bearing MDA-MB-231-luc skeletal metastases were systemically administered with the viral vectors, and skeletal tumor growth was monitored over time. The results of bioluminescence imaging and X-ray radiography indicated that Ad.dcn and Ad(E1-).dcn significantly inhibited the progression of bone metastases. At the terminal time point, histomorphometric analysis, micro-computed tomography, and bone destruction biomarkers showed that Ad.dcn and Ad(E1-).dcn reduced tumor burden and inhibited bone destruction. A nonreplicating adenovirus Ad(E1-).luc expressing the luciferase 2 gene had no significant effect on inhibiting bone metastases, and in several assays, Ad.dcn and Ad(E1-).dcn were better than Ad.luc, a replicating virus expressing the luciferase 2 gene. Our data suggest that adenoviral replication coupled with decorin expression could produce effective antitumor responses in a MDA-MB-231 bone metastasis model of breast cancer. Thus, Ad.dcn could potentially be developed as a candidate gene therapy vector for treating breast cancer bone metastases.

  11. CNS Metastases from Bone and Soft Tissue Sarcomas in Children, Adolescents, and Young Adults: Are They Really So Rare?

    Directory of Open Access Journals (Sweden)

    Monika Bekiesinska-Figatowska

    2017-01-01

    Full Text Available Purpose. To check whether primary involvement of brain/spinal cord by bone/soft tissue sarcomas’ metastases in children is as rare as described and to present various morphological forms of bone/soft tissue sarcomas’ CNS metastases. Methods. Patients with first diagnosis in 1999–2014 treated at single center were included with whole course of disease evaluation. Brain/spinal canal magnetic resonance imaging (MRI/computed tomography were performed in cases suspicious for CNS metastases. Extension from skull/vertebral column metastases was excluded. Results. 550 patients were included. MRI revealed CNS metastases in 19 patients (incidence 3.45%, 14 boys, aged 5–22 years. There were 12/250 osteosarcoma cases, 2/200 Ewing’s sarcoma, 1/50 chondrosarcoma, 3/49 rhabdomyosarcoma (RMS, and 1/1 malignant mesenchymoma. There were 10 single metastases and 7 cases of multiple ones; in 2 RMS cases only leptomeningeal spread in brain and spinal cord was found. Calcified metastases were found in 3 patients and hemorrhagic in 4. In one RMS patient there were numerous solid, cystic, hemorrhagic lesions and leptomeningeal spread. Conclusions. CNS metastases are rare and late in children with bone/soft tissue sarcomas, although in our material more frequent (3.45% than in other reports (0.7%. Hematogenous spread to brain and hemorrhagic and calcified lesions dominated in osteosarcoma. Ewing sarcoma tended to metastasize to skull bones. Soft tissue sarcomas presented various morphological forms.

  12. CNS Metastases from Bone and Soft Tissue Sarcomas in Children, Adolescents, and Young Adults: Are They Really So Rare?

    Science.gov (United States)

    Duczkowska, Agnieszka; Duczkowski, Marek; Bragoszewska, Hanna; Romaniuk-Doroszewska, Anna; Iwanowska, Beata; Szkudlinska-Pawlak, Sylwia; Madzik, Jaroslaw; Bilska, Katarzyna; Raciborska, Anna

    2017-01-01

    Purpose. To check whether primary involvement of brain/spinal cord by bone/soft tissue sarcomas' metastases in children is as rare as described and to present various morphological forms of bone/soft tissue sarcomas' CNS metastases. Methods. Patients with first diagnosis in 1999–2014 treated at single center were included with whole course of disease evaluation. Brain/spinal canal magnetic resonance imaging (MRI)/computed tomography were performed in cases suspicious for CNS metastases. Extension from skull/vertebral column metastases was excluded. Results. 550 patients were included. MRI revealed CNS metastases in 19 patients (incidence 3.45%), 14 boys, aged 5–22 years. There were 12/250 osteosarcoma cases, 2/200 Ewing's sarcoma, 1/50 chondrosarcoma, 3/49 rhabdomyosarcoma (RMS), and 1/1 malignant mesenchymoma. There were 10 single metastases and 7 cases of multiple ones; in 2 RMS cases only leptomeningeal spread in brain and spinal cord was found. Calcified metastases were found in 3 patients and hemorrhagic in 4. In one RMS patient there were numerous solid, cystic, hemorrhagic lesions and leptomeningeal spread. Conclusions. CNS metastases are rare and late in children with bone/soft tissue sarcomas, although in our material more frequent (3.45%) than in other reports (0.7%). Hematogenous spread to brain and hemorrhagic and calcified lesions dominated in osteosarcoma. Ewing sarcoma tended to metastasize to skull bones. Soft tissue sarcomas presented various morphological forms.

  13. Diagnostic efficacy of bone scintigraphy, magnetic resonance imaging, and positron emission tomography in bone metastases of myxoid liposarcoma.

    Science.gov (United States)

    Conill, Carlos; Setoain, Xavier; Colomo, Luis; Palacín, Antonio; Combalia-Aleu, Andreu; Pomés, Jaime; Marruecos, Jordi; Vargas, Mauricio; Maurel, Joan

    2008-03-01

    Myxoid liposarcomas (MLS) have a tendency to metastasize to unusual sites. We report an unusual case of bone metastases not detected by bone scan and neither by fluorodeoxyglucose positron emission tomography (PET-FDG) and successfully identified with magnetic resonance imaging (MRI) in a patient with metachronic MLS. Histopathological examination of the primary tumor evidenced a tumor with unfavorable prognostic markers, and the biopsy of an iliac bone lesion confirmed the diagnosis of metastatic disease. On histological grounds, the tumor showed features of a more differentiated neoplasm without foci of round cells or necrosis in the latter. MRI allowed the identification of disseminated disease compared to computed tomography (CT) and PET scans. Thus, because of the heterogeneous histological features of MLS and the biological behavior of the disease, a combined approach of FDGPET-CT and MRI, may allow a more accurate staging of soft tissue sarcomas.

  14. Excess TGF-β mediates muscle weakness associated with bone metastases in mice

    Science.gov (United States)

    Reiken, Steven; Xie, Wenjun; Andersson, Daniel C.; John, Sutha; Chiechi, Antonella; Wright, Laura E.; Umanskaya, Alisa; Niewolna, Maria; Trivedi, Trupti; Charkhzarrin, Sahba; Khatiwada, Pooja; Wronska, Anetta; Haynes, Ashley; Benassi, Maria Serena; Witzmann, Frank A.; Zhen, Gehua; Wang, Xiao; Cao, Xu; Roodman, G. David; Marks, Andrew R.; Guise, Theresa A.

    2015-01-01

    Cancer-associated muscle weakness is poorly understood and there is no effective treatment. Here, we find that seven different mouse models of human osteolytic bone metastases, representing breast, lung and prostate cancers, as well as multiple myeloma exhibited impaired muscle function, implicating a role for the tumor-bone microenvironment in cancer-associated muscle weakness. We found that TGF-β, released from the bone surface as a result of metastasis-induced bone destruction upregulated NADPH oxidase 4 (Nox4), resulting in elevated oxidization of skeletal muscle proteins, including the ryanodine receptor/calcium (Ca2+) release channel (RyR1). The oxidized RyR1 channels leaked Ca2+, resulting in lower intracellular signaling required for proper muscle contraction. We found that inhibiting RyR1 leak, TGF-β signaling, TGF-β release from bone or Nox4 all improved muscle function in mice with MDA-MB-231 bone metastases. Humans with breast cancer- or lung cancer-associated bone metastases also had oxidized skeletal muscle RyR1 that is not seen in normal muscle. Similarly, skeletal muscle weakness, higher levels of Nox4 protein and Nox4 binding to RyR1, and oxidation of RyR1 were present in a mouse model of Camurati-Engelmann disease, a non-malignant metabolic bone disorder associated with increased TGF-β activity. Thus, metastasis-induced TGF-β release from bone contributes to muscle weakness by decreasing Ca2+-induced muscle force production. PMID:26457758

  15. Treatment of bone pain secondary to metastases using samarium-153-EDTMP

    Directory of Open Access Journals (Sweden)

    Elba Cristina Sá de Camargo Etchebehere

    Full Text Available CONTEXT: More than 50% of patients with prostate, breast or lung cancer will develop painful bone metastases. The purpose of treating bone metastases is to relieve pain, reduce the use of steroids and to maintain motion. OBJECTIVE: To evaluate the use of samarium-153-EDTMP (153Sm-EDTMP for the treatment of bone pain secondary to metastases that is refractory to clinical management. TYPE OF STUDY: Retrospective. SETTING: Division of Nuclear Medicine, Universidade Estadual de Campinas (Unicamp. METHODS: Fifty-eight patients were studied (34 males with mean age 62 years; 31 patients had prostate cancer, 20 had breast cancer, three had lung cancer, one had lung hemangioendothelioma, one had parathyroid adenocarcinoma, one had osteosarcoma and one had an unknown primary tumor. All patients had multiple bone metastases demonstrated by bone scintigraphy using 99mTc-MDP,and were treated with 153Sm-EDTMP. Response to treatment was graded as good (pain reduction of 50-100%, intermediate (25-49% and poor (0-24%. RESULTS: All patients showed good uptake of 153Sm-EDTMP by bone metastases. Among the patients with prostate cancer, intermediate or good response to therapy occurred in 80.6% (25 patients and poor response in 19.4% (6. Among the patients with breast cancer, 85% (17 showed intermediate or good response to therapy while 15% (3 showed poor response. All three patients with lung cancer showed poor response to treatment. The lung hemangioendothelioma and unknown primary lesion patients showed intermediate response to treatment; the osteosarcoma and parathyroid adenocarcinoma patients showed good response to treatment. No significant myelotoxicity occurred. DISCUSSION: Pain control is important for improving the quality of life of patients with advanced cancers. The mechanism by which pain is relieved with the use of radionuclides is still not yet completely understood, however, the treatment is simple and provides a low risk of mielotoxicity

  16. Immunoscintigraphy With 99mTc-Nimotuzumab for Planning Immunotherapy in Patients With Bone Metastases Due to Prostate Cancer.

    Science.gov (United States)

    Quián, Yamilé P; Crombet, Tania; Batista, Juan F; Prats, Anaís; Perera, Alejandro

    2016-03-01

    Detection of bone metastases indicates poor prognosis for patients with prostate cancer. The immunotherapy with monoclonal antibody has been an important advance in the treatment of the cancer in the last years. Nimotuzumab is a humanized IgG1 monoclonal antibody directed against epidermal growth factor receptor that has been evaluated in solid tumors. The authors show images of 2 patients with bone metastases secondary to prostate cancer, "pre-cold therapy" with nimotuzumab. Immunoscintigraphic images were acquired 4 and 24 hours after the intravenous administration of 1110 MBq (30 mCi) of Tc-labeled nimotuzumab. Bone metastases expressing the receptor are visualized.

  17. Assessing Response to Radiation Therapy Treatment of Bone Metastases: Short-Term Followup of Radiation Therapy Treatment of Bone Metastases with Diffusion-Weighted Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Salvatore Cappabianca

    2014-01-01

    Full Text Available This study examined the usefulness of diffusion-weighted (DW Magnetic Resonance Imaging (MRI in monitoring bone metastases response to radiation therapy in 15 oligometastatic patients. For each metastasis, both mean apparent diffusion coefficient (ADC changes and high b-value DW metastasis/muscle signal intensity ratio (SIR variations were evaluated at 30 ± 5 days and 60 ± 7 days after the end of treatment. On baseline DW-MRI, all bone metastases were hyperintense and had signal intensities higher than normal bone marrow on calculated ADC maps. At follow-up evaluations, 4 patterns of response were identified: (I decreased high b-value DW SIR associated with increased mean ADC (83.3% of cases; (II increased mean ADC with no change of high b-value DW SIR (10% of cases; (III decreased both high b-value DW SIR and mean ADC (3.3% of cases; (IV a reduction in mean ADC associated with an increase in high b-value DW SIR compared to pretreatment values (3.3% of cases. Patterns (I and (II suggested a good response to therapy; pattern (III was classified as indeterminate, while pattern (IV was suggestive of disease progression. This pattern approach may represent a useful tool in the differentiation between treatment-induced necrosis and highly cellular residual tumor.

  18. Dickkopf-1 and bone metastases%Dickkopf-1与骨转移癌

    Institute of Scientific and Technical Information of China (English)

    乔华; 尤丽娜; 范谷红

    2012-01-01

    Recent studies show that the abnormalities of dickkopf-1 (DKK-1)are closely related to the bone metastasis and therapeutic effect of breast cancer,prostatic carcinoma,multiple myeloma,neuroblastoma and non-small cell lung cancer.Clinical researches of large sample on the relationships between serum DKK-1 concentration and malignant tumors bone metastases have important clinical significance for evaluating the value of DKK-1 as a clinical biological biomarker of bone metastases and understanding the tumor mechanisms of bone metastases.%研究显示DKK-1(dickkopf-1)异常与乳腺癌、前列腺癌、多发性骨髓瘤及神经母细胞瘤等骨转移的发生及治疗效果密切相关,亦与非小细胞肺癌密切相关.进一步进行血清DKK-1水平与常见肿瘤骨转移关系的大样本临床研究,对评价DKK-1作为骨转移癌临床生物标志物的价值、了解骨转移肿瘤机制具有重要临床意义.

  19. Patterns of Care Among Patients Receiving Radiation Therapy for Bone Metastases at a Large Academic Institution

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    Ellsworth, Susannah G. [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Alcorn, Sara R., E-mail: salcorn2@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Hales, Russell K.; McNutt, Todd R.; DeWeese, Theodore L. [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Smith, Thomas J. [Department of Medical Oncology and Harry J. Duffey Family Program in Palliative Care, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States)

    2014-08-01

    Purpose: This study evaluates outcomes and patterns of care among patients receiving radiation therapy (RT) for bone metastases at a high-volume academic institution. Methods and Materials: Records of all patients whose final RT course was for bone metastases from April 2007 to July 2012 were identified from electronic medical records. Chart review yielded demographic and clinical data. Rates of complicated versus uncomplicated bone metastases were not analyzed. Results: We identified 339 patients whose final RT course was for bone metastases. Of these, 52.2% were male; median age was 65 years old. The most common primary was non-small-cell lung cancer (29%). Most patients (83%) were prescribed ≤10 fractions; 8% received single-fraction RT. Most patients (52%) had a documented goals of care (GOC) discussion with their radiation oncologist; hospice referral rates were higher when patients had such discussions (66% with vs 50% without GOC discussion, P=.004). Median life expectancy after RT was 96 days. Median survival after RT was shorter based on inpatient as opposed to outpatient status at the time of consultation (35 vs 136 days, respectively, P<.001). Hospice referrals occurred for 56% of patients, with a median interval between completion of RT and hospice referral of 29 days and a median hospice stay of 22 days. Conclusions: These data document excellent adherence to American Society for Radiation Oncolology Choosing Wisely recommendation to avoid routinely using >10 fractions of palliative RT for bone metastasis. Nonetheless, single-fraction RT remains relatively uncommon. Participating in GOC discussions with a radiation oncologist is associated with higher rates of hospice referral. Inpatient status at consultation is associated with short survival.

  20. An Easy Tool to Predict Survival in Patients Receiving Radiation Therapy for Painful Bone Metastases

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    Westhoff, Paulien G., E-mail: p.g.westhoff@umcutrecht.nl [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands); Graeff, Alexander de [Department of Medical Oncology, University Medical Center Utrecht, Utrecht (Netherlands); Monninkhof, Evelyn M. [Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht (Netherlands); Bollen, Laurens; Dijkstra, Sander P. [Department of Orthopedic Surgery, Leiden University Medical Center (Netherlands); Steen-Banasik, Elzbieta M. van der [ARTI Institute for Radiation Oncology Arnhem, Arnhem (Netherlands); Vulpen, Marco van [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands); Leer, Jan Willem H. [Department of Radiotherapy, University Medical Center Nijmegen, Nijmegen (Netherlands); Marijnen, Corrie A.; Linden, Yvette M. van der [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands)

    2014-11-15

    Purpose: Patients with bone metastases have a widely varying survival. A reliable estimation of survival is needed for appropriate treatment strategies. Our goal was to assess the value of simple prognostic factors, namely, patient and tumor characteristics, Karnofsky performance status (KPS), and patient-reported scores of pain and quality of life, to predict survival in patients with painful bone metastases. Methods and Materials: In the Dutch Bone Metastasis Study, 1157 patients were treated with radiation therapy for painful bone metastases. At randomization, physicians determined the KPS; patients rated general health on a visual analogue scale (VAS-gh), valuation of life on a verbal rating scale (VRS-vl) and pain intensity. To assess the predictive value of the variables, we used multivariate Cox proportional hazard analyses and C-statistics for discriminative value. Of the final model, calibration was assessed. External validation was performed on a dataset of 934 patients who were treated with radiation therapy for vertebral metastases. Results: Patients had mainly breast (39%), prostate (23%), or lung cancer (25%). After a maximum of 142 weeks' follow-up, 74% of patients had died. The best predictive model included sex, primary tumor, visceral metastases, KPS, VAS-gh, and VRS-vl (C-statistic = 0.72, 95% CI = 0.70-0.74). A reduced model, with only KPS and primary tumor, showed comparable discriminative capacity (C-statistic = 0.71, 95% CI = 0.69-0.72). External validation showed a C-statistic of 0.72 (95% CI = 0.70-0.73). Calibration of the derivation and the validation dataset showed underestimation of survival. Conclusion: In predicting survival in patients with painful bone metastases, KPS combined with primary tumor was comparable to a more complex model. Considering the amount of variables in complex models and the additional burden on patients, the simple model is preferred for daily use. In addition, a risk table for survival is

  1. Osteoprotegerin in bone metastases: mathematical solution to the puzzle.

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    Marc D Ryser

    Full Text Available Bone is a common site for cancer metastasis. To create space for their growth, cancer cells stimulate bone resorbing osteoclasts. Cytokine RANKL is a key osteoclast activator, while osteoprotegerin (OPG is a RANKL decoy receptor and an inhibitor of osteoclastogenesis. Consistently, systemic application of OPG decreases metastatic tumor burden in bone. However, OPG produced locally by cancer cells was shown to enhance osteolysis and tumor growth. We propose that OPG produced by cancer cells causes a local reduction in RANKL levels, inducing a steeper RANKL gradient away from the tumor and towards the bone tissue, resulting in faster resorption and tumor expansion. We tested this hypothesis using a mathematical model of nonlinear partial differential equations describing the spatial dynamics of OPG, RANKL, PTHrP, osteoclasts, tumor and bone mass. We demonstrate that at lower expression rates, tumor-derived OPG enhances the chemotactic RANKL gradient and osteolysis, whereas at higher expression rates OPG broadly inhibits RANKL and decreases osteolysis and tumor burden. Moreover, tumor expression of a soluble mediator inducing RANKL in the host tissue, such as PTHrP, is important for correct orientation of the RANKL gradient. A meta-analysis of OPG, RANKL and PTHrP expression in normal prostate, carcinoma and metastatic tissues demonstrated an increase in expression of OPG, but not RANKL, in metastatic prostate cancer, and positive correlation between OPG and PTHrP in metastatic prostate cancer. The proposed mechanism highlights the importance of the spatial distribution of receptors, decoys and ligands, and can be applied to other systems involving regulation of spatially anisotropic processes.

  2. Pheochromocytoma presenting as musculoskeletal pain from bone metastases

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    Lynn, M.D.; Braunstein, E.M.; Shapiro, B.

    1987-10-01

    Six patients presented with musculoskeletal pain resulting from destructive bone lesions. These patients were ultimately shown to have metastatic pheochromocytoma. None of the cases exhibited typical symptoms of metastatic pheochromocytoma, nor was it suspected at the time of presentation. In three patients, hypertension caused pheochromocytoma to be considered as a diagnosis. The three remaining patients, all of whom had documented hypertension in the past, underwent bone biopsy. Two of these patients became markedly hypertensive in the postoperative period. Malignant pheochromocytoma may present with metastatic skeletal disease in some patients in whom the presence of hypertension as well as a carefully elicited history may suggest the diagnosis. In such patients, the possibility of pheochromocytoma should be taken into account, as biopsy may trigger a hypertensive crisis in patients not under adrenergic blockade.

  3. Clinical Analysis of Bisphosphonates Treatment on Bone Metastases and Hypercalcemia of Malignancy in Advanced Solid Tumor

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    MING Shu-hong; SUN Tie-ying

    2007-01-01

    Objective: To evaluate the efficacy and toleration of bisphosphonates therapy in patients with bone metastases and hypercalcemia of malignancy in advanced solid tumor. Methods: Patients with histologically or cytologically confirmed cancer and hypercalcemia with bone metastases were designed to open treatment with either 4mg zoledronic acid or 90mg pamidronate. The primary efficacy parameters were pain scores(NRS), Corrected serum calcium(CSC) and CSC effective rate. The vital signs, biochemical and hematological parameters were determined. Results: Twenty patients were enrolled in this study, twelve patients in zoledronic acid group and eight in pamidronate group. Zoledronic acid and pamidronate significantly palliated pain. Pain scores were significantly lower at end-point after Zoledronic acid or pamidronate infusion(5.92 vs 3.25,P<0.01;6.13 vs 4.38, P<0.01, respectively). The mean CSC level decreased significantly after Zoledronic acid or pamidronate infusion from 12.86 to 10.28mg/dl and 13.19 to 10.36mg/dl respectively. The CSC effective rate was about 90% at 14 days after infusion in two groups. There was no statistical significance for all primary efficacy parameters in zoledronic acid group compared with pamidronate group. An adverse reaction was mild fever after pamidronate infusion and then completely reversible. Conclusion: Zoledronic acid and pamidronate disodium were well tolerated and effective for bone metastases and hypercalcemia of malignancy in advanced solid tumor.

  4. Pain in castration-resistant prostate cancer with bone metastases: a qualitative study

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    Gater Adam

    2011-10-01

    Full Text Available Abstract Background Bone metastases are a common painful and debilitating consequence of castration-resistant prostate cancer (CPRC. Bone pain may predict patients' prognosis and there is a need to further explore CRPC patients' experiences of bone pain in the overall context of disease pathology. Due to the subjective nature of pain, assessments of pain severity, onset and progression are reliant on patient assessment. Patient reported outcome (PRO measures, therefore, are commonly used as key endpoints for evaluating the efficacy of CRPC treatments. Evidence of the content validity of leading PRO measures of pain severity used in CRPC clinical trials is, however, limited. Methods To document patients' experience of CRPC symptoms including pain, and their impact on health-related quality of life (HRQL, semi-structured in-depth qualitative interviews were conducted with 17 patients with CRPC and bone metastases. The content validity of the Present Pain Intensity (PPI scale from the McGill Pain Questionnaire (MPQ, and the 'Average Pain' and 'Worst Pain' items of the Brief Pain Inventory Short-Form (BPI-SF was also assessed. Results Patients with CRPC and bone metastases present with a constellation of symptoms that can have a profound effect on HRQL. For patients in this study, bone pain was the most prominent and debilitating symptom associated with their condition. Bone pain was chronic and, despite being generally well-managed by analgesic medication, instances of breakthrough cancer pain (BTcP were common. Cognitive debriefing of the selected PRO measures of pain severity highlighted difficulties among patients in understanding the verbal response scale (VRS of the MPQ PPI scale. There were also some inconsistencies in the way in which the BPI-SF 'Average Pain' item was interpreted by patients. In contrast, the BPI-SF 'Worst Pain' item was well understood and interpreted consistently among patients. Conclusions Study findings support the

  5. Detection of bone marrow metastases in prostate cancer: Role of trephine biopsy and Immunohistochemistry

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    Manish Kumar Singh

    2013-01-01

    Full Text Available Context: Bone marrow (BM metastases are an integral part of tumor dissemination in many malignancies. Prostate carcinoma, which has high tendency to metastasize to bone, shown to have affinity for endosteal niche as well as tendency to compete with hematopoietic cells to home in BM. This marrow dissemination can be confidently proved by histopathological examination of BM. Aims: In this study, we are trying to detect the presence of metastases and micrometastases in BM of prostate carcinoma patients with the help of immunohistochemical markers prostate-specific antigen (PSA and prostate-specific acid phosphatase and correlate the findings with American Joint Committee on Cancer Tumor, Node and Metastasis 7 th (2010 classification, serum PSA, and biopsy Gleason′s score. Materials and Methods: We performed BM examination and hematological workup of 11 known prostate carcinoma patients including metastatic cases also, during our study period of 1 year. The BM biopsy sections and clot sections were used to carry out immunohistochemistry. The data were analyzed by using SPSS (Statistical Package for Social Sciences version 15.0 statistical analysis software. Results: We found that two patients were positive for metastases in BM out of the 11. Both of these patients already had metastases to other site with very high serum PSA levels. Anemia was common hematological alteration in both of them and one of them showed increased osteoblasts in the aspirate film. Conclusion: Taking into account our small sample size and short study duration, we conclude that further large sized future studies with long-term follow-up in to this BM dissemination by prostate cancer cells could open new horizons to understand the biology of metastasis of this common malignancy and also provide more effective therapeutic options as well as prognostic implications in these patients.

  6. Radioactive bone cement for the treatment of spinal metastases: a dosimetric analysis of simulated clinical scenarios

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    Kaneko, T. S.; Sehgal, V.; Skinner, H. B.; Al-Ghazi, M. S. A. L.; Ramsinghani, N. S.; Marquez Miranda, M.; Keyak, J. H.

    2012-07-01

    Vertebral metastases are a common manifestation of many cancers, potentially leading to vertebral collapse and neurological complications. Conventional treatment often involves percutaneous vertebroplasty/kyphoplasty followed by external beam radiation therapy. As a more convenient alternative, we have introduced radioactive bone cement, i.e. bone cement incorporating a radionuclide. In this study, we used a previously developed Monte Carlo radiation transport modeling method to evaluate dose distributions from phosphorus-32 radioactive cement in simulated clinical scenarios. Isodose curves were generally concentric about the surface of bone cement injected into cadaveric vertebrae, indicating that dose distributions are relatively predictable, thus facilitating treatment planning (cement formulation and dosimetry method are patent pending). Model results indicated that a therapeutic dose could be delivered to tumor/bone within ∼4 mm of the cement surface while maintaining a safe dose to radiosensitive tissue beyond this distance. This therapeutic range should be sufficient to treat target volumes within the vertebral body when tumor ablation or other techniques are used to create a cavity into which the radioactive cement can be injected. With further development, treating spinal metastases with radioactive bone cement may become a clinically useful and convenient alternative to the conventional two-step approach of percutaneous strength restoration followed by radiotherapy.

  7. A case of recurrent giant cell tumor of bone with malignant transformation and benign pulmonary metastases

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    Gray Robert

    2010-09-01

    Full Text Available Abstract Giant cell tumor (GCT of bone is a locally destructive tumor that occurs predominantly in long bones of post-pubertal adolescents and young adults, where it occurs in the epiphysis. The majority are treated by aggressive curettage or resection. Vascular invasion outside the boundary of the tumor can be seen. Metastasis, with identical morphology to the primary tumor, occurs in a few percent of cases, usually to the lung. On occasion GCTs of bone undergo frank malignant transformation to undifferentiated sarcomas. Here we report a case of GCT of bone that at the time of recurrence was found to have undergone malignant transformation. Concurrent metastases were found in the lung, but these were non-transformed GCT.

  8. Assessing response to treatment of bone metastases from breast cancer: what should be the standard of care?

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    Woolf, D K; Padhani, A R; Makris, A

    2015-06-01

    Bone is the most common site for breast cancer metastases, occurring in up to 70% of those with metastatic disease. In order to effectively manage these patients, it is essential to have consistent, reproducible and validated methods of assessing response to therapy. We present current clinical practice of imaging response assessment of bone metastases. We also review the biology of bone metastases and measures of response assessment including clinical assessment, tumour markers and imaging techniques; bone scans (BSs), computed tomography (CT), positron emission tomography, magnetic resonance imaging (MRI) and whole-body diffusion-weighted MRI (WB DW-MRI). The current standard of care of BSs and CT has significant limitations and are not routinely recommended for the purpose of response assessment in the bones. WB DW-MRI has the potential to address this unmet need and should be evaluated in clinical trials.

  9. Effectiveness of Reirradiation for Painful Bone Metastases: A Systematic Review and Meta-Analysis

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    Huisman, Merel, E-mail: m.huisman-7@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Utrecht (Netherlands); Bosch, Maurice A.A.J. van den; Wijlemans, Joost W. [Department of Radiology, University Medical Center Utrecht, Utrecht (Netherlands); Vulpen, Marco van [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands); Linden, Yvette M. van der [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Verkooijen, Helena M. [Department of Radiology, University Medical Center Utrecht, Utrecht (Netherlands)

    2012-09-01

    Purpose: Reirradiation of painful bone metastases in nonresponders or patients with recurrent pain after initial response is performed in up to 42% of patients initially treated with radiotherapy. Literature on the effect of reirradiation for pain control in those patients is scarce. In this systematic review and meta-analysis, we quantify the effectiveness of reirradiation for achieving pain control in patients with painful bone metastases. Methods and Materials: A free text search was performed to identify eligible studies using the MEDLINE, EMBASE, and the Cochrane Collaboration library electronic databases. After study selection and quality assessment, a pooled estimate was calculated for overall pain response for reirradiation of metastatic bone pain. Results: Our literature search identified 707 titles, of which 10 articles were selected for systematic review and seven entered the meta-analysis. Overall study quality was mediocre. Of the 2,694 patients initially treated for metastatic bone pain, 527 (20%) patients underwent reirradiation. Overall, a pain response after reirradiation was achieved in 58% of patients (pooled overall response rate 0.58, 95% confidence interval = 0.49-0.67). There was a substantial between-study heterogeneity (I{sup 2} = 63.3%, p = 0.01) because of clinical and methodological differences between studies. Conclusions: Reirradiation of painful bone metastases is effective in terms of pain relief for a small majority of patients; approximately 40% of patients do not benefit from reirradiation. Although the validity of results is limited, this meta-analysis provides a comprehensive overview and the most quantitative estimate of reirradiation effectiveness to date.

  10. Use of disodium pamidronate bisphosphonate in patients with bone metastases of lung cancer

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    Ranković Boško

    2002-01-01

    Full Text Available Disodium pamidronate (Aredia®, a drug of the bisphosphonate group, was administered to 20 patients with pains in the bones due to secondary deposits of lung cancer. The aim of the study was to investigate the analgesic effect of pamidronate to osteolytic metastases of lung cancer in the bone. In 16 (80% patients non-small-cell lung cancer was diagnosed, and in 4 (20% patients small-cell-lung cancer was confirmed. Intensive disseminated pains in the bones were present in all the patients. Metastases in the skeleton were confirmed by radiography and scintigraphy of the bones. Initial values of calcium in the plasma were determined in those patients. In 11 (55% patients, initial values of calcium in the serum were normal, and in 9 (45% patients, they were elevated. Patients with normal calcium values received 30 mg of pamidronate in 250 ml of normal saline, and patients with hypercalcaemia received 45-60 mg in 500 ml of normal saline. Analgesic effect of pamidronate was present in 12 (60% patients, and the completely painless state was achieved in 4 out of 12 patients. Evaluation of the pain was done by questionnaire, using a simple, descriptive scale. In all 9 (100% patients with hypercalcaemia, values of calcium in plasma were normalized. Pamidronate exerted favorable analgesic effect in the case of metastases of lung cancer in the bones in more than 50% patients. Satisfactory results were also achieved in the patients non-responsive to palliative therapy by irradiation This enables the use of opiates in lower doses.

  11. The Use of Massive Endoprostheses for the Treatment of Bone Metastases

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    D. H. Park

    2007-01-01

    Full Text Available Purpose. We report a series of 58 patients with metastatic bone disease treated with resection and endoprosthetic reconstruction over a five-year period at our institution. Introduction. The recent advances in adjuvant and neoadjuvant therapy in cancer treatment have resulted in improved prognosis of patients with bone metastases. Most patients who have either an actual or impending pathological fracture should have operative stabilisation or reconstruction. Endoprosthetic reconstructions are indicated in patients with extensive bone loss, failed conventional reconstructions, and selected isolated metastases. Methods and Results. We identified all patients who were diagnosed with metastatic disease to bone between 1999 and 2003. One hundred and seventy-one patients were diagnosed with bone metastases. Metastatic breast and renal cancer accounted for 84 lesions (49%. Fifty-eight patients with isolated bone metastasis to the appendicular skeleton had an endoprosthetic reconstruction. There were 28 males and 30 females. Twelve patients had an endoprosthesis in the upper extremity and 46 patients had an endoprosthesis in the lower extremity. The mean age at presentation was 62 years (24 to 88. At the time of writing, 19 patients are still alive, 34 patients have died, and 5 have been lost to follow up. Patients were followed up and evaluated using the musculoskeletal society tumour score (MSTS and the Toronto extremity salvage score (TESS. The mean MSTS was 73% (57% to 90% and TESS was 71% (46% to 95%. Mean follow-up was 48.2 months (range 27 to 82 months and patients died of disease at a mean of 22 months (2 to 51 months from surgery. Complications included 5 superficial wound infections, 1 aseptic loosening, 4 dislocations, 1 subluxation, and 1 case, where the tibial component of a prosthesis rotated requiring open repositioning. Conclusions. We conclude that endoprosthetic replacement for the treatment of isolated bone metastases is a reliable

  12. A multidisciplinary bone metastases clinic at Toronto Sunnybrook Regional Cancer Centre - A review of the experience from 1999 to 2005.

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    Li, Kathy K; Sinclair, Emily; Pope, Joan; Farhadian, Macey; Harris, Kristin; Napolskikh, Julie; Yee, Albert; Librach, Lawrence; Wynnychuk, Lesia; Danjoux, Cyril; Chow, Edward; Bone, On Behalf Of The; Team, Metastases

    2008-09-01

    Our objective in this study was to review the experience of a one-stop multidisciplinary bone metastases clinic (BMC) that offers a coordinated multidisciplinary approach to the care of cancer patients with bone metastases in a tertiary cancer centre. Patients with symptomatic bone metastases were referred to BMC and assessed by a team of specialists in various disciplines - interventional radiology, orthopedic surgery, palliative medicine, and radiation oncology. At initial consultation, patient demographics, reasons for referral, and case disposition were recorded. From January 1999 to February 2005, a total of 272 patients with bone metastases were referred to the BMC. The median age was 65 years (range 28-95) and median KPS score at consultation was 60 (range 30-90). The majority of patients came from home (74%), while others came from a nursing home or the hospital (9%). Almost a third (28%) of patients had 2 or more reasons of referral, yielding a total of 354 reasons. The most common reason for referral was bone pain (42%), bone metastases (21%), high risk for pathological fracture (12%), and pathological fracture (10%). Of the 272 patients who received consultation, 40% received palliative radiotherapy, 19% received interventional surgery, 7% were referred to other support services such as palliative care, physiotherapy, and 7% had further investigation or imaging. A multidisciplinary clinic is useful for co-coordinating the management of bone metastatic disease in symptomatic patients.

  13. Palliative radiotherapy of bone metastases; Palliative Strahlentherapie von Knochenmetastasen. Eine retrospektive Analyse von 176 Patienten

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    Koswig, S.; Buchali, A.; Boehmer, D.; Schlenger, L.; Budach, V. [Berlin Univ. (Germany). Universitaetsklinik Charite

    1999-10-01

    Background: The effect of the palliative irradiation of bone metastases was explored in this retrospective analysis. The spectrum of primary tumor sites, the localization of the bone metastases and the fractionation schedules were analyzed with regard to palliation discriminating total, partial and complete pain response. Patients and Methods: One hundred seventy-six patients are included in this retrospective quantitative study from April 1992 to November 1993. Two hundred fifty-eight localizations of painful bone metastases were irradiated. The percentage of bone metastases of the total irradiated localizations in our department of radiotherapy in the Carite-Hospital, the primary tumor sites, the localizations and the different fractionation schedules were explored. The total, partial and complete pain response was analyzed in the most often used fractionation schedules and by primary tumor sites. Results: Eight per cent of all irradiated localizations in the observation period were bone metastases. There were irradiated bone metastases of 21 different tumor sites. Most of the primary tumor sites were breast cancer (49%), lung cancer (6%) and kidney cancer (6%). The most frequent site of metastases was the vertebral column (52%). The most often used fractionation schedules were: 4x5 Gy (32%), 10x3 Gy (18%), 6x5 Gy (9%), 7x3 Gy (7%), 10x2 Gy (5%) and 2x8 Gy. The total response rates in this fractionation schedules were 72%, 79%, 74%, 76%, 75% and 72%, the complete response rates were 35%, 32%, 30%, 35%, 33% and 33%. There were no significant differences between the most often irradiated primary tumor sites, the most frequent localizations and the palliation with regard to total, partial and complete pain response. (orig.) [German] Ziel: Die Effizienz der palliativen Strahlentherapie bei ossaerer Metastasierung wird in dieser retrospektiven Studie untersucht. Das Spektrum der den Knochenmetastasen zugrundeliegenden unterschiedlichen Primaertumoren und

  14. 18F-NaF Positive Bone Metastases of Non 18F-FDG Avid Mucinous Gastric Cancer

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    Çiğdem Soydal

    2015-10-01

    Full Text Available Detection of gastric cancer bone metastasis is crucial since its presence is an independent prognostic factor. In this case report, we would like to present 18F-NaF positive bone metastases of non 18F-FDG avid gastric mucinous cancer

  15. Modeling invasion of metastasizing cancer cells to bone marrow utilizing ecological principles

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    Chen Kun-Wan

    2011-10-01

    Full Text Available Abstract Background The invasion of a new species into an established ecosystem can be directly compared to the steps involved in cancer metastasis. Cancer must grow in a primary site, extravasate and survive in the circulation to then intravasate into target organ (invasive species survival in transport. Cancer cells often lay dormant at their metastatic site for a long period of time (lag period for invasive species before proliferating (invasive spread. Proliferation in the new site has an impact on the target organ microenvironment (ecological impact and eventually the human host (biosphere impact. Results Tilman has described mathematical equations for the competition between invasive species in a structured habitat. These equations were adapted to study the invasion of cancer cells into the bone marrow microenvironment as a structured habitat. A large proportion of solid tumor metastases are bone metastases, known to usurp hematopoietic stem cells (HSC homing pathways to establish footholds in the bone marrow. This required accounting for the fact that this is the natural home of hematopoietic stem cells and that they already occupy this structured space. The adapted Tilman model of invasion dynamics is especially valuable for modeling the lag period or dormancy of cancer cells. Conclusions The Tilman equations for modeling the invasion of two species into a defined space have been modified to study the invasion of cancer cells into the bone marrow microenvironment. These modified equations allow a more flexible way to model the space competition between the two cell species. The ability to model initial density, metastatic seeding into the bone marrow and growth once the cells are present, and movement of cells out of the bone marrow niche and apoptosis of cells are all aspects of the adapted equations. These equations are currently being applied to clinical data sets for verification and further refinement of the models.

  16. Diagnosis of bone metastases: a meta-analysis comparing {sup 18}FDG PET, CT, MRI and bone scintigraphy

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    Yang, Hui-Lin; Liu, Tao [Hospital of Soochow University, Department of Orthopaedics, Suzhou (China); Wang, Xi-Ming [Hospital of Soochow University, Department of Radiology, Suzhou (China); Xu, Yong [Public Health School of Soochow University, Department of Epidemiology and Biostatistics, Suzhou (China); Deng, Sheng-Ming [Department of Nuclear Medicine, The first affiliated hospital of Soochow University, Suzhou (China)

    2011-12-15

    To perform a meta-analysis to compare {sup 18}FDG PET, CT, MRI and bone scintigraphy (BS) for the diagnosis of bone metastases. Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 1995 to January 2010. Software was used to obtain pooled estimates of sensitivity, specificity and summary receiver operating characteristic curves (SROC). 67 articles consisting of 145 studies fulfilled all inclusion criteria. On per-patient basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 89.7%, 72.9%, 90.6% and 86.0% respectively. PET=MRI>BS>CT. (''=''indicated no significant difference, P > 0.05; ''>'' indicated significantly higher, P < 0.05). The pooled specificity estimates for PET, CT, MRI and BS were 96.8%, 94.8%, 95.4% and 81.4% respectively. PET = CT = MRI>BS. On per-lesion basis, the pooled sensitivity estimates for PET, CT, MRI and BS were 86.9%, 77.1%, 90.4% and 75.1% respectively. PET = MRI>BS>CT. The pooled specificity estimates for PET, CT, MRI and BS were 97.0%, 83.2%, 96.0% and 93.6% respectively. PET>MRI>BS>CT. PET and MRI were found to be comparable and both significantly more accurate than CT and BS for the diagnosis of bone metastases. (orig.)

  17. Bone metastases: assessment of therapeutic response through radiological and nuclear medicine imaging modalities.

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    Vassiliou, V; Andreopoulos, D; Frangos, S; Tselis, N; Giannopoulou, E; Lutz, S

    2011-11-01

    Radiological and nuclear medicine imaging modalities used for assessing bone metastases treatment response include plain and digitalised radiography (XR), skeletal scintigraphy (SS), dual-energy X-ray absorptiometry (DEXA), computed tomography (CT), magnetic resonance imaging (MRI), [(18)F] fluorodeoxyglucose positron emission tomography (FDG-PET) and PET/CT. Here we discuss the advantages and disadvantages of these assessment modalities as evident through different clinical trials. Additionally, we present the more established response criteria of the International Union Against Cancer and the World Health Organization and compare them with newer MD Anderson criteria. Even though serial XR and SS have been used to assess the therapeutic response for decades, several months are required before changes are evident. Newer techniques, such as MRI or PET, may allow an earlier evaluation of response that may be quantified through monitoring changes in signal intensity and standard uptake value, respectively. Moreover, the application of PET/CT, which can follow both morphological and metabolic changes, has yielded interesting and promising results that give a new insight into the natural history of metastatic bone disease. However, only a few studies have investigated the application of these newer techniques and further clinical trials are needed to corroborate their promising results and establish the most suitable imaging parameters and evaluation time points. Last, but not least, there is an absolute need to adopt uniform response criteria for bone metastases through an international consensus in order to better assess treatment response in terms of accuracy and objectivity.

  18. Radiotherapy for bone metastases - Practice in Norway 1997 - 2007. A national registry-based study

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    Sande Laugsand, Tonje [European Palliative Care Research Centre (PRC), Faculty of Medicine, Norwegian Univ. of Technology and Science (NTNU), Trondheim (Norway)], e-mail: tonje.laugsand@ntnu.no; Kaasa, Stein; Lund, Jo-Aasmund [European Palliative Care Research Centre (PRC), Faculty of Medicine, Norwegian Univ. of Technology and Science (NTNU), Trondheim (Norway); Cancer Clinic, St. Olavs Hospital, Univ. Hospital of Trondheim, Trondheim (Norway); Romundstad, Paal [Dept. of Public Health, Faculty of Medicine, Norwegian Univ. of Technology and Science (NTNU), Trondheim (Norway); Johannesen, Tom Boerge [Cancer Registry of Norway, Oslo (Norway)

    2013-08-15

    Numerous randomised clinical trials have shown that the efficacy of single fraction radiotherapy for metastatic bone pain corresponds to that of multiple fractions of radiotherapy for the majority of patients. It is not clear to which extent single fraction radiotherapy has been implemented into clinical practice. Material and methods: A Norwegian national registry based study was conducted, including all radiotherapy schedules of 8 Gy x 1 and 3 Gy x 10 delivered to bone metastases in 1997 - 2007. Binomial regression analyses were used to study whether treatment centre, primary diagnosis, anatomical region irradiated, age, sex, and travel distance, were associated with the choice of fractionation. Results: A total of 14 380 radiotherapy episodes were identified. During the period 31% of the treatments were delivered as 8 Gy x 1. The proportion of single fraction treatments increased from 16% in 1997 to 41% in 2007. There were substantial differences in the proportion of single fraction treatments between the treatment centres (range 25 - 54%). These differences persisted after adjustment for sex, age, primary diagnosis, anatomical region, and travel distance. Conclusions: The study demonstrates an under utilisation of single fraction treatment for bone metastases in Norway during the study period.

  19. {sup 18}F-Fluoride PET/CT is highly effective for excluding bone metastases even in patients with equivocal bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Bortot, Daniel C.; Amorim, Barbara J.; Oki, Glaucia C.; Santos, Allan O.; Lima, Mariana C.L.; Etchebehere, Elba C.S.C.; Ramos, Celso Dario [State University of Campinas (UNICAMP), Division of Nuclear Medicine, Department of Radiology, Avenue Zeferino Vaz, S/N., PO Box 6149, Campinas (Brazil); Gapski, Sergio B. [Medicina Nuclear Diagnostico e Terapia, Nuclear Medicine Clinic, Campinas (Brazil); Barboza, Marycel F.; Mengatti, Jair [Nuclear and Energy Research Institute (IPEN)-CNEN, Radiopharmacy Directory, Sao Paulo (Brazil)

    2012-11-15

    Bone scintigraphy (BS) has been used extensively for many years for the diagnosis of bone metastases despite its low specificity and significant rate of equivocal lesions. {sup 18}F-Fluoride PET/CT has been proven to have a high sensitivity and specificity in the detection of malignant bone lesions, but its effectiveness in patients with inconclusive lesions on BS is not well documented. This study evaluated the ability of {sup 18}F-fluoride PET/CT to exclude bone metastases in patients with various malignant primary tumours and nonspecific findings on BS. We prospectively studied 42 patients (34-88 years of age, 26 women) with different types of tumour. All patients had BS performed for staging or restaging purposes but with inconclusive findings. All patients underwent {sup 18}F-fluoride PET/CT. All abnormalities identified on BS images were visually compared with their appearance on the PET/CT images. All the 96 inconclusive lesions found on BS images of the 42 patients were identified on PET/CT images. {sup 18}F-Fluoride PET/CT correctly excluded bone metastases in 23 patients (68 lesions). Of 19 patients (28 lesions) classified by PET/CT as having metastases, 3 (5 lesions) were finally classified as free of bone metastases on follow-up. The sensitivity, specificity, and positive and negative predictive values of {sup 18}F-fluoride PET/CT were, respectively, 100 %, 88 %, 84 % and 100 % for the identification of patients with metastases (patient analysis) and 100 %, 82 % and 100 % for the identification of metastatic lesions (lesion analysis). The factors that make BS inconclusive do not affect {sup 18}F-fluoride PET/CT which shows a high sensitivity and negative predictive value for excluding bone metastases even in patients with inconclusive conventional BS. (orig.)

  20. Ascorbic-acid Treatment for Progressive Bone Metastases After Radiotherapy: A Pilot Study.

    Science.gov (United States)

    Kiziltan, Huriye Senay; Bayir, Ayse Gunes; Demirtas, Murat; Meral, Ismail; Taspinar, Ozgur; Eris, Ali Hikmet; Aydin, Teoman; Mayadagli, Alparslan

    2014-10-01

    Context • Researchers have reported improved survival rates for patients with cancer when 10-75 g of vitamin C (ascorbic acid, or AA) is administered intravenously. AA exhibits a cytotoxic effect upon entering a cancer cell. Objective • The current study examined the benefits of intravenous administration of AA in treatment of bone metastases. Design • The study was a pilot study. Setting • The study was performed at Bezmialem Vakif University Medical Facility (BVUMF) in the Department of Radiation Oncology, from 2010-2012. Participants • Participants were 11 cancer patients with bone metastases who were unresponsive to standard cancer treatments and who experienced the following issues after receiving a total of 3000 cGy of radiotherapy: (1) intensifying pain, (2) an increase in metastatic sites, and/or (3) a deterioration in general health. Intervention • The 11 patients received 2.5 g of AA in a physiological saline solution, within 1 h period with 3-10 applications following at 1-wk intervals. Outcome Measures • The ECOG Performance Scale and Visual Analog Scale were used to assess performance and pain. Results • Among the participants administered AA, the mean reduction in pain was 55%, and the median survival time was 10 mo. Participants experienced a 40% grade-I gastrointestinal toxicity and a 30% urinary toxicity. Conclusions • Given the study's results, the current research team found considerable encouragement in the use of AA after radiotherapy for treatment of patients with bone metastases. Toxicity was in the acceptable range for AA treatment.

  1. Case report demonstrating effectiveness of sorafenib in multiple lung and bone metastases of renal cell carcinoma

    OpenAIRE

    HOSHI, MANABU; OEBISU, NAOTO; Takada, Jun; IWAI, TDASHI; Nakamura, Hiroaki

    2015-01-01

    The current study presents the case of a 59-year-old male with advanced-stage renal cell carcinoma and bone metastases in the proximal femur and ilium (cT3aN3M1; stage IV). Resection of the primary renal cell cancer and palliative surgery with a γ-nail for an impending fracture of the right proximal femur were performed, followed by radiotherapy. Sorafenib, a multi-kinase inhibitor that blocks the raf and tyrosine kinases of the vascular endothelial and platelet-derived growth factor receptor...

  2. Samarium-153 ethylenediamine tetramethylene phosphonate therapy for bone pain palliation in skeletal metastases

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    Tripathi Madhavi

    2006-01-01

    Full Text Available BACKGROUND: Systemic therapy with radionuclides may be used for the treatment of patients with painful skeletal metastases owing to its efficacy, low cost and low toxicity. Imported radionuclides for pain palliation, like Strontium-89 are expensive; particularly for developing countries. In the Indian scenario, Samarium-153 (Sm-153 is produced in our own reactors and as a result, it is readily available and economical. AIM: We undertook this study to determine the efficacy and toxicity of single-dose Sm-153 ethylenediamine tetramethylene phosphonate as a palliative treatment for painful skeletal metastases. MATERIALS AND METHODS: Eightysix patients with painful skeletal metastases from various primaries, were treated with Sm-153 EDTMP at a dose of 37 MBq/kg. The effects were evaluated according to change in visual analogue pain score, analgesic consumption, Karnofsky performance score, mobility score and blood count tests, conducted regularly for 16 weeks. STATISTICS: Repeated measures analysis. RESULTS: The overall response rates were 73%, while complete response was seen in 12.4%. Reduction in analgesic consumption with improvement in Karnofsky performance score and mobility score, was seen in all responders. Response rates were 80.3 and 80.5% in breast and prostate cancer, respectively. One case, each of Wilms tumor, ovarian cancer, germ cell tumor testis, multiple myeloma, primitive neuroectodermal tumor and oesophageal cancer, did not respond to therapy. No serious side-effects were noted, except for fall in white blood cell, platelet and haemoglobin counts, which gradually returned to normal levels by six-eight weeks. CONCLUSION: Sm-153 EDTMP provided effective palliation in 73% patients with painful bone metastases: the major toxicity was temporary myelosuppression.

  3. Anaemia and thrombocytopenia in patients with prostate cancer and bone metastases

    Directory of Open Access Journals (Sweden)

    Pawinski Adam

    2010-06-01

    Full Text Available Abstract Background The purpose of this study was to determine the incidence, risk factors and prognostic impact of anaemia and thrombocytopenia in patients with bone metastases (BM from prostate cancer. Methods Retrospective cohort study including 51 consecutive patients treated at a community hospital. Twenty-nine patients (57% received taxotere after diagnosis of BM. Results Haemoglobin (Hb ≤ 12.0 g/dL at BM detection was associated with shorter overall survival. During follow-up, 25 patients (49% experienced episodes with Hb 9/L. All of these had previously received blood transfusion. Median interval from Hb 9/L was 2.5 months. Survival after thrombocytopenia was short (3 weeks to 4 months. Haematuria and subdural haematoma were among the causes of death. Conclusions We found high rates of significant bone marrow failure in treatment-refractory patients. Both Hb 9/L predict for unfavourable survival.

  4. Palliative treatment of bone metastases with samarium-153 EDTMP at onset of pain.

    Science.gov (United States)

    Gallicchio, Rosj; Giacomobono, Sabrina; Nardelli, Anna; Pellegrino, Teresa; Simeon, Vittorio; Gattozzi, Domenico; Maddalena, Francesca; Mainenti, Pierpaolo; Storto, Giovanni

    2014-07-01

    We evaluated the pain response and daily discomfort in patients suffering from a borderline degree of bone pain due to breast or lung cancer bone metastases, who had undergone early palliative radionuclide treatment. The results were compared with those from patients who had received standard analgesic therapy. Twenty-one patients (65.7 ± 3 years; 17 women) with metastatic bone cancer underwent samarium-153 (Sm-153) ethylene diamine tetramethylene phosphonate (EDTMP) administration (group A) and 18 patients (64.3 ± 8 years; 16 women)continued to receive standard analgesics (group B; control group). The patients kept a daily pain diary assessing both their discomfort and the pain at specific sites by means of a visual analog scale, rating from 0 (no discomfort–no pain)to 10 (worst discomfort–pain). These diaries were reviewed weekly for 2 months and three physicians rated the pain response on a scale from -2 (considerable deterioration) to +2 (considerable improvement). Baseline characteristics were similar in both groups. The reduction of total discomfort and of bone pain in group A was significantly greater compared to group B (p < 0.0001). A significant improvement of clinical conditions was observed in group A, where the physician rate changed from -1 to 1, compared to group B in which the rate changed from -1 to 0. Sm-153 EDTMP therapy can be considered for patients with bone pain from breast and lung cancer in advance, i.e.,before the establishment of severe pain syndrome.

  5. 博宁联合化疗治疗恶性肿瘤骨转称疼痛%Combined chemotherapy with Boning in the treatment of pain due to bone metastases from malignant tumors

    Institute of Scientific and Technical Information of China (English)

    安晓华; 焦立新; 王正艳

    2002-01-01

    Objective To investigate the effect of Boning on pain due to bone metastases from malignant tumors. Method From December,1998 to December,2000,86 patients with pathologically proved bone metastases from malignant tumors were randomly divided into two groups, study group(combined chemotherapy with boning),control group(simple chemotherapy).Boning (60 mg) dissolved in saline solution(500 ml) were given IV for consecutive 3 days. Then 60 mg Boning was given every half month .Patients in control group accepted simple chemotherapy. Results Efficacy in study group was 88.37% which was significantly superior to that in control group (66.47% ).Boning could repair injured bone. Adverse reaction associated with Boning was weak. Boning quickly relieved symptoms for a long time. Conclusion Effect of large dose Boning for relieving pain due to bone metastases from malignant tumors is satisfying. At the same time, Boning play important role in repair of destructed bone.

  6. Debate: single-fraction treatment should be standard in the retreatment of uncomplicated bone metastases.

    Science.gov (United States)

    Tsang, Derek S; Yau, Vivian; Raziee, Hamid; Niglas, Mark; Soliman, Hany; Chow, Edward; Tsao, May

    2015-10-01

    There is controversy surrounding the optimal radiotherapy dose-fractionation for retreatment of painful bone metastases. Two commonly used regimens are 8 Gy in a single-fraction or 20 Gy in five or eight fractions. Randomized evidence, including the NCIC SC.20 randomized clinical trial, has failed to standardize clinical practice. Practitioners who use single-fraction regimens cite patient convenience, fewer acute adverse effects, and better cost-effectiveness. Practitioners who prefer multiple fractions raise questions about the interpretation of data that justifies single-fraction treatment, and the possibility that single-fraction treatment may provide inferior pain relief. Given this clinical controversy, should single-fraction irradiation be standard in retreatment of uncomplicated bone metastases? In this article, two teams debate both sides of the argument with commentary to summarize the relevant issues. The conclusion from the debate is that the "standard" treatment should be individualized to the patient with shared-decision making between the oncologist, patient and family members. In a cancer patient with poor performance status and short life expectancy, single-fraction repeat radiotherapy may be preferred; in a patient with a prolonged disease course, perhaps multiple fraction retreatments would be preferred. The choice between different fractionation schemes depends on an assessment of individual patient factors, tumour factors and unique patient circumstances.

  7. Usefulness of {sup 18}F fluoride PET/CT in breast cancer patients with osteosclerotic bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Ho; Kim, Ku Sang; Kang, Seok Yun; Song, Hee Sung; Jo, Kyung Sook; Lee, Su Jin; Yoon, Joon Kee; An, Young Sil [Ajou Univ., Suwon (Korea, Republic of); Choi, Bong Hoi [Gyeongsang National Univ. Hospital, Jinju (Korea, Republic of)

    2012-03-15

    Bone metastasis is an important factor for the treatment and prognosis of breast cancer patients. Whole body bone scintigraphy (WBBS) can evaluate skeletal metastases, and {sup 18}F FDG PET/CT seems to exhibit high specificity and accuracy in detecting bone metastases. However, there is a limitation of {sup 18}F FDG PET in assessing sclerotic bone metastases because some lesions may be undetectable. Recent studies showed that {sup 18}F fluoride PET/CT is more sensitive than WBBS in detecting bone metastases. This study aims to evaluate the usefulness of {sup 18}F fluoride PET/CT by comparing it with WBBS and {sup 18}F FDG PET/CT in breast cancer patients with osteosclerotic skeletal metastases. Nine breast cancer patients with suspected bone metastases (9 females; mean age {+-} SD, 55.6{+-}10.0 years) underwent {sup 99m}Tc MDP WBBS, {sup 18}F FDG PET/CT and {sup 18}F fluoride PET/CT. Lesion based analysis of five regions of the skeletons(skull, vertebral column, thoracic cage, pelvic bones and long bones of extremities) and patient based analysis were performed. {sup 18}F fluoride PET/CT, {sup 18}F FDG PET/CT and WBBS detected 49, 20 and 25 true metastases, respectively. Sensitivity, specificity, positive predictive value and negative predictive value of {sup 18}F fluoride PET/CT were 94.2%, 46.3%, 57.7% and 91.2%, respectively. Most true metastatic lesions of {sup 18}F fluoride PET/CT had osteosclerotic change (45/49, 91.8%), and only four lesions showed osteolytic change. Most lesions on {sup 18}F FDG PET/CT also demonstrated osteosclerotic change (17/20, 85.0%) with three osteolytic lesions. All true metastatic lesions detected on WBBS and {sup 18}F FDG PET/CT were identified on {sup 18}F fluoride PET/CT. {sup 18}F FDG PET/CT in detecting osteosclerotic metastatic lesions. {sup 18}F fluoride PET/CT might be useful in evaluating osteosclerotic metastases in breast cancer patients.

  8. The SK-N-AS human neuroblastoma cell line develops osteolytic bone metastases with increased angiogenesis and COX-2 expression

    Directory of Open Access Journals (Sweden)

    Takahiro Tsutsumimoto

    2014-11-01

    Full Text Available Neuroblastoma (NB, which arises from embryonic neural crest cells, is the most common extra-cranial solid tumor of childhood. Approximately half of NB patients manifest bone metastasis accompanied with bone pain, fractures and bone marrow failure, leading to disturbed quality of life and poor survival. To study the mechanism of bone metastasis of NB, we established an animal model in which intracardiac inoculation of the SK-N-AS human NB cells in nude mice developed osteolytic bone metastases with increased osteoclastogenesis. SK-N-AS cells induced the expression of receptor activator of NF-κB ligand and osteoclastogenesis in mouse bone marrow cells in the co-culture. SK-N-AS cells expressed COX-2 mRNA and produced substantial amounts of prostaglandin E2 (PGE2. In contrast, the SK-N-DZ and SK-N-FI human NB cells failed to develop bone metastases, induce osteoclastogenesis, express COX-2 mRNA and produce PGE2. Immunohistochemical examination of SK-N-AS bone metastasis and subcutaneous tumor showed strong expression of COX-2. The selective COX-2 inhibitor NS-398 inhibited PGE2 production and suppressed bone metastases with reduced osteoclastogenesis. NS-398 also inhibited subcutaneous SK-N-AS tumor development with decreased angiogenesis and vascular endothelial growth factor-A expression. Of interest, metastasis to the adrenal gland, a preferential site for NB development, was also diminished by NS-398. Our results suggest that COX2/PGE2 axis plays a critical role in the pathophysiology of osteolytic bone metastases and tumor development of the SK-NS-AS human NB. Inhibition of angiogenesis by suppressing COX-2/PGE2 may be an effective therapeutic approach for children with NB.

  9. Development of [{sup 90}Y]DOTA-conjugated bisphosphonate for treatment of painful bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Kazuma [Advanced Science Research Center, Kanazawa University, Kanazawa 920-8640 (Japan)], E-mail: kogawa@med.kanazawa-u.ac.jp; Kawashima, Hidekazu [Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Graduate School of Medicine, Kyoto University, Kyoto 606-8507 (Japan); Shiba, Kazuhiro [Advanced Science Research Center, Kanazawa University, Kanazawa 920-8640 (Japan); Washiyama, Kohshin; Yoshimoto, Mitsuyoshi [Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-0942 (Japan); Kiyono, Yasushi [Biomedical Imaging Research Center, University of Fukui, Yoshida-gun 910-1193 (Japan); Radioisotopes Research Laboratory, Kyoto University Hospital, Faculty of Medicine, Kyoto University, Kyoto 606-8507 (Japan); Ueda, Masashi [Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan); Radioisotopes Research Laboratory, Kyoto University Hospital, Faculty of Medicine, Kyoto University, Kyoto 606-8507 (Japan); Mori, Hirofumi [Advanced Science Research Center, Kanazawa University, Kanazawa 920-8640 (Japan); Saji, Hideo [Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501 (Japan)

    2009-02-15

    Introduction: Based on the concept of bifunctional radiopharmaceuticals, we have previously developed {sup 186}Re-complex-conjugated bisphosphonate analogs for palliation of painful bone metastases and have demonstrated the utility of these compounds. By applying a similar concept, we hypothesized that a bone-specific directed {sup 90}Y-labeled radiopharmaceutical could be developed. Methods: In this study, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) was chosen as the chelating site, and DOTA was conjugated with 4-amino-1-hydroxybutylidene-1,1-bisphosphonate. [{sup 90}Y]DOTA-complex-conjugated bisphosphonate ([{sup 90}Y]DOTA-HBP) was prepared by coordination with {sup 90}Y, and its biodistribution was studied in comparison to [{sup 90}Y]citrate. Results: In biodistribution experiments, [{sup 90}Y]DOTA-HBP and [{sup 90}Y]citrate rapidly accumulated and resided in the bone. Although [{sup 90}Y]citrate showed a higher level of accumulation in the bone than [{sup 90}Y]DOTA-HBP, the clearances of [{sup 90}Y]DOTA-HBP from the blood and from almost all soft tissues were much faster than those of [{sup 90}Y]citrate. As a result, the estimated absorbed dose ratios of soft tissues to osteogenic cells (target organ) of [{sup 90}Y]DOTA-HBP were lower than those of [{sup 90}Y]citrate. Conclusions: [{sup 90}Y]DOTA-HBP showed superior biodistribution characteristics as a bone-seeking agent and led to a decrease in the level of unnecessary radiation compared to [{sup 90}Y]citrate. Since the DOTA ligand forms a stable complex not only with {sup 90}Y but also with lutetium ({sup 177}Lu), indium ({sup 111}In), gallium ({sup 67/68}Ga), gadolinium (Gd) and so on, complexes of DOTA-conjugated bisphosphonate with various metals could be useful as agents for palliation of metastatic bone pain, bone scintigraphy and magnetic resonance imaging.

  10. Efficacy of Magnetic Resonance-guided Focused Ultrasound Surgery for Bone Metastases Pain Palliation

    Science.gov (United States)

    Kawasaki, Motohiro; Nanba, Hirofumi; Kato, Tomonari; Tani, Toshikazu; Ushida, Takahiro

    2011-09-01

    Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a novel treatment method that achieves non-invasive thermal ablation by focusing many ultrasound waves on a target tissue with real-time monitoring of the location and temperature of the target during the procedure. We investigated the palliative effect on pain and safety of MRgFUS in painful bone metastases. Six patients (mean age, 65.8 years) who met eligibility criteria for the clinical study approved by our Institutional Ethics Committee based on the cooperative protocol were treated with MRgFUS. Targeted sites included the sacrum (n = 1), ilium (n = 2), scapula (n = 2), and femur (n = 1). The mean follow-up period was 9.2 months. All procedures were performed as a single-session treatment using the treatment system that is integrated into the patient table of a magnetic resonance image (MRI) scanner. Endpoints were change in the intensity of pain due to bone metastases from before to after the treatment, as measured on a numerical rating scale, pain interference with daily activities as determined by the Brief pain inventory (BPI), change in images, and safety. Pain relief was obtained in all patients early after treatment, with a reduction in the mean pain score from 6.0±1.3 at baseline to 1.2±1.0 at the end of follow-up as well as in pain interference with daily activities. The mean time required for a single-session treatment was 83.7±37.0 min, with a mean number of sonications required of 13.3±3.7 and mean energy applied of 846.4±273.5 J. No significant growth of tumors was observed, nor were there treatment-related adverse events. These results suggest that MRgFUS has a non-invasive palliative effect on the localized pain in patients with bone metastasis. MRgFUS could become an option in treatment strategies for painful bone metastases in the future.

  11. Management of bone metastases in refractory prostate cancer – role of denosumab

    Directory of Open Access Journals (Sweden)

    Paller CJ

    2012-09-01

    Full Text Available Channing J Paller,1 Michael A Carducci,1 George K Philips21Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA; 2Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USAAbstract: This article reviews the problem of bone disease in prostate cancer and the evolving role of the novel agent denosumab, a fully human monoclonal antibody that inhibits the receptor activator of nuclear factor-ΚB ligand, in suppressing bone resorption and offering bone protection in this disease. Prostate cancer frequently metastasizes to bone, and additionally its treatment with androgen deprivation leads to accelerated bone loss resulting in clinically relevant skeletal complications associated with disabling symptoms. Among the bone-targeting therapeutic strategies investigated for the prevention of bone complications, the potent bisphosphonate zoledronic acid has been the most widely used agent for bone protection in the past decade. Denosumab is the first among a new class of osteoclast-targeting agents to show superior efficacy in several clinical scenarios in both prostate and breast cancer, as well as in osteoporosis, but the focus of this review will be on its role in prostate cancer. The safety and efficacy of denosumab versus zoledronic acid was established in a randomized trial, demonstrating a delay in skeletal-related events in metastatic castration-resistant prostate cancer patients. This study led to the approval of denosumab in the US. The chief risks of denosumab were hypocalcemia and osteonecrosis of the jaw. Denosumab was also approved for fracture risk reduction in patients on androgen-deprivation therapy for nonmetastatic prostate cancer. Although denosumab extended bone metastasis-free survival in a Phase III trial in men with castration-resistant nonmetastatic prostate cancer to a statistically significant degree, a Food and Drug Administration committee found that the effect was not sufficiently clinically

  12. Combined Microwave Ablation and Cementoplasty in Patients with Painful Bone Metastases at High Risk of Fracture

    Energy Technology Data Exchange (ETDEWEB)

    Pusceddu, Claudio, E-mail: clapusceddu@gmail.com [Regional Referral Center for Oncologic Diseases, Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital “A. Businco” (Italy); Sotgia, Barbara, E-mail: barbara.sotgia@gmail.com; Fele, Rosa Maria, E-mail: rosellafele@tiscali.it [Regional Referral Center for Oncological Diseases, Department of Oncological Radiology, Oncological Hospital “A. Businco” (Italy); Ballicu, Nicola, E-mail: nicolaballicu77@gmail.com [Regional Referral Center for Oncologic Diseases, Division of Interventional Radiology, Department of Oncological Radiology, Ocological Hospital “A. Businco” (Italy); Melis, Luca, E-mail: doclucamelis@tiscali.it [Regional Referral Center for Oncological Diseases, Department of Oncological Radiology, Oncological Hospital “A. Businco” (Italy)

    2016-01-15

    PurposeTo retrospectively evaluate the effectiveness of computed tomography-guided percutaneous microwave ablation (MWA) and cementoplasty in patients with painful bone metastases at high risk of fracture.Materials and MethodsThirty-five patients with 37 metastatic bone lesions underwent computed tomography-guided MWA combined with cementoplasty (polymethylmethacrylate injection). Vertebrae, femur, and acetabulum were the intervention sites and the primary end point was pain relief. Pain severity was estimated by visual analog scale (VAS) before treatment; 1 week post-treatment; and 1, 6, and 12 months post-treatment. Functional outcome was assessed by improved patient walking ability. Radiological evaluation was performed at baseline and 3 and 12 months post-procedure.ResultsIn all patients, pain reduction occurred from the first week after treatment. The mean reduction in the VAS score was 84, 90, 90 % at week 1, month 1, and month 6, respectively. Improved walking ability occurred in 100 and 98 % of cases at the 1- and 6-month functional outcome evaluations, respectively. At the 1-year evaluation, 25 patients were alive, and 10 patients (28 %) had died because of widespread disease. The mean reduction in the VAS score and improvement in surviving patients’ walking ability were 90 and 100 %, respectively. No patients showed evidence of local tumor recurrence or progression and pathological fracture in the treated sites.ConclusionOur results suggest that MWA combined with osteoplasty is safe and effective when treating painful bone metastases at high risk of fracture. The number of surviving patients at the 1-year evaluation confirms the need for an effective and long-lasting treatment.

  13. Role of denosumab in the management of skeletal complications in patients with bone metastases from solid tumors

    Directory of Open Access Journals (Sweden)

    Stopeck AT

    2012-04-01

    Full Text Available Ursa Brown-Glaberman, Alison T StopeckUniversity of Arizona Cancer Center, Tucson, AZ, USAAbstract: Skeletal-related events (SREs including pain, fractures, and hypercalcemia are a major source of morbidity for cancer patients with bone metastases. The receptor activator of NF-κB ligand (RANKL is a key mediator of osteoclast formation and activity in normal bone physiology as well as cancer-induced bone resorption. The first commercially available drug that specifically targets and inhibits the RANKL pathway is denosumab, a fully human monoclonal antibody that binds and neutralizes RANKL, thereby inhibiting osteoclast function. In this review, we summarize the major studies leading to the US Food and Drug Administration-approval of denosumab for the prevention of SREs in patients with bone metastases from solid tumors. Further, we discuss the role of denosumab in the prevention and treatment of SREs and bone loss in cancer patients. As a monoclonal antibody, denosumab has several advantages over bisphosphonates, including improved efficacy, better tolerability, and the convenience of administration by subcutaneous injection. In addition, as denosumab has no known renal toxicity, it may be the preferred choice over bisphosphonates in patients with baseline renal insufficiency or receiving nephrotoxic therapies. However, other toxicities, including osteonecrosis of the jaw and hypocalcemia, appear to be class effects of agents that potently inhibit osteoclast activity and are associated with both denosumab and bisphosphonate use. The data presented highlight the differences associated with intravenous bisphosphonate and denosumab use as well as confirm the essential role bone-modifying agents play in maintaining the quality of life for patients with bone metastases.Keywords: denosumab, bone metastases, solid tumor, breast cancer, prostate cancer, skeletal related events, skeletal complications 

  14. Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases

    NARCIS (Netherlands)

    Lam, M.G.E.H.; Dahmane, Amel; Stevens, W.H.M.; Rijk, Peter P. van; Klerk, J.M.H. de; Zonnenberg, Bernard A.

    2008-01-01

    Purpose: 153Sm-ethylenediaminetetramethylenephosphonic acid (EDTMP; Quadramet®) is indicated for the treatment of painful bone metastases, whereas zoledronic acid (Zometa®) is indicated for the prevention of skeletal complications. Because of the different therapeutic effects, combining the treatmen

  15. Diagnostic role of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for early and atypical bone metastases.

    Science.gov (United States)

    Chen, Xiao-Liang; Li, Qian; Cao, Lin; Jiang, Shi-Xi

    2014-01-01

    The bone metastasis appeared early before the bone imaging for most of the above patients. (99)Tc(m)-MDP ((99)Tc(m) marked methylene diphosphonate) bone imaging could diagnosis the bone metastasis with highly sensitivity, but with lower specificity. The aim of this study is to explore the diagnostic value of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for the early period atypical bone metastases. 15 to 30 mCi (99)Tc(m)-MDP was intravenously injected to the 34 malignant patients diagnosed as doubtful early bone metastases. SPECT, CT and SPECT/CT images were captured and analyzed consequently. For the patients diagnosed as early period atypical bone metastases by SPECT/CT, combining the SPECT/CT and MRI together as the SPECT/MRI integrated image. The obtained SPECT/MRI image was analyzed and compared with the pathogenic results of patients. The results indicated that 34 early period doubtful metastatic focus, including 34 SPECT positive focus, 17 focus without special changes by using CT method, 11 bone metastases focus by using SPECT/CT method, 23 doubtful bone metastases focus, 8 doubtful bone metastases focus, 14 doubtful bone metastases focus and 2 focus without clear image. Totally, SPECT/CT combined with SPECT/MRI method diagnosed 30 bone metastatic focus and 4 doubtfully metastatic focus. In conclusion, (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging shows a higher diagnostic value for the early period bone metastases, which also enhances the diagnostic accuracy rate.

  16. TU-A-12A-08: Computing Longitudinal Material Changes in Bone Metastases Using Dual Energy Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Schmidtlein, CR; Hwang, S; Veeraraghavan, H; Fehr, D; Humm, J; Deasy, J [Memorial Sloan Kettering Cancer Center, New York, NY (United States)

    2014-06-15

    Purpose: This study demonstrates a methodology for tracking changes in metastatic bone disease using trajectories in material basis space in serial dual energy computed tomography (DECT) studies. Methods: This study includes patients with bone metastases from breast cancer that had clinical surveillance CT scans using a General Electric CT750HD in dual energy mode. A radiologist defined regions-of-interested (ROI) for bone metastasis, normal bone, and marrow across the serial DECT scans. Our approach employs a Radon transform to forward-projection the basis images, namely, water and iodine, into sinogram space. This data is then repartitioned into fat/bone and effective density/Z image pairs using assumed energy spectrums for the x-ray energies. This approach both helps remove negative material densities and avoids adding spectrum-hardening artifacts. These new basis data sets were then reconstructed via filtered back-projection to create new material basis pair images. The trajectories of these pairs were then plotted in the new basis space providing a means to both visualize and quantitatively measure changes in the material properties of the tumors. Results: ROI containing radiologist defined metastatic bone disease showed well-defined trajectories in both fat/bone and effective density/Z space. ROI that contained radiologist defined normal bone and marrow did not exhibit any discernible trajectories and were stable from scan to scan. Conclusions: The preliminary results show that changes in material composition and effective density/Z image pairs were seen primarily in metastasis and not in normal tissue. This study indicates that by using routine clinical DECT it may be possible to monitor therapy response of bone metastases because healing or worsening bone metastases change material composition of bone. Additional studies are needed to further validate these results and to test for their correlation with outcome.

  17. Bone multicentric epithelioid hemangioendothelioma of the lower and upper extremities with pulmonary metastases: A case report

    Science.gov (United States)

    ZHANG, HUA; FU, YANBIAO; YE, ZHAOMING

    2015-01-01

    The present study reports a rare case of bone multicentric epithelioid hemangioendothelioma (EH) involving the upper and lower extremities simultaneously, with visceral involvement of the lung. Osteolytic lesions were first identified in the right distal femur and proximal tibia. Slight increased radionuclide uptake was observed in the right shoulder joint on bone scintigraphy, however, this was ignored, as no clinical symptoms were present. The patient was initially misdiagnosed with multifocal chondroblastoma, and an extra-articular curettage of lesions was performed in the proximal tibia and medial femoral condyle, which was filled with bone cement. The histopathological diagnosis was corrected post-operatively following immunohistochemical analysis, which indicated EH, and subsequently, an amputation of the right leg at thigh level was performed. In addition, multiple lytic lesions in the right shoulder joint and pulmonary metastases were identified on whole-body radiological examination. Radiotherapy was administered to the right shoulder joint, however, the patient refused chemotherapy or further surgery. At 15 months after the initial surgery, the patient currently remains alive. This case indicates that an improved understanding with regard to the clinical features of this disease may prevent misdiagnosis and improve EH treatment. PMID:26137035

  18. Half body irradiation of patients with multiple bone metastases: A phase II trial

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Randi S.; Yilmaz, Mette K. (Dept. of Oncology, Aalborg Hospital, Aarhus Univ., Aalborg (Denmark)); Hoeyer, Morten; Nielsen, Ole S. (Dept. of Oncology, Aarhus Univ. Hospital, Aarhus (Denmark)); Keldsen, Nina (Dept. of Oncology, Herning Hospital, Herning (Denmark)); Ewertz, Marianne (Dept. of Oncology, Odense Univ. Hospital, Odense (Denmark))

    2009-05-15

    Aim of study. The primary aim of this study was to evaluate the effect of half-body irradiation (HBI) on pain and quality of life in cancer patients with multiple bone metastases. The secondary aim was to evaluate side effects of the treatment. Patients and methods. A total of 44 patients received lower (n = 37), upper (n = 5), or sequential HBI (n = 2). The dose for lower HBI was 8 Gy in one fraction and for upper HBI 7 Gy in one fraction, with reduction of the lung dose to 6 Gy in one fraction by partial shielding. The majority of patients (n = 41) were males with prostate cancers (93%). Outcome and side effects were measured by the EORTC Quality of Life Questionnaire C30 (QLQ-C30), and by the doctors' toxicity scores in the medical record. Pain relief was defined as a reduction of more than 10 points on the QLQ-C30 scale. Evaluations were performed before and 2, 4, 8, 16, and 24 weeks after treatment. Results. Relief of pain was observed in 76% of the patients receiving HBI with 8.8% of the patients experiencing complete pain relief with no residual pain in the treated field. For most patients, the pain relief was lasting throughout the follow-up period. About one third of the patients were able to reduce their intake of analgesics. Grade 1-2 diarrhoea was the most common side effect observed in 49% of the patients two weeks after treatment. Mild pulmonary symptoms (grade 1-2) were observed in four of seven patients receiving upper HBI. No clear effect was observed on the patients' global quality of life.Conclusion. Single fraction HBI is safe and effective providing long lasting pain reduction in 76% of patients with multiple bone metastases.

  19. A radiobiological model of metastatic burden reduction for molecular radiotherapy: application to patients with bone metastases

    Science.gov (United States)

    Denis-Bacelar, Ana M.; Chittenden, Sarah J.; Murray, Iain; Divoli, Antigoni; McCready, V. Ralph; Dearnaley, David P.; O’Sullivan, Joe M.; Johnson, Bernadette; Flux, Glenn D.

    2017-04-01

    Skeletal tumour burden is a biomarker of prognosis and survival in cancer patients. This study proposes a novel method based on the linear quadratic model to predict the reduction in metastatic tumour burden as a function of the absorbed doses delivered from molecular radiotherapy treatments. The range of absorbed doses necessary to eradicate all the bone lesions and to reduce the metastatic burden was investigated in a cohort of 22 patients with bone metastases from castration-resistant prostate cancer. A metastatic burden reduction curve was generated for each patient, which predicts the reduction in metastatic burden as a function of the patient mean absorbed dose, defined as the mean of all the lesion absorbed doses in any given patient. In the patient cohort studied, the median of the patient mean absorbed dose predicted to reduce the metastatic burden by 50% was 89 Gy (interquartile range: 83–105 Gy), whilst a median of 183 Gy (interquartile range: 107–247 Gy) was found necessary to eradicate all metastases in a given patient. The absorbed dose required to eradicate all the lesions was strongly correlated with the variability of the absorbed doses delivered to multiple lesions in a given patient (r  =  0.98, P  <  0.0001). The metastatic burden reduction curves showed a potential large reduction in metastatic burden for a small increase in absorbed dose in 91% of patients. The results indicate the range of absorbed doses required to potentially obtain a significant survival benefit. The metastatic burden reduction method provides a simple tool that could be used in routine clinical practice for patient selection and to indicate the required administered activity to achieve a predicted patient mean absorbed dose and reduction in metastatic tumour burden.

  20. TU-G-204-02: Automatic Sclerotic Bone Metastases Detection in the Pelvic Region From Dual Energy CT

    Energy Technology Data Exchange (ETDEWEB)

    Fehr, D; Schmidtlein, C; Hwang, S; Deasy, J; Veeraraghavan, H [Memorial Sloan Kettering Cancer Center, New York, NY (United States)

    2015-06-15

    Purpose: To automatically detect sclerotic bone metastases in the pelvic region using dual energy computed tomography (DECT). Methods: We developed a two stage algorithm to automatically detect sclerotic bone metastases in the pelvis from DECT for patients with multiple bone metastatic lesions and with hip implants. The first stage consists of extracting the bone and marrow regions by using a support vector machine (SVM) classifier. We employed a novel representation of the DECT images using multi-material decomposition, which represents each voxel as a mixture of different physical materials (e.g. bone+water+fat). Following the extraction of bone and marrow, in the second stage, a bi -histogram equalization method was employed to enhance the contrast to reveal the bone metastases. Next, meanshift segmentation was performed to separate the voxels by their intensity levels. Finally, shape-based filtering was performed to extract the possible locations of the metastatic lesions using multiple shape criteria. We used the following shape parameters: area, eccentricity, major and minor axis, perimeter and skeleton. Results: A radiologist with several years of experience with DECT manually labeled 64 regions consisting of metastatic lesions from 10 different patients. However, the patients had many more metastasic lesions throughout the pelvis. Our method correctly identified 46 of the marked 64 regions (72%). In addition, our method also identified several other lesions, which can then be validated by the radiologist. The missed lesions were typically very large elongated regions consisting of several islands of very small (<4mm) lesions. Conclusion: We developed an algorithm to automatically detect sclerotic lesions in the pelvic region from DECT. Preliminary assessment shows that our algorithm generated lesions agreeing with the radiologist generated candidate regions. Furthermore, our method reveals additional lesions that can be inspected by the radiologist, thereby

  1. Survival and prognostic factors in non-small cell lung cancer patients with spinal bone metastases. A retrospective analysis of 303 patients

    Energy Technology Data Exchange (ETDEWEB)

    Rief, H.; Welzel, T.; Rieken, S.; Bischof, M.; Lindel, K.; Combs, S.E.; Debus, J. [University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Muley, T. [University Hospital of Heidelberg, Thorax Clinic, Department of Thoracic Oncology, Heidelberg (Germany); Bruckner, T. [University Hospital of Heidelberg, Department of Medical Biometry, Heidelberg (Germany)

    2014-01-15

    For palliative care of spinal bone metastases, stability assessment is of crucial importance. Pathological fractures, instability-related patient immobility and the extent of bone metastasis have been reported to affect patient outcome and these parameters have therefore been used for treatment stratification. We report on stability-dependent fracture and survival rates in over 300 non-small cell lung cancer (NSCLC) patients. Data from 303 patients with 868 osteolytic metastases treated with radiotherapy (RT) between 2000 and 2012 were evaluated retrospectively. In NSCLC patients with bone metastases only, the retrospective 6- and 12-month overall survival (OS) rates were 76.7 and 47.2%, respectively. In patients with additional non-bone distant metastases, these values were 60.0 and 34.0%, respectively. Survival rates were significantly lower in patients with multiple bone metastases and in those suffering pathological fractures (p=0.017). No significant impact of histological type, location of spinal lesions or treatment regime was detected. Furthermore, stability assessment revealed no influence of vertebral column stability on patient outcome (p=0.739). Our analysis demonstrated a correlation between the pathological fractures of bone lesions, the number of bone metastases, additional distant metastases and survival. The results offer a rationale for future prospective investigations. (orig.)

  2. Betulinic acid, a bioactive pentacyclic triterpenoid, inhibits skeletal-related events induced by breast cancer bone metastases and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Park, Se Young; Kim, Hyun-Jeong; Kim, Ki Rim; Lee, Sun Kyoung; Lee, Chang Ki; Park, Kwang-Kyun, E-mail: biochelab@yuhs.ac; Chung, Won-Yoon, E-mail: wychung@yuhs.ac

    2014-03-01

    Many breast cancer patients experience bone metastases and suffer skeletal complications. The present study provides evidence on the protective and therapeutic potential of betulinic acid on cancer-associated bone diseases. Betulinic acid is a naturally occurring triterpenoid with the beneficial activity to limit the progression and severity of cancer, diabetes, cardiovascular diseases, atherosclerosis, and obesity. We first investigated its effect on breast cancer cells, osteoblastic cells, and osteoclasts in the vicious cycle of osteolytic bone metastasis. Betulinic acid reduced cell viability and the production of parathyroid hormone-related protein (PTHrP), a major osteolytic factor, in MDA-MB-231 human metastatic breast cancer cells stimulated with or without tumor growth factor-β. Betulinic acid blocked an increase in the receptor activator of nuclear factor-kappa B ligand (RANKL)/osteoprotegerin ratio by downregulating RANKL protein expression in PTHrP-treated human osteoblastic cells. In addition, betulinic acid inhibited RANKL-induced osteoclastogenesis in murine bone marrow macrophages and decreased the production of resorbed area in plates with a bone biomimetic synthetic surface by suppressing the secretion of matrix metalloproteinase (MMP)-2, MMP-9, and cathepsin K in RANKL-induced osteoclasts. Furthermore, oral administration of betulinic acid inhibited bone loss in mice intra-tibially inoculated with breast cancer cells and in ovariectomized mice causing estrogen deprivation, as supported by the restored bone morphometric parameters and serum bone turnover markers. Taken together, these findings suggest that betulinic acid may have the potential to prevent bone loss in patients with bone metastases and cancer treatment-induced estrogen deficiency. - Highlights: • Betulinic acid reduced PTHrP production in human metastatic breast cancer cells. • Betulinic acid blocked RANKL/OPG ratio in PTHrP-stimulated human osteoblastic cells. • Betulinic

  3. Prostate cancer cell-stromal cell crosstalk via FGFR1 mediates antitumor activity of dovitinib in bone metastases.

    Science.gov (United States)

    Wan, Xinhai; Corn, Paul G; Yang, Jun; Palanisamy, Nallasivam; Starbuck, Michael W; Efstathiou, Eleni; Li Ning Tapia, Elsa M; Tapia, Elsa M Li-Ning; Zurita, Amado J; Aparicio, Ana; Ravoori, Murali K; Vazquez, Elba S; Robinson, Dan R; Wu, Yi-Mi; Cao, Xuhong; Iyer, Matthew K; McKeehan, Wallace; Kundra, Vikas; Wang, Fen; Troncoso, Patricia; Chinnaiyan, Arul M; Logothetis, Christopher J; Navone, Nora M

    2014-09-01

    Bone is the most common site of prostate cancer (PCa) progression to a therapy-resistant, lethal phenotype. We found that blockade of fibroblast growth factor receptors (FGFRs) with the receptor tyrosine kinase inhibitor dovitinib has clinical activity in a subset of men with castration-resistant PCa and bone metastases. Our integrated analyses suggest that FGF signaling mediates a positive feedback loop between PCa cells and bone cells and that blockade of FGFR1 in osteoblasts partially mediates the antitumor activity of dovitinib by improving bone quality and by blocking PCa cell-bone cell interaction. These findings account for clinical observations such as reductions in lesion size and intensity on bone scans, lymph node size, and tumor-specific symptoms without proportional declines in serum prostate-specific antigen concentration. Our findings suggest that targeting FGFR has therapeutic activity in advanced PCa and provide direction for the development of therapies with FGFR inhibitors.

  4. A multidisciplinary bone metastases clinic at Toronto Sunnybrook Regional Cancer Centre – A review of the experience from 1999 to 2005

    Directory of Open Access Journals (Sweden)

    Kathy K Li

    2008-11-01

    Full Text Available Kathy K Li, Emily Sinclair, Joan Pope, Macey Farhadian, Kristin Harris, Julie Napolskikh, Albert Yee, Lawrence Librach, Lesia Wynnychuk, Cyril Danjoux, Edward Chow. On behalf of the Bone Metastases Team.Bone Metastases Site Group, Toronto-Sunnybrook Regional Cancer Centre, University of Toronto, Toronto, ON, CanadaAbstract: Our objective in this study was to review the experience of a one-stop multidisciplinary bone metastases clinic (BMC that offers a coordinated multidisciplinary approach to the care of cancer patients with bone metastases in a tertiary cancer centre. Patients with symptomatic bone metastases were referred to BMC and assessed by a team of specialists in various disciplines – interventional radiology, orthopedic surgery, palliative medicine, and radiation oncology. At initial consultation, patient demographics, reasons for referral, and case disposition were recorded. From January 1999 to February 2005, a total of 272 patients with bone metastases were referred to the BMC. The median age was 65 years (range 28–95 and median KPS score at consultation was 60 (range 30–90. The majority of patients came from home (74%, while others came from a nursing home or the hospital (9%. Almost a third (28% of patients had 2 or more reasons of referral, yielding a total of 354 reasons. The most common reason for referral was bone pain (42%, bone metastases (21%, high risk for pathological fracture (12%, and pathological fracture (10%. Of the 272 patients who received consultation, 40% received palliative radiotherapy, 19% received interventional surgery, 7% were referred to other support services such as palliative care, physiotherapy, and 7% had further investigation or imaging. A multidisciplinary clinic is useful for co-coordinating the management of bone metastatic disease in symptomatic patients.Keywords: bone metastases, multidisciplinary approach, experience

  5. PGK1 as Predictor of CXCR4 Expression, Bone Marrow Metastases and Survival in Neuroblastoma

    Science.gov (United States)

    von Loga, Katharina; Escherich, Gabriele; Wenke, Katharina; Izbicki, Jakob R.; Reinshagen, Konrad; Gros, Stephanie J.

    2013-01-01

    Background and Aim A close relationship between phosphoglycerate kinase 1 (PGK1) and the CXCR4/SDF1 axis (chemokine receptor 4/stromal cell derived factor 1) has been shown for several cancers. However, the role of PGK1 has not been investigated for neuroblastoma, and PGK1 might be a therapeutic target for this tumor entity. The aim of the current study was to evaluate the role of PGK1 expression in neuroblastoma patients, to determine the impact of PGK1 expression levels on survival, and to correlate PGK1 expression with CXCR4 expression and bone marrow dissemination. Materials and Methods Samples from 22 patients with neuroblastoma that were surgically treated at the University Medical Center Hamburg-Eppendorf were evaluated for expression of PGK1 and CXCR4 using immunohistochemistry. Results were correlated with clinical parameters, metastases and outcome of patients. Immunocytochemistry, proliferation and expression analysis of CXCR4 and PGK1 were performed in neuroblastoma cell lines. Results PGK1 is expressed in neuroblastoma cells. PGK1 expression is significantly positively correlated with CXCR4 expression and tumor dissemination to the bone marrow. Moreover the expression of PGK1 is significantly associated with a negative impact on survival in patients with neuroblastoma. PGK1 is downregulated by inhibition of CXCR4 in neuroblastoma cells. Conclusion PGK1 appears to play an important role for neuroblastoma, predicting survival and tumor dissemination. Further in vivo studies outstanding, it is a candidate target for novel therapeutic strategies. PMID:24376734

  6. PGK1 as predictor of CXCR4 expression, bone marrow metastases and survival in neuroblastoma.

    Directory of Open Access Journals (Sweden)

    Helen M Ameis

    Full Text Available BACKGROUND AND AIM: A close relationship between phosphoglycerate kinase 1 (PGK1 and the CXCR4/SDF1 axis (chemokine receptor 4/stromal cell derived factor 1 has been shown for several cancers. However, the role of PGK1 has not been investigated for neuroblastoma, and PGK1 might be a therapeutic target for this tumor entity. The aim of the current study was to evaluate the role of PGK1 expression in neuroblastoma patients, to determine the impact of PGK1 expression levels on survival, and to correlate PGK1 expression with CXCR4 expression and bone marrow dissemination. MATERIALS AND METHODS: Samples from 22 patients with neuroblastoma that were surgically treated at the University Medical Center Hamburg-Eppendorf were evaluated for expression of PGK1 and CXCR4 using immunohistochemistry. Results were correlated with clinical parameters, metastases and outcome of patients. Immunocytochemistry, proliferation and expression analysis of CXCR4 and PGK1 were performed in neuroblastoma cell lines. RESULTS: PGK1 is expressed in neuroblastoma cells. PGK1 expression is significantly positively correlated with CXCR4 expression and tumor dissemination to the bone marrow. Moreover the expression of PGK1 is significantly associated with a negative impact on survival in patients with neuroblastoma. PGK1 is downregulated by inhibition of CXCR4 in neuroblastoma cells. CONCLUSION: PGK1 appears to play an important role for neuroblastoma, predicting survival and tumor dissemination. Further in vivo studies outstanding, it is a candidate target for novel therapeutic strategies.

  7. Incidence of bone metastases and skeletal-related events in breast cancer patients: A population-based cohort study in Denmark

    Directory of Open Access Journals (Sweden)

    Fryzek Jon P

    2011-01-01

    Full Text Available Abstract Background Breast cancer (BrCa is the most commonly diagnosed cancer among women in the industrialized world. More than half of women presenting with metastatic BrCa develop bone metastases. Bone metastases increase the risk of skeletal-related events (SREs, defined as pathological fractures, spinal cord compression, bone pain requiring palliative radiotherapy, and orthopaedic surgery. Both bone metastases and SREs are associated with unfavorable prognosis and greatly affect quality of life. Few epidemiological data exist on SREs after primary diagnosis of BrCa and subsequent bone metastasis. We therefore estimated the incidence of bone metastases and SREs in newly-diagnosed BrCa patients in Denmark from 1999 through 2007. Methods We estimated the overall and annual incidence of bone metastases and SREs in newly-diagnosed breast cancer patients in Denmark from January 1, 1999 to December 31, 2007 using the Danish National Patient Registry (DNPR, which covers all Danish hospitals. We estimated the cumulative incidence of bone metastases and SREs and associated 95% confidence intervals (CI using the Kaplan-Meier method. Results Of the 35,912 BrCa patients, 178 (0.5% presented with bone metastases at the time of primary breast cancer diagnosis, and of these, 77 (43.2% developed an SRE during follow up. A total of 1,272 of 35,690 (3.6% BrCa patients without bone metastases at diagnosis developed bone metastases during a median follow-up time of 3.4 years. Among these patients, 590 (46.4% subsequently developed an SRE during a median follow-up time of 0.7 years. Incidence rates of bone metastases were highest the first year after the primary BrCa diagnosis, particularly among patients with advanced BrCa at diagnosis. Similarly, incidence rates of a first SRE was highest the first year after first diagnosis of a bone metastasis. Conclusions The high incidence of SREs following the first year after first diagnosis of a bone metastasis

  8. Radionuclide Treatment with 153Sm-EDTMP is Effective for the Palliation of Bone Pain in the Context of Extensive Bone Marrow Metastases: A Case Report

    Directory of Open Access Journals (Sweden)

    Kalevi Kairemo

    2014-10-01

    Full Text Available Radionuclide therapy is widely used as an effective modality in the management of bone pain. The main indication for this treatment is symptomatic bone metastases, confirmed by bone scintigraphy. We present a case of small cell lung cancer (SCLC stage T4N2M1b, with a good metabolic response to systemic therapy and radiotherapy of the primary tumor and locoregional disease, which became metabolically less active and remarkably smaller in size (reduction to 1/6 of the original volume. In spite of the good overall response, the patient developed a syndrome with severe bone pain and had progression in the bone marrow metastases, confirmed by 18F-FDG PET/CT. The patient received 153Sm-EDTMP treatment with a good clinical response. However, in the whole body bone scan with the therapeutic dose, there was no visual evidence of bone metastasis. Retrospectively, by drawing the region of interest, it was possible to identify one metastatic site. The possible mechanisms of the efficacy of this treatment modality, in this specific setting, are also discussed.

  9. Radionuclide Treatment with 153Sm-EDTMP is Effective for the Palliation of Bone Pain in the Context of Extensive Bone Marrow Metastases: A Case Report

    Science.gov (United States)

    Kairemo, Kalevi; Rasulova, Nigora; Suslaviciute, Justina; Alanko, Tuomo

    2014-01-01

    Radionuclide therapy is widely used as an effective modality in the management of bone pain. The main indication for this treatment is symptomatic bone metastases, confirmed by bone scintigraphy. We present a case of small cell lung cancer (SCLC) stage T4N2M1b, with a good metabolic response to systemic therapy and radiotherapy of the primary tumor and locoregional disease, which became metabolically less active and remarkably smaller in size (reduction to 1/6 of the original volume). In spite of the good overall response, the patient developed a syndrome with severe bone pain and had progression in the bone marrow metastases, confirmed by 18F-FDG PET/CT. The patient received 153Sm-EDTMP treatment with a good clinical response. However, in the whole body bone scan with the therapeutic dose, there was no visual evidence of bone metastasis. Retrospectively, by drawing the region of interest, it was possible to identify one metastatic site. The possible mechanisms of the efficacy of this treatment modality, in this specific setting, are also discussed. PMID:27408870

  10. Phase II study of concurrent capecitabine and external beam radiotherapy for pain control of bone metastases of breast cancer origin.

    Directory of Open Access Journals (Sweden)

    Yulia Kundel

    Full Text Available Pain from bone metastases of breast cancer origin is treated with localized radiation. Modulating doses and schedules has shown little efficacy in improving results. Given the synergistic therapeutic effect reported for combined systemic chemotherapy with local radiation in anal, rectal, and head and neck malignancies, we sought to evaluate the tolerability and efficacy of combined capecitabine and radiation for palliation of pain due to bone metastases from breast cancer.Twenty-nine women with painful bone metastases from breast cancer were treated with external beam radiation in 10 fractions of 3 Gy, 5 fractions a week for 2 consecutive weeks. Oral capecitabine 700 mg/m(2 twice daily was administered throughout radiation therapy. Rates of complete response, defined as a score of 0 on a 10-point pain scale and no increase in analgesic consumption, were 14% at 1 week, 38% at 2 weeks, 52% at 4 weeks, 52% at 8 weeks, and 48% at 12 weeks. Corresponding rates of partial response, defined as a reduction of at least 2 points in pain score without an increase in analgesics consumption, were 31%, 38%, 28%, 34% and 38%. The overall response rate (complete and partial at 12 weeks was 86%. Side effects were of mild intensity (grade I or II and included nausea (38% of patients, weakness (24%, diarrhea (24%, mucositis (10%, and hand and foot syndrome (7%.External beam radiation with concurrent capecitabine is safe and tolerable for the treatment of pain from bone metastases of breast cancer origin. The overall and complete response rates in our study are unusually high compared to those reported for radiation alone. Further evaluation of this approach, in a randomized study, is warranted.ClinicalTrials.gov NCT01784393NCT01784393.

  11. Acute myocardial infarction mimicking squamous cell lung cancer with bone metastases due to hypercalcemia: a case report

    Institute of Scientific and Technical Information of China (English)

    FANG Chong-feng; XU Geng; CHEN Yang-xin

    2010-01-01

    @@ Acute myocardial infarction (AMI), the most severe coronary artery disease, is one of the most frequent cardiac emergencies, and early diagnosis and treatment are very important to decrease the subsequent cardiac adverse events such as malignant arrhythmia and sudden cardiac death. But in fact, lots of diseases are similar to AMI in clinical practice, of which the most common are myocarditis, pulmonary embolism in department of cardiology. Here we report a case of AMI-like squamous cell lung cancer with bone metastases.

  12. Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases

    OpenAIRE

    2008-01-01

    Purpose 153Sm-ethylenediaminetetramethylenephosphonic acid (EDTMP; Quadramet®) is indicated for the treatment of painful bone metastases, whereas zoledronic acid (Zometa®) is indicated for the prevention of skeletal complications. Because of the different therapeutic effects, combining the treatments may be beneficial. Both, however, accumulate in areas with increased osteoblastic activity. Possible drug interactions were investigated. Methods Patients with hormone-refractory prostate cancer ...

  13. MR diagnosis of bone metastases at 1.5 T and 3 T. Can STIR imaging be omitted?

    Energy Technology Data Exchange (ETDEWEB)

    Ohlmann-Knafo, S.; Tarnoki, A.D.; Tarnoki, D.L.; Pickuth, D. [Caritasklinikum Saarbruecken St. Theresia (Germany). Dept. of Diagnostic and Interventional Radiology

    2015-10-15

    To date, no prospective comparative study of the diagnostic value of STIR versus T1-weighted (T1w) sequences at both 1.5 T and 3 T has been performed with special focus on the detectability of bone metastases. 212 oncological patients had a whole-body MRI at 1.5 T and/or at 3 T. The standard protocol comprised STIR and T1w sequences. All patients who showed typical signs of bone metastases were included in the study. Evaluation of the images was performed by the calculation of the number of metastases by three independent readers and by visual assessment on a 4-point scale. 86 patients fulfilled the inclusion criteria. The total number of metastases was significantly higher on T1w than on STIR images at both field strengths (p < 0.05). T1w revealed a sensitivity of 99.72 % (3 T) and 100.00 % (1.5 T) versus STIR with 70.99 % (3 T) and 79.34 % (1.5 T). In 53 % (38/72) of all patients, STIR detected fewer bone metastases in comparison with T1w at 3 T. At 1.5 T, STIR showed inferior results in 37.5 % (18/48) of all patients. Qualitative analysis indicated a significantly better lesion conspicuity, lesion delineation and an improved image quality on T1w compared to STIR imaging at both field strengths (p < 0.05) with similar results for T1w at 1.5 T and 3 T, but inferior results for STIR especially at 3 T. The whole-body MRI protocol for the detection of bone metastases could safely be limited to the T1w sequence in adults, especially at 3 T. There is no need for an additional STIR sequence. These initial results will have a major impact on the department's workflow if confirmed by larger studies as they will help reduce examination time and therefore save financial resources.

  14. Pharmaceutical and clinical development of phosphonate-based radiopharmaceuticals for the targeted treatment of bone metastases.

    Science.gov (United States)

    Lange, Rogier; Ter Heine, Rob; Knapp, Russ Ff; de Klerk, John M H; Bloemendal, Haiko J; Hendrikse, N Harry

    2016-10-01

    Therapeutic phosphonate-based radiopharmaceuticals radiolabeled with beta, alpha and conversion electron emitting radioisotopes have been investigated for the targeted treatment of painful bone metastases for >35years. We performed a systematic literature search and focused on the pharmaceutical development, preclinical research and early human studies of these radiopharmaceuticals. The characteristics of an ideal bone-targeting therapeutic radiopharmaceutical are presented and compliance with these criteria by the compounds discussed is verified. The importance of both composition and preparation conditions for the stability and biodistribution of several agents is discussed. Very few studies have described the characterization of these products, although knowledge on the molecular structure is important with respect to in vivo behavior. This review discusses a total of 91 phosphonate-based therapeutic radiopharmaceuticals, of which only six agents have progressed to clinical use. Extensive clinical studies have only been described for (186)Re-HEDP, (188)Re-HEDP and (153)Sm-EDTMP. Of these, (153)Sm-EDTMP represents the only compound with worldwide marketing authorization. (177)Lu-EDTMP has recently received approval for clinical use in India. This review illustrates that a thorough understanding of the radiochemistry of these agents is required to design simple and robust preparation and quality control methods, which are needed to fully exploit the potential benefits of these theranostic radiopharmaceuticals. Extensive biodistribution and dosimetry studies are indispensable to provide the portfolios that are required for assessment before human administration is possible. Use of the existing knowledge collected in this review should guide future research efforts and may lead to the approval of new promising agents.

  15. Bone pain palliation with internal radiotherapy; Traitement antalgique des metastases osseuses douloureuses par radiotherapie interne vectorisee

    Energy Technology Data Exchange (ETDEWEB)

    Tessonnier, L.; Fontana, X.; Chaborel, J.P.; Bussiere, F.; Darcourt, J. [CRLCC Centre Antoine-Lacassagne, Service Central de Medecine Nucleaire, 06 - Nice (France); Ciais, C. [CRLCC Centre Antoine-Lacassagne, Unite Mobile d' algologie, 06 - Nice (France); Valerio, L. [Centre Hospitalier Universitaire de Nice, Service de Sante Publique, Hopital de l' Archet, 06 - Nice (France); Carrier, P.; Darcourt, J. [Centre Hospitalier Universitaire de Nice, Service de Medecine Nucleaire-centre TEP, Hopital de l' Archet, 06 - Nice (France)

    2007-05-15

    The aim of this retrospective study was to evaluate the efficacy and the safety of Quadramet and Metastron in 76 patients with painful bone metastases. The analgesic response was evaluated at six weeks, three months and six months. Blood counts performed every week allowed an assessment of the toxicity. The internal radiotherapy reduced the pain in 60% of patients with a complete pain disappearance in 26% and a reduction of analgesic consumption in 67% of them. This study did not show any statistically significant difference between the two treatments. However, we demonstrated that patients with a relatively long survival ({>=} 4 months) had a better analgesic response (73 against 29%, p = 0.0004). The patients with a less than four months survival and those with CIVD and liver metastasis had a higher risk of thrombopenia. This retrospective study suggests that these treatments should be given preferably to treat patients with a relatively tong life expectancy and that the detection of sub-clinic CIVD and liver metastasis could help to avoid severe thrombopenia. (authors)

  16. Palliative Vitamin C Application in Patients with Radiotherapy-Resistant Bone Metastases: A Retrospective Study.

    Science.gov (United States)

    Günes-Bayir, Ayse; Kiziltan, Huriye Senay

    2015-01-01

    The aim of this study was to observe effects of ascorbic acid application on pain, performance status, and survival time in cancer patients. A retrospective cohort of 39 patients with bone metastases treated with radiotherapy was identified. All patients were radiotherapy-resistant. Fifteen patients who received chemotherapy, and 15 patients who received an infusion of 2.5 g ascorbic acid were included in the study. Nine control patients were treated with neither chemotherapy nor vitamin C. Eastern Cooperative Oncology Group Performance Status Scale and Visual Analog Scale were used to determine performance status and pain assessments. Survival time and rate in patients were defined. Statistical analyses were performed to compare the results of groups. Performance status was increased in 4 patients of vitamin C group and 1 patient of chemotherapy group, whereas performance status in control group was decreased. A median reduction of 50% in pain was observed among the patients in the vitamin C group. Median survival time was 10 mo in patients receiving ascorbic acid, whereas the chemotherapy and control groups had a median survival of 2 mo. Intravenous vitamin C application seems to reduce pain in patients in comparison to other patients who did not receive it. Patient performance status and survival rate were increased using vitamin C.

  17. SU-D-303-01: Spatial Distribution of Bone Metastases In Metastatic Castrate-Resistant Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Perk, T; Bradshaw, T; Harmon, S; Perlman, S; Liu, G; Jeraj, R [University of Wisconsin, Madison, WI (United States)

    2015-06-15

    Purpose: Identification of metastatic bone lesions is critical in prostate cancer, where treatments may be more effective in patients with fewer lesions. This study aims characterize the distribution and spread of bone lesions and create a probability map of metastatic spread in bone. Methods: Fifty-five metastatic castrate-resistant prostate cancer patients received up to 3 whole-body [F-18]NaF PET/CT scans. Lesions were identified by physician on PET/CT and contoured using a threshold of SUV>15. An atlas-based segmentation method was used to create CT regions, which determined skeletal location of lesions. Patients were divided into 3 groups with low (N<40), medium (40100) numbers of lesions. A combination of articulated and deformable registrations was used to register the skeletal segments and lesions of each patient to a single skeleton. All the lesion data was then combined to make a probability map. Results: A total of 4038 metastatic lesions (mean 74, range 2–304) were identified. Skeletal regions with highest occurrence of lesions included ribs, thoracic spine, and pelvis with 21%, 19%, and 15% of the total number lesions and 8%, 18%, and 31 % of the total lesion volume, respectively. Interestingly, patients with fewer lesions were found to have a lower proportion of lesions in the ribs (9% in low vs. 27% in high number of lesions). Additionally, the probability map showed specific areas in the spine and pelvis where over 75% of patients had metastases, and other areas in the skeleton with a less than 2% of metastases. Conclusion: We identified skeletal regions with higher incidence of metastases and specific sub-regions in the skeleton that had high or low probability of occurrence of metastases. Additionally, we found that metastatic lesions in the ribs and skull occur more commonly in advanced disease. These results may have future applications in computer-aided diagnosis. Funding from the Prostate Cancer Foundation.

  18. Expression pattern of receptor activator of NFκB (RANK) in a series of primary solid tumors and related bone metastases.

    Science.gov (United States)

    Santini, Daniele; Perrone, Giuseppe; Roato, Ilaria; Godio, Laura; Pantano, Francesco; Grasso, Donatella; Russo, Antonio; Vincenzi, Bruno; Fratto, Maria Elisabetta; Sabbatini, Roberto; Della Pepa, Chiara; Porta, Camillo; Del Conte, Alessandro; Schiavon, Gaia; Berruti, Alfredo; Tomasino, Rosa Maria; Papotti, Mauro; Papapietro, Nicola; Onetti Muda, Andrea; Denaro, Vincenzo; Tonini, Giuseppe

    2011-03-01

    Receptor activator of NFκB ligand (RANKL), RANK, and osteoprotegerin (OPG) represent the key regulators of bone metabolism both in normal and pathological conditions, including bone metastases. To our knowledge, no previous studies investigated and compared RANK expression in primary tumors and in bone metastases from the same patient. We retrospectively examined RANK expression by immunohistochemistry in 74 bone metastases tissues from solid tumors, mostly breast, colorectal, renal, lung, and prostate cancer. For 40 cases, tissue from the corresponding primary tumor was also analyzed. Sixty-six (89%) of the 74 bone metastases were RANK-positive and, among these, 40 (59.5%) showed more than 50% of positive tumor cells. The median percentage of RANK-positive cells was 60% in primary tumors and metastases, without any statistically significant difference between the two groups (P=0.194). The same percentage was obtained by considering only cases with availability of samples both from primary and metastasis. Our study shows that RANK is expressed by solid tumors, with high concordance between bone metastasis and corresponding primary tumor. These data highlight the central role of RANK/RANKL/OPG pathway as potential therapeutic target not only in bone metastasis management, but also in the adjuvant setting.

  19. DEGRO practice guidelines for palliative radiotherapy of metastatic breast cancer. Bone metastases and metastatic spinal cord compression (MSCC)

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    Souchon, Rainer [Dept. of Radiation Oncology, UKT Tuebingen (Germany); Wenz, Frederik [Univ. Hospital Mannheim (Germany); Sedlmayer, Felix [Univ. Hospital, Salzburger Landeskliniken, Salzburg (Austria); Budach, Wilfried [Univ. Hospital Duesseldorf (Germany); Dunst, Juergen [Univ. Hospital Schleswig-Holstein, Luebeck (Germany); Feyer, Petra [Klinikum Neukoelln, Berlin (Germany); Haase, Wulf [St.-Vincentius-Kliniken, Karlsruhe (Germany); Harms, Wolfgang [St. Clara Hospital, Basel (Switzerland); Sautter-Bihl, Marie-Luise [Municipal Hospital, Karlsruhe (Germany); Sauer, Rolf [Univ. Hospital Erlangen (Germany)

    2009-07-15

    To provide practice guidelines and clinical recommendations on preferred standard palliative radiation therapy of bone metastases as well as metastatic spinal cord compression (MSCC) for metastatic breast cancer patients. Methods: The breast cancer expert panel of the German Society of Radiation Oncology (DEGRO) performed a comprehensive survey of the literature comprising recently published data from clinical controlled trials. The literature search encompassed the period 1995-2008 using databases of PubMed and Guidelines International Network (G-I-N). Search terms were ''breast cancer'', ''bone metastasis'', ''osseous metastasis'', ''metastatic spinal cord compression'' as well as ''radiotherapy'' and ''radiation therapy''. Clinical recommendations were formulated based on the panel's interpretation of the level of evidence referring to the criteria of evidence-based medicine. Results: Different therapeutic goals (pain relief, local tumor control, prevention or improvement of motor deficits, stabilization of the spine or other bones) require complex approaches considering individual factors (i.e. life expectancy, tumor progression at other sites). Best results are achieved by close interdisciplinary cooperation minimizing the interval between diagnosis and onset of treatment. Most important criteria for prognosis and choice of treatment (mostly combined multimodal therapy) are neurologic status at diagnosis of MSCC, time course of duration and progression of the neurologic symptoms. Radiation therapy is effective and regarded as treatment of choice for MSCC with or without motor deficits and/or bone metastases, which do not need immediate surgical intervention. It may be used either postoperatively or as primary treatment in case of inoperability. An optimal dose fractionation schedule or optimal standard dose for treatment of bone

  20. The efficacy of 89Sr combined with 99Tc-MDP in the treatment of the advanced breast cancers with bone metastases

    Institute of Scientific and Technical Information of China (English)

    Qiuju Lin ; Wenhui Li

    2014-01-01

    Objective: The aim of our study was to evaluate the ef icacy of 89Sr combined with Technetium [99Tc] Methylene-diphosphonate Injection (99Tc-MDP) in the treatment of cancer pain in the advanced breast cancers with bone metastases. Methods: A total of 80 patients with various degrees of bone pain due to multiple metastases of breast cancer were treated with 89Sr combined with 99Tc-MDP. 89Sr was given intravenously at 4mCi on day 1 during the 3-month schedule. After 7 days, 99Tc-MDP was given at 22 mg/day on days 1–10 during the 1-month schedule, for 3 to 6 months. Results: The ef ective rate of relieving pain was 83.75%. The ef ective rate of curing bone metastases was 81.25%. So there was a significant improvement in the quality of life of the patients. Conclusion: 89Sr combined with 99Tc-MDP are ef ective in the treatment of cancer pain in the breast cancers with bone metastasis, and can obviously repair the bone destruction caused by metastases, thereby improving the quality of life in advanced breast cancer patients with bone metastases.

  1. Magnetic resonance guided focused ultrasound surgery (MRgFUS) of bone metastases: From primary pain palliation to local tumor control

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    Napoli, A.; Leonardi, A.; Andrani, F.; Boni, F.; Anzidei, M.; Catalano, C.

    2017-03-01

    Purpose: To evaluate the clinical performance of MRgFUS in primary pain palliation of painful bone metastases and in local tumor control. Materials and Methods: We enrolled 26 consecutive patients (female/male 12/14; age: 64.7±7.5yrs) with painful bone metastases. Before and 3 months after MRgFUS treatment pain severity and pain interference scores were assessed according to Brief Pain Inventory-Quality of Life (BPI-QoL) criteria and patients underwent both CT and MRI. Local tumor control was evaluated according to lesion size, density and perfusion at CT, dynamic contrast enhancement at MRI (Discovery 750HD, GE; Gd-Bopta, Bracco) and metabolic activity at PET or scintigraphy. Patients were classified as responders or non-responders. Results: No treatment-related adverse events were recorded during the study. As statistically significant difference between baseline and follow-up values for both pain severity and pain interference scores was observed (p<0.05). Increased bone density was observed in 9/26 (34.6%) patients. Non-Perfused Volume values ranged between 20% and 92%. There was no difference in NPV values between responders and non-responders (46.7±24.2% [25 - 90 %] vs. 45±24.9% [20 - 93 %]; p=0.7). In 6 patients (5 prostate and 1 breast primary cancer) there was nearly absence of metabolic activity after treatment (mean SUV=1.2). Conclusion: MRgFUS can be safely and effectively used as the primary treatment for pain palliation in patients with painful bone metastases; moreover our experience demonstrated also a potential role for the MRgFUS in local tumor control.

  2. Co-existent Paget’s Disease of the Bone, Prostate Carcinoma Skeletal Metastases and Fracture on Skeletal Scintigraphy-Lessons to be Learned

    Directory of Open Access Journals (Sweden)

    Luke I Sonoda

    2013-08-01

    Full Text Available Bone scintigraphy, despite being non-specific, is a very sensitive and simple investigation for patients with active Paget’s disease of the bone. Skeletal metastases and Paget’s disease may co-exist in the elderly patients as both conditions are commonly seen in this age group. Clinical and radiological correlation may help to improve the diagnostic specificity of a bone scintigram. We report a patient in whom concurrent Paget’s disease and a rib fracture became evident only on repeat scintigraphy following successful treatment of prostate carcinoma skeletal metastases.

  3. MIR-9-1 ABERRANT METHYLATION IS A FREQUENT EVENT IN BREAST CANCER AND IS ASSOCIATED WITH BONE METASTASES

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    Anca Florescu

    2012-10-01

    Full Text Available Abstract: Background. Aberrant promoter methylation of classical tumor suppressor genes occurs frequently during carcinogenesis. Several lines of evidences suggest that this epigenetic change also regulates microRNAs expression and may represent a potential molecular marker for cancer. Methods. We examined the methylation status at the hsa-miR-9-1 gene promoter in a series of 66 breast cancer cases by methylation sensitive PCR (MSP analysis. For 43 of the 66 patients paired normal breast tissue and/or pre invasive (ADH, DCIS lesions were also available. As control methylation status was determined on 6 normal breast tissues obtained from reductive mammoplasty.   Results. Methylation at mir-9-1 gene was detected in 32 out of 66 breast tumours (49% and in none of the 6 normal breast tissues derived from reductive mammoplasty (P=0.02 χ2- Test. In all cases the same methylation status was demonstrated in tumour specimen, paired normal breast tissues and/or pre-invasive (ADH and DCIS lesions. An higher frequency of methylation was found in patients showing metastases at diagnosis as compared with non metastatic patients (P=0.03 χ2-Test. Moreover, methylation at mir-9-1 gene was more frequent in patients showing bone metastases as first metastatic sites (P=0.04 χ2-Test, and in the subgroup of patients developing only bone metastases as compared with patients developing metastases  to visceral organs (P=0.03 χ2-Test. Conclusions. This study give further evidence of epigenetic mechanisms as regulators of miR-9 expression in breast cancer. Moreover, our results suggest an association between hypermethylation  at the miR-9-1 gene and metastatic site.

  4. Radionuclide bone scanning in neuroblastoma: skeletal metastases and primary tumor localization of /sup 99m/Tc-MDP

    Energy Technology Data Exchange (ETDEWEB)

    Podrasky, A.E.; Stark, D.D.; Hattner, R.S.; Gooding, C.A.; Moss, A.A.

    1983-09-01

    Of 42 radionuclide bone scans in 35 children with neuroblastoma, 21 were abnormal for the presence of skeletal metastases. Of the 21 abnormal scans, 16 were corroborated by positive bone-marrow biopsy or clinical data. The false-negative and false-positive rates for bone scanning were 4.8% and 9.5%, respectively. Calcification of the primary tumor was seen on pretreatment computed tomographic (CT) scans in 24 (89%) of 27 cases, while only 13 (48%) of 27 were detectable by plain radiographs. Uptake of /sup 99m/Tc methylene diphosphate /sup 99m/Tc-MDP) by the primary tumor occurred in 20 of 27 cases, but correlation between tumor uptake and calcification was not statistically significant. All children with markedly elevated urinary vanillylmandelic acid exhibited primary tumor uptake. Survival was not affected independently by primary tumor uptake.

  5. Doxorubicin-mediated bone loss in breast cancer bone metastases is driven by an interplay between oxidative stress and induction of TGFβ.

    Directory of Open Access Journals (Sweden)

    Tapasi Rana

    Full Text Available Breast cancer patients, who are already at increased risk of developing bone metastases and osteolytic bone damage, are often treated with doxorubicin. Unfortunately, doxorubicin has been reported to induce damage to bone. Moreover, we have previously reported that doxorubicin treatment increases circulating levels of TGFβ in murine pre-clinical models. TGFβ has been implicated in promoting osteolytic bone damage, a consequence of increased osteoclast-mediated resorption and suppression of osteoblast differentiation. Therefore, we hypothesized that in a preclinical breast cancer bone metastasis model, administration of doxorubicin would accelerate bone loss in a TGFβ-mediated manner. Administration of doxorubicin to 4T1 tumor-bearing mice produced an eightfold increase in osteolytic lesion areas compared untreated tumor-bearing mice (P = 0.002 and an almost 50% decrease in trabecular bone volume expressed in BV/TV (P = 0.0005, both of which were rescued by anti-TGFβ antibody (1D11. Doxorubicin, which is a known inducer of oxidative stress, decreased osteoblast survival and differentiation, which was rescued by N-acetyl cysteine (NAC. Furthermore, doxorubicin treatment decreased Cu-ZnSOD (SOD1 expression and enzyme activity in vitro, and treatment with anti-TGFβ antibody was able to rescue both. In conclusion, a combination therapy using doxorubicin and anti-TGFβ antibody might be beneficial for preventing therapy-related bone loss in cancer patients.

  6. Which metabolic imaging, besides bone scan with 99mTc-phosphonates, for detecting and evaluating bone metastases in prostatic cancer patients? An open discussion.

    Science.gov (United States)

    Bombardieri, E; Setti, L; Kirienko, M; Antunovic, L; Guglielmo, P; Ciocia, G

    2015-12-01

    Prostate cancer bone metastases occur frequently in advanced cancer and this is matter of particular attention, due to the great impact on patient's management and considering that a lot of new emerging therapeutic options have been recently introduced. Imaging bone metastases is essential to localize lesions, to establish their size and number, to study characteristics and changes during therapy. Besides radiological imaging, nuclear medicine modalities can image their features and offer additional information about their metabolic behaviour. They can be classified according to physical characteristics, type of detection, mechanism of uptake, availability for daily use. The physiopathology of metastases formation and the mechanisms of tracer uptake are essential to understand the interpretation of nuclear medicine images. Therefore, radiopharmaceuticals for bone metastases can be classified in agents targeting bone (99mTc-phosphonates, 18F-fluoride) and those targeting prostatic cancer cells (18F-fluoromethylcholine, 11C-choline, 18F-fluorodeoxyglucose). The modalities using the first group of tracers are planar bone scan, SPECT or SPECT/CT with 99mTc-diphosphonates, and 18F-fluoride PET/CT, while the modalities using the second group include 18F/11C-choline derivatives PET/CT, 18F-FDG PET/CT and PET/CT scans with several other radiopharmaceuticals described in the literature, such as 18F/11C-acetate derivatives, 18F-fluoro-5α-dihydrotestosterone (FDHT), 18F-anti-1-amino-3-fluorocyclobutane-1-carboxylic acid (FACBC), 18F-2'-fluoro-5-methyl-1-β-D-arabinofuranosyluracil (FMAU) and 68Ga-labeled-prostate specific membrane antigen (PMSA) PET/TC. However, since data on clinical validation for these last novel modalities are not conclusive and/or are not still sufficient in number, at present they can be still considered as promising tools under evaluation. The present paper considers the nuclear modalities today available for the clinical routine. This overview wants

  7. Treatment of painful bone metastases in hormone-refractory prostate cancer with zoledronic acid and samarium-153-ethylenediaminetetramethylphosphonic acid combined.

    Science.gov (United States)

    Lam, Marnix G E H; de Klerk, John M H; Zonnenberg, Bernard A

    2009-07-01

    Abstract Bone-seeking radiopharmaceuticals and bisphosphonates may be indicated in patients with cancer with painful osseous metastases to palliate pain symptoms or to prevent skeletal-related events. Both pharmaceuticals may have an additive or even synergistic palliative effect. The combined use of bone-seeking radiopharmaceuticals and bisphosphonates is, however, controversial because of assumed competition between both phosphonate-compounds at the bone level. We report a case of hormone-refractory prostate cancer (HRPC) with multiple painful osseous metastases. The patient was treated with samarium-153-ethylenediaminetetramethylphosphonic acid ((153)Sm-EDTMP; Quadramet, CIS bio International, Saclay, France) in combination with zoledronic acid (Zometa, Novartis, Stein, Switzerland). He was treated for 6 months with 4 weekly intervals of zoledronic acid in combination with 3 monthly intervals of (153)Sm-EDTMP. No negative interaction was found, toxicity was low, and efficacy high. He experienced a total relief of pain, a significant decrease of prostate-specific antigen (PSA) and, surprisingly, a significant decrease of tumor burden.

  8. Diffusion-weighted imaging and dynamic contrast-enhanced MRI of experimental breast cancer bone metastases – A correlation study with histology

    Energy Technology Data Exchange (ETDEWEB)

    Merz, Maximilian [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Department of Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Seyler, Lisa; Bretschi, Maren; Semmler, Wolfhard [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Bäuerle, Tobias, E-mail: tobias.baeuerle@uk-erlangen.de [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Institute of Radiology, University Medical Center Erlangen, Palmsanlage 5, 90154 Erlangen (Germany)

    2015-04-15

    Purpose: To validate imaging parameters from diffusion-weighted imaging and dynamic contrast-enhanced MRI with immunohistology and to non-invasively assess microstructure of experimental breast cancer bone metastases. Materials and methods: Animals bearing breast cancer bone metastases were imaged in a clinical 1.5 T MRI scanner. HASTE sequences were performed to calculate apparent diffusion coefficients. Saturation recovery turbo FLASH sequences were conducted while infusing 0.1 mmol/l Gd–DTPA for dynamic contrast-enhanced MRI to quantify parameters amplitude A and exchange rate constant k{sub ep}. After imaging, bone metastases were analyzed immunohistologically. Results: We found correlations of the apparent diffusion coefficients from diffusion-weighted imaging with tumor cellularity as assessed with cell nuclei staining. Histological vessel maturity was correlated negatively with parameters A and k{sub ep} from dynamic contrast-enhanced MRI. Tumor size correlated inversely with cell density and vessel permeability as well as positively with mean vessel calibers. Parameters from the rim of bone metastases differed significantly from values of the center. Conclusion: In vivo diffusion-weighted imaging and dynamic contrast-enhanced MRI in experimental bone metastases provide information about tumor cellularity and vascularity and correlate well with immunohistology.

  9. 乳腺癌术后骨转移回顾性分析%A retrospective analysis of cases of bone metastases in patients operated for breast cancer

    Institute of Scientific and Technical Information of China (English)

    方平; 杨俊兰; 伍建宇; 张娟; 游俊浩; 林海丽

    2011-01-01

    目的 分析乳腺癌术后骨转移的临床特征.方法 对407例原发乳腺癌术后发生骨转移的情况进行回顾性分析.结果 50例患者术后发生骨转移.这50例患者中,术后30个月内发生骨转移的病例占54.0%,5年内骨转移发生率为76.0%,发病年龄≤50岁的占60%.病理类型以浸润性导管癌为主的占82.0%.骨转移部位最多发生在脊柱,以胸椎、腰椎为主.其次是骨盆、肋骨、胸骨、颅骨、下肢骨.乳腺癌术后是否出现骨转移在年龄、腋淋巴结转移、孕激素受体(PR)、癌基因CerbB2表达方面无统计学差异(P>0.05).但在肿瘤病理类型及雌激素受体(ER)表达方面的差异有统计学意义(P<0.05).结论 乳腺癌术后30个月内为骨转移高发期,骨转移部位以脊柱及骨盆、肋骨、胸骨多见.乳腺癌术后发生骨转移与年龄、腋淋巴结转移、PR、CerbB2表达方面无关,与肿瘤病理类型、ER有关.%Objective To analyze the clinical symptoms of bone metastases after breast cancer operation.Methods Retrospectively analyze a total number of 407 cases of patients who have received surgery treatnent for breast cancer Results There were fifty patients who have developed bone metastases postoperatively.There were fiftyfive percent of patients who have developed bone metastases in 30 months; Seventy-six percent of patients developed bone metastases in 5 years; Sixty percent of patients are under the age of 50.In term of pathology, eighty-two percent of patients have developed invasive ductal carcinoma.The most common metastases sites were thoracic vertebra and lumbar vertebra.Then were pelvis, costal bone, sternum.Less common sites were cranial bone and bones of lower limb.In both metastases cases, there were no statistics difference in examining factors of ages, axillary lymph node metastases,PR and oncogene CerbB2 expressions (P>0.05).There were statistical significance between bone metastases of breast cancer and

  10. Stability of spinal bone metastases in breast cancer after radiotherapy. A retrospective analysis of 157 cases

    Energy Technology Data Exchange (ETDEWEB)

    Schlampp, Ingmar; Rieken, Stefan; Habermehl, Daniel; Foerster, Robert; Debus, Juergen; Rief, Harald [University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany); Bruckner, Thomas [University Hospital of Heidelberg, Department of Medical Biometry, Heidelberg (Germany)

    2014-09-15

    This retrospective analysis was performed to evaluate osteolytic bone lesions of breast cancer in the thoracic and lumbar spine after radiotherapy (RT) in terms of stability using a validated scoring system. The stability of 157 osteolytic metastases, treated from January 2000 to January 2012, in 115 patients with breast cancer was evaluated retrospectively using the Taneichi score. Predictive factors for stability were analyzed and survival rates were calculated. Eighty-five (54 %) lesions were classified as unstable prior to RT. After 3 and 6 months, 109 (70 %) and 124 (79 %) lesions, respectively, were classified as stable. Thirty fractures were detected prior to RT, and after RT seven cases (4.5 %) with pathologic fractures were found within 6 months. None of the examined predictive factors showed significant correlation with stability 6 months after RT. After a median follow-up of 16.7 months, Kaplan-Meier estimates revealed an overall survival of 83 % after 5 years. The majority of patients showed an improved or unchanged stability of the involved vertebral bodies after 6 months. The patients showed only minor cancer-related morbidity during follow-up and reached comparably high survival rates. (orig.) [German] Die retrospektive Analyse untersuchte osteolytische Knochenmetastasen von Patienten mit Mammakarzinom der thorakalen und lumbalen Wirbelsaeule nach Radiotherapie (RT) hinsichtlich Stabilitaet anhand eines validierten Scores. Die Stabilitaet von 157 osteolytischen Metastasen bei 115 Patienten mit Brustkrebs, behandelt von Januar 2000 bis Januar 2012, wurde retrospektiv anhand des Taneichi-Scores evaluiert. Prognostische Faktoren bezueglich Stabilitaet und Ueberlebensraten wurden analysiert. Vor RT wurden 85 Laesionen (54 %) als instabil gewertet. Nach 3 und 6 Monaten wurden 109 (70 %) und 124 (79 %) Laesionen als stabil klassifiziert. Vor RT wurden 30 Frakturen gefunden, nach RT zeigten sich 7 weitere (4,5 %) pathologische Frakturen. Kein prognostischer

  11. Pain and quality of life following palliative radiotherapy of bone metastases; Der Einfluss palliativer Strahlentherapie auf Schmerz und Lebensqualitaet bei Patienten mit Knochenmetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Sauer, N.; Wild, B.; Henningsen, P.; Jakobsen, T. [Klinik fuer Psychosomatische und Allgemeine Klinische Medizin, Univ. Heidelberg (Germany); Leising, D. [Inst. fuer Psychologie, Univ. Wuerzburg (Germany); Treiber, M. [Radiologische Universitaetsklinik, Heidelberg (Germany)

    2006-09-15

    Pain and quality of life following palliative radiotherapy of bone metastases Background and purpose: palliative irradiation is used to provide pain relief and to increase quality of life. Most studies exclude patients with advanced cancer disease and, therefore, a positive selection results. This prospective clinical study investigates the effect of palliative radiotherapy on pain and quality of life of patients with painful bone metastases. Patients and methods: 263 patients with bone metastases due to advanced cancer were observed with respect to pain and quality of life during a 2-month course of radiotherapy. Missing data were substituted by the LOCF method (last observation carried forward) to prevent a biased reduction of data. Results: radiotherapy resulted in pain relief. In the complete group, pain medication was not increased. Quality of life was not affected positively. Side effects of radiotherapy increased remarkably. Conclusion: Radiotherapy leads to pain relief. However, risks and benefits must be considered critically due to side effects. (orig.)

  12. Utilization of bone densitometry for prediction and administration of bisphosphonates to prevent osteoporosis in patients with prostate cancer without bone metastases receiving antiandrogen therapy

    Directory of Open Access Journals (Sweden)

    Holt A

    2014-12-01

    Full Text Available Abby Holt,1 Muhammad A Khan,2 Swetha Gujja,3 Rangaswmy Govindarajan31Arkansas Department of Health, Little Rock, 2White River Health System, Batesville, 3Division of Hematology/Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USABackground: Prostate cancer subjects with prostate-specific antigen (PSA relapse who are treated with androgen deprivation therapy (ADT are recommended to have baseline and serial bone densitometry and receive bisphosphonates. The purpose of this community population study was to assess the utilization of bone densitometry and bisphosphonate therapy in men receiving ADT for non-metastatic prostate cancer.Methods: A cohort study of men aged 65 years or older with non-metastatic incident diagnoses of prostate cancer was obtained from the Surveillance Epidemiology End Results (SEER-linked Medicare claims between 2004 and 2008. Claims were used to assess prescribed treatment of ADT, bone densitometry, and bisphosphonates.Results: A total of 30,846 incident prostate cancer cases receiving ADT and aged 65 years or older had no bone metastases; 87.3% (n=26,935 on ADT did not receive either bone densitometry or bisphosphonate therapy. Three percent (n=931 of the cases on ADT received bisphosphonate therapy without ever receiving bone densitometry, 8.8% (n=2,702 of the cases on ADT received bone densitometry without receiving intravenous bisphosphonates, while nearly 1% (0.90%, n=278 of the cases on ADT received both bone densitometry and bisphosphonates. Analysis showed treatment differed by patient characteristics.Conclusion: Contrary to the recommendations, bone densitometry and bisphosphonate therapy are underutilized in men receiving ADT for non-metastatic prostate cancer.Keywords: prostatic neoplasms, androgen antagonists, bone densitometry, gonadotropin-releasing hormone, osteoporosis

  13. Value of percutaneous radiofrequency ablation with or without percutaneous vertebroplasty for pain relief and functional recovery in painful bone metastases

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    Clarencon, Frederic; Jean, Betty; Cormier, Evelyne; Chiras, Jacques [Pitie-Salpetriere Hospital, Department of Neuroradiology, Paris (France); Pham, Hang-Phuong; Bensimon, Gilbert [Pitie-Salpetriere Hospital, Department of Clinical Pharmacology, Paris (France); Rose, Michele [Pitie-Salpetriere Hospital, Department of Critical Care, Paris (France); Maksud, Philippe [Pitie-Salpetriere Hospital, Assistance Publique des, Hopitaux de Paris, Department of Nuclear Medicine, Paris (France)

    2013-01-15

    To evaluate the effectiveness of percutaneous radiofrequency (RF) ablation with or without percutaneous vertebroplasty (PV) on pain relief, functional recovery and local recurrence at 6 months' follow-up (FU), in patients with painful osseous metastases. Thirty RF ablations were performed in 24 patients (mean age: 61 years) with bone metastases. Half of the patients had an additional PV. The primary end point was pain relief evaluated by a visual analogue scale (VAS) before treatment, and at 1 and 6 months' FU. Functional outcome was assessed according to the evolution of their ability to walk at 6 months' FU. Imaging FU was available in 20 out of 24 patients with a mean delay of 4.7 months. Reduction of pain was obtained at 6 months FU in 81% of cases (15 out of 18). Mean pretreatment VAS was 6.4 ({+-}2.7). Mean VAS was 1.9 ({+-}2.4) at 1 month FU, and 2.3 ({+-}2.9) at 6 months' FU. Pain was significantly reduced at 6 months FU (mean VAS reduction = 4.1; P < 0.00001). Functional improvement was obtained in 74% of the cases. Major complications rate was 12.5 % (3 out of 24) with 2 skin burns, and 1 case of myelopathy. Local tumour recurrence or progression was recorded in 5 cases. Radiofrequency ablation is an effective technique in terms of pain relief and functional recovery for the treatment of bone metastases, which provides a relatively low rate of local recurrence. (orig.)

  14. Prostate cancer in patients from rural and suburban areas – PSA value, Gleason score and presence of metastases in bone scan

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2014-11-01

    Full Text Available [b]Introduction[/b]. Prostate cancer is the second most common neoplasm among men both worldwide and in Poland. In prostate cancer, bone metastasis is related to a poorer prognosis. A diagnosis of metastatic bone disease is important in prostate cancer patients prior to therapy. Prostate specific antigen (PSA serum value is used both as a screening tool and for staging of prostate cancer. aim. To evaluate whether there is a link between symptoms presented by patients, pain in particular, and the presence, number and location of bone metastases as assessed by bone scan scintigraphy in concordance with PSA values and Gleason scores. [b]material[/b]. A group of 186 patients (aged: 68.38±6.16 diagnosed with prostate cancer, from rural and suburban areas of Małopolska province, that was directed for bone scan scintigraphy to the Nuclear Medicine Dept, John Paul II Hospital in Kraków. [b]methods[/b]. Analysis of all laboratory findings (including PSA value and a biopsy were performed. Then, bone scan scintigraphy was done with the use of methylene disphosphonate (MDP labeled with Tc-99m. [b]results[/b]. In patients with a Gleason value ≤7 and a PSA value ≤20 ng/ml, the cutoff value for a negative bone scan with a confidence interval of 0.95 was established at a PSA value below 10 ng/ml (p<0.01. Correlations were established between PSA value and presence of metastases in bone scan (r=0.45, p=0.05, the number of metastases (r=0.66, p<0.01, and their presence in particular body regions. [b]conclusions[/b]. The correlation between PSA value and both presence and number of metastases confirms the usefulness of bone scan scintigraphy in prostate cancer staging. The cutoff value for negative bone scan with a 95% confidence interval was established at PSA = 10 ng/ml.

  15. A Comparative Study Between Whole Body Magnetic Resonance Imaging and Bone Scintgraphy In Detection of Bone Metastases In Patients With Known Breast or Lung Cancer

    Directory of Open Access Journals (Sweden)

    Wafaa Raafat Ali Abdel Hamid

    2013-04-01

    Full Text Available Purpose: The aim of this work is to compare the ability of whole body MRI including diffusion study with that of 99m Tc-Methylene Diphosphonate Scintigraphy to detected skeletal metastases in patients with breast and lung cancer.Patients and methods: 60 patients comprising 38 females and 22 males ranging in age from 30 to 60 years with a mean age of 48.1 years (mean age 47.3 years for females and 49 years for males were enrolled in the study. 29 females are histopathologically proven cases of breast malignancy, 9 females and the 22 males are histopathologically proven cases of lung cancer. The patients were referred from Oncological departments to perform the whole body MR study and bone scan at Ain Shams University hospitals MRI units and a private center during the time interval from December 2008 till December 2012.All patients were subjected to both whole body MRI and bone scintigraphy. The whole body MRI was mainly obtained using 4 contiguous coronal stations for body coverage using the body coil and 2 contiguous sagittal stations for the spine using T1W FSE and STIR sequences. 48 out of 60 patients toke IV contrast and post contrast T1W imagaes with fat suppression were taken. The MRI examinations were performed using a superconducting 1.5 Tesla magnet (Achieva: Philips Medical Systems.Standard skeletal Scintigraphy was performed using a planar one phase technique (delayed phase. The examination was done 2-3 hours after IV injection of technicium 99m labeled Methylene Diphosphonate with a maximum dose of 20 mCi.Results: 42 patients out of 60 were positive for metastases based on histopathological verification or follow up. On MRI, 39 patients had metastases, 3 were false negative, 12 were true negative and 6 were false positive. On bone scan, 35 were true positive, 7 were false negative, 4 were false positive and 14 were true negative.Based on lesion detection, on comparing bone scan to WB-MRI with and without diffusion, bone scan had an

  16. Diagnostic role of whole body bone scintigraphy in atypical skeletal tuberculosis resembling multiple metastases: a case report

    Directory of Open Access Journals (Sweden)

    Assadi Majid

    2009-11-01

    Full Text Available Abstract Introduction Osseous tuberculosis can be present with unifocal or multifocal bony involvement. Although multifocal involvement of the skeletal system in areas where tuberculosis is endemic is not a rare presentation, its exact prevalence is not well known. A case of atypical skeletal tuberculosis mimicking multiple secondary metastases on radiologic and scintigraphic imaging is presented to emphasize the contribution of bone scintigraphy in the assessment of osseous tuberculosis in typical and atypical presentations. Case presentation A 73-year-old cachectic Asian man (Iranian presented with a general feeling of being unwell and an acute loss of vision in his left eye accompanied by a severe headache. A Tc-99 m-methylene diphosphonate bone scan demonstrated multiple regions of intense activity in the appendicular and axial skeleton, suggesting metastatic involvement. Tumor markers (PSA, CA125, CA 19-9 and AFP were within normal ranges. Based on clinical presentation and laboratory, radiological and scintigraphic findings, a presumptive diagnosis of tuberculosis was made. Quadruple antituberculous chemotherapy was consequently started and the patient later showed marked improvement. Conclusion Scintigraphic bone scanning should be kept in mind when assessing bone pain in patients at a high risk of tuberculosis infection or reactivation. We present this unusual case of multifocal skeletal tuberculosis, and stress the related clinical and diagnostic points with the aim of stimulating a high index of suspicion that could facilitate early diagnosis and appropriate treatment.

  17. 乳腺癌骨转移的高危因素分析%Analysis of high risk factors of bone metastases in breast cancer

    Institute of Scientific and Technical Information of China (English)

    藕院林; 王本忠; 颜蕴文

    2012-01-01

    目的 探讨可能影响因素与乳腺癌骨转移发生的相关性.方法回顾分析2007年1月至2010年9月间172例乳腺癌患者中76例骨转移患者,对年龄、病理类型、腋窝淋巴结有无转移及数目、HER-2状况、原发肿块大小、激素受体状况、Ki-67等因素进行分析,了解其与骨转移发生是否有相关性.结果乳腺癌发生骨转移与腋窝淋巴结有无转移、HER-2状况、激素受体情况、Ki-67有相关性,与年龄无相关性.结论乳腺癌患者腋窝淋巴结转移4个及以上、HER-2高表达、激素受体阳性、Ki-67高表达患者,骨转移发生率相对较高,应加强术后定期随访,对同时具备多项骨转移高危因素的乳腺癌患者,术后化疗后可预防性应用骨保护药物.%Objective To investigate the correlation between the following related factors and bone metastases in breast cancer. Methods A total of 76 patients with bone metastases in breast cancer among 172 breast cancer patients during 2007 to 2010 were retrospectively analysed. Factors such as age, pathological types, axillary lymph node metastases and their number, HER-2, estrogen and progesteron receptor, tumor size, Ki-67 were analysed to clarify whether there was any correlation with bone metastases in breast cancer. Results Bone metastases in breast cancer were associated with axillary lymph node metastases and their number, HER-2, estrogen and progesteron receptor, Ki-67,but there was no correlation with age. Conclusion Breast cancers patients with more than 4 axillary lymph node metastases, positive HER-2, positive estrogen and progesteron receptor and high expression of Ki-67 are more likely to undergo bone metastases. These patients should strengthen the regular follow-up after operation. Patients who have several risk factors should use bone protection drugs after operation and adjuvant chemotherapy as preventive measures.

  18. Samarium-153 EDTMP reduces multiple bone metastasis besides pain relieve; Reduction des metastases osseuses apres traitement au samarium 153-EDTMP en complement de son effet antalgique

    Energy Technology Data Exchange (ETDEWEB)

    Haffaf, E.M.; Oufriha, N. [Hopital Central de l' Armee, Service de Medecine Nucleaire, Alger (Algeria)

    2006-10-15

    This case report shows an almost disappearance of multiple painful bone metastases, on a {sup 99m}Tc-HMDP bone scintigraphy, about three months after administration of {sup 153}Sm-EDTMP (Quadramet in a 78 year-old man with hormone refractory prostate adenocarcinoma. One {sup 153}Sm-EDTMP reduced the PSA level in this patient by more than 70% for at least 2 months. It raises the possibility that this radiopharmaceutical could have therapeutic effect on bone metastasis in addition to its bone pain palliation effect. (authors)

  19. Single- versus multiple-fraction radiotherapy in patients with painful bone metastases: cost-utility analysis based on a randomized trial.

    NARCIS (Netherlands)

    Hout, W.B. van den; Linden, Y.J.M. van der; Steenland, E.; Wiggenraad, R.G.; Kievit, J.; Haes, J.C.J.M. de; Leer, J.W.H.

    2003-01-01

    BACKGROUND: Radiotherapy is an effective palliative treatment for cancer patients with painful bone metastases. Although single- and multiple-fraction radiotherapy are thought to provide equal palliation, which treatment schedule provides better value for the money is unknown. We compared quality-ad

  20. Dexamethasone for the prevention of a pain flare after palliative radiotherapy for painful bone metastases : a multicenter double-blind placebo-controlled randomized trial

    NARCIS (Netherlands)

    Westhoff, Paulien G.; de Graeff, Alexander; Geerling, Jenske I.; Reyners, Anna K. L.; van der Linden, Yvette M.

    2014-01-01

    Background: Radiotherapy has a good effect in palliation of painful bone metastases, with a pain response rate of more than 60%. However, shortly after treatment, in approximately 40% of patients a temporary pain flare occurs, which is defined as a two-point increase of the worst pain score on an 11

  1. 89Sr Treatment for Bone Metastases in Patients with Prostatic Cancer%放射性核素89Sr治疗前列腺癌骨转移

    Institute of Scientific and Technical Information of China (English)

    庞雁; 何景华; 朱殿清; 庹培昱; 常克力

    2011-01-01

    目的:探讨利用89Sr治疗前列腺癌骨转移的临床效果.方法:选取47例前列腺癌骨转移病人,采用静脉滴注89Sr的方法进行治疗,每6个月注射一次.结果:89Sr治疗前列腺癌骨转移患者不但可使骨转移疼痛缓解(91.7%),而且对骨转移肿瘤灶有显著的治疗作用(85.11%).结论:放射性核素治疗方法简单,副作用较小,治疗效果较好,具有很强的临床实用性.%Objective To study the effects of 89Sr treatment for bone metastases in patients with prostatic cancer. Methods Forty-seven patients with bone metastases from prostatic cancer received intravenous 89Sr (148MBq) every 6 months for more than three times (the longest ones even over ten times). Results The effects of 89Sr treatment on bone metastases from prostate cancer were pain palliation complete remission + partial remission, CR + PR (91.7%) and tumor reduction CR + PR ( 85.11% ). Conclusion Radionuclide 89Sr therapy for prostate cancer patients with bone metastases is quite effective with much improvement of quality of life.

  2. Sarcomatoid Carcinoma of Male Urethra with Bone and Lung Metastases Presenting as Urethral Stricture

    OpenAIRE

    Niraj Badhiwala; Robert Chan; Hai-Jun Zhou; Steven Shen; Michael Coburn

    2013-01-01

    A 57-year-old man who presented with urinary retention was found to have a sarcomatoid carcinoma of the urethra. Evaluation with CT scan of the abdomen and pelvis revealed multiple pulmonary nodules and osteolytic lesions of left posterior ribs. After external beam radiation therapy and six cycles of systemic chemotherapy, patient underwent a surgical resection of the urethral cancer. After his surgery, patient was also found to have multiple brain metastases and underwent whole brain radiati...

  3. Bone-seeking radiopharmaceuticals for treatment of osseous metastases, Part 1: α therapy with 223Ra-dichloride.

    Science.gov (United States)

    Pandit-Taskar, Neeta; Larson, Steven M; Carrasquillo, Jorge A

    2014-02-01

    Metastatic disease to bone is commonly seen in the advanced stages of many cancers. The cardinal symptom, pain, is often the cause of significant morbidity and reduced quality of life. Treatment of bone pain includes nonsteroidal analgesics and opiates; however, long-term use of these drugs is commonly associated with significant side effects, and tolerance is common. External-beam radiation therapy is effective mainly in localized disease sites. Bone-targeting radiopharmaceuticals are beneficial in the management of patients with multiple metastatic lesions. This article focuses on the 3 most commonly used agents: the Food and Drug Administration-approved (89)Sr-chloride, (153)Sm-ethylenediaminetetramethylene phosphonic acid (EDTMP), and (223)Ra-dichloride. We will discuss the physical characteristics, clinical data, dosage, and administration of these agents, including optimal patient selection and toxicity associated with their use. These radioactive agents have proven efficacy in the treatment of painful osseous metastases from prostate cancer and breast cancer. Significant recent advances include use of these agents in combination with chemotherapy and the use of the α emitter (223)Ra-dichloride in prostate cancer, primarily to improve survival and skeletal related events. The review is presented in 2 parts. The first will discuss the characteristics and clinical use of (223)Ra-dichloride, and the second will discuss the β emitters (89)Sr and (153)Sm-EDTMP.

  4. Enhancing Quality of Life for Breast Cancer Patients with Bone Metastases

    Science.gov (United States)

    2008-04-01

    Sellinger, D. S., McBeath, A. A., and Engber, W. D. Metastatic breast cancer in the femur . A search for the lesion at risk of fracture . Clin Orthop...cancer, bone metastasis , animal model, radiation therapy, anabolic agents, bisphosphonates, biomechanical testing, histology 16. SECURITY...Current treatment for osteolytic breast cancer bone metastasis typically involves radiation therapy (RTX) to palliate bone pain and a

  5. Sarcomatoid Carcinoma of Male Urethra with Bone and Lung Metastases Presenting as Urethral Stricture

    Directory of Open Access Journals (Sweden)

    Niraj Badhiwala

    2013-01-01

    Full Text Available A 57-year-old man who presented with urinary retention was found to have a sarcomatoid carcinoma of the urethra. Evaluation with CT scan of the abdomen and pelvis revealed multiple pulmonary nodules and osteolytic lesions of left posterior ribs. After external beam radiation therapy and six cycles of systemic chemotherapy, patient underwent a surgical resection of the urethral cancer. After his surgery, patient was also found to have multiple brain metastases and underwent whole brain radiation therapy, nine months after his initial diagnosis. Sarcomatoid carcinomas of the genitourinary tract are extremely rare tumors that require a very aggressive, multimodal treatment approach.

  6. USE OF ZOLEDRONIC ACID AND A RАNK LIGAND INHIBITOR IN THE PALLIATIVE TREATMENT OF CANCERS OF THE PROSTATE WITH BONE METASTASES

    Directory of Open Access Journals (Sweden)

    S. V. Mushigin

    2013-01-01

    Full Text Available In the metastatic patterns of the cancer, the tumor foci are located more frequently in the tubular bones and vertebral column, just less frequently in the bones of the pelvis, and even more rarely in those of the shoulder and skull. Bone pain is usually related to the involvement of the periosteum that has an extensive network of nociceptors. Auxiliary exposures that directly affect the intensity of pain syndrome and the strength of bone structures are used in addition to basic therapy options for cancer of the prostate. Among these agents there are bisphosphonates. Once ingested, bisphosphonates are transported by blood to the areas of active bone tissue rearrangement where they are tightly bound to the mineral matrix. Their administration causes a considerable reduction in pain syndrome, a decrease in the frequency of complications of bone metastases, and an increase in time before a first bone complication. Antiresorptive therapy including particularly zoledronic acid (resorba or denosumab is a necessary treatment option in the above category of patients with bone metastases.

  7. USE OF ZOLEDRONIC ACID AND A RАNK LIGAND INHIBITOR IN THE PALLIATIVE TREATMENT OF CANCERS OF THE PROSTATE WITH BONE METASTASES

    Directory of Open Access Journals (Sweden)

    S. V. Mushigin

    2014-07-01

    Full Text Available In the metastatic patterns of the cancer, the tumor foci are located more frequently in the tubular bones and vertebral column, just less frequently in the bones of the pelvis, and even more rarely in those of the shoulder and skull. Bone pain is usually related to the involvement of the periosteum that has an extensive network of nociceptors. Auxiliary exposures that directly affect the intensity of pain syndrome and the strength of bone structures are used in addition to basic therapy options for cancer of the prostate. Among these agents there are bisphosphonates. Once ingested, bisphosphonates are transported by blood to the areas of active bone tissue rearrangement where they are tightly bound to the mineral matrix. Their administration causes a considerable reduction in pain syndrome, a decrease in the frequency of complications of bone metastases, and an increase in time before a first bone complication. Antiresorptive therapy including particularly zoledronic acid (resorba or denosumab is a necessary treatment option in the above category of patients with bone metastases.

  8. Fractionated half body irradiation for palliation of multiple symptomatic bone metastases from solid tumors

    Energy Technology Data Exchange (ETDEWEB)

    Sekiguchi, Kenji; Hayashi, Shinya; Sunagawa, Yoshimitsu; Sougawa, Mitsuharu; Nakazawa, Masanori; Yamashita, Takashi (Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital)

    1992-06-01

    This was a phase I-II nonrandomized study that explored the toxicity and response of fractionated half-body irradiation (F-HBI) in patients with multiple symptomatic osseous metastases. The patients had no premedication and received 10 Gy in 5 fractions with a dose rate of 15 cGy/min. At the Cancer Institute Hospital, 9 patients were treated by this technique (1 upper and lower F-HBI, 6 upper F-HBI, 2 lower F-HBI). All patients were female and had adenocarcinomas (8 breast and 1 lung). Adverse effects were myelosuppression, vomiting and partial alopecia. But hematologic toxicity was treated with blood transfusion or G-CSF. All toxicity was transient, and no pneumonitis nor radiation-related deaths occurred. When given as palliation, F-HBI was found to relieve pain in 80% of the patients. In 10% of the patients the pain relief was complete. The mean time to achieve pain relief in responders after F-HBI was 9 days. The pain relief was long-lasting and continued without need of reirradiation for 40% of the remaining patient's life. This treatment modality appears to be well tolerated and effective in patients with multiple symptomatic osseous metastases. The optimal indications, dose and fractionation for F-HBI should be further explored in randomized trials. (author).

  9. [The diagnostic value of 99mTc-MDP bone scan and computed tomography for bone metastases of breast cancer: a systematic review].

    Science.gov (United States)

    Yu, Yanxia; Kuang, Anren

    2014-06-01

    According to the inclusion and exclusion criteria, we searched for relevant original articles in some big Chinese and English databases. The qualities of the studies were evaluated with QUADAS quality assessment tool. A software program, Meta-disc, was used to obtain the pooled estimates and heterogeneity test for sensitivity, specificity, SROC curve, and so on. Finally the 17 article were included. On a per-patient basis, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (LR+), negative likelihood ratio (LR-), diagnostic odds ratio (DOR), Q*, SROC area under curve for 99mTc-MDP bone scan and computed tomography (CT) were 0. 87 and 0.99, 0.81 and 0.98, 3.88 and 13.86, 0.2 and 0.03, 27.73 and 612.17, 0.8418 and 0.9732, 0.9097 and 0.9952, respectively. On a per-focus basis, the pooled SEN, SPE, LR+, LR-, DOR, Q*, SROC area under curve for 99mTc-MDP bone scan was 0.86, 0.97, 13.32, 0.16, 102.4, 0.8944, 0.9528, respectively. For CT, only 1 article were included. This paper demonstrate: whether 99mTc-MDP or CT both have high diagnostic efficiency for bone metastase of breast cancer.

  10. Preparation and bio-distribution of 153Sm-HEDTMP as a radiopharmaceutical for bone metastases

    Institute of Scientific and Technical Information of China (English)

    JIANG Shu-Bin; LUO Shun-Zhong; HU Shu; DENG Hou-Fu; BIN Wen-Zeng; WANG Wen-Jin; WEI Hong-Yuan; LEI Yong

    2004-01-01

    HEDTMP (N-(2-hydroxyethyl) ethlenediamine-1,1,2-tri(methylene phosphonic acid)) was labeled with 153Sm. The formation condition, stability, rabbit bone imaging and mouse bio-distribution of 153Sm -HEDTMP were investigated. The results showed that weak basic media and high ligand's concentration were favorable to form 153Sm-HEDTMP, and neutral or weak basic media increase the stability of 153Sm-HEDTMP. And the higher the concentration of HEDTMP was, the more stable the labeling complex was. Bio-distribution study indicated the uptake of 153Sm-HEDTMP in skeleton was high ((25.68±1.22)ID%/g bone at 3 h post injection and (16.56±1.01)ID%/g bone at 48 h post injection), while the non-target tissue uptake and retention were relatively low, so 153Sm-HEDTMP is a promising bone tumor therapeutic agent.

  11. Time evaluation of image-guided radiotherapy in patients with spinal bone metastases. A single-center study

    Energy Technology Data Exchange (ETDEWEB)

    Rief, H.; Habermehl, D.; Schubert, K.; Debus, J.; Combs, S.E. [University Hospital of Heidelberg, Department of Radiation Oncology, Heidelberg (Germany)

    2014-03-15

    Time is an important factor during immobilization for radiotherapy (RT) of painful spinal bone metastases. The different RT techniques currently in use have differing impacts on medical staff requirements, treatment planning and radiation delivery. This prospective analysis aimed to evaluate time management during RT of patients with spine metastases, focusing particularly on the impact of image-guided RT (IGRT). Between 21 March 2013 and 17 June 2013, we prospectively documented the time associated with the core work procedures involving the patient during the first day of RT at three different linear accelerators (LINACs). The study included 30 patients; 10 in each of three groups. Groups 1 and 2 were treated with a single photon field in the posterior-anterior direction; group 3 received a three-dimensional conformal treatment plan. The median overall durations of one treatment session were 24 and 25.5 min for the conventional RT groups and 15 min for IGRT group. The longest single procedure was patient immobilization in group 1 (median 9.5 min), whereas this was image registration and matching in groups 2 and 3 (median duration 9.5 and 5 min, respectively). Duration of irradiation (beam-on time) was similar for all groups at 4 or 5 min. The shortest immobilization procedure was observed in group 3 with a median of 3 min, compared to 4 min in group 2 and 9.5 min in group 1. With this analysis, we have shown for the first time that addition of modern IGRT does not extend the overall treatment time for patients with painful bone metastases and can be applied as part of clinical routine in a palliative setting. The choice of treatment technique should be based upon the patient's performance status, as well as the size of the target volume and location of the metastasis. (orig.) [German] Der Zeitfaktor ist ein wesentlicher Bestandteil bei der Immobilisation waehrend der Radiotherapie (RT) bei schmerzhaften Knochenmetastasen der Wirbelsaeule. Unterschiedliche RT

  12. Detection of metastases in breast cancer patients. Comparison of FDG PET with chest X-ray, bone scintigraphy and ultrasound of the abdomen

    Energy Technology Data Exchange (ETDEWEB)

    Dose-Schwarz, J.; Mahner, S.; Schirrmacher, S.; Mueller, V. [Klinik und Poliklinik fuer Gynaekologie, Universitaetsklinikum Hamburg-Eppendorf (Germany); Jenicke, L.; Brenner, W. [Klinik fuer Nuklearmedizin, Universitaetsklinikum Hamburg-Eppendorf (Germany); Habermann, C.R. [Klinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)

    2008-07-01

    Distant metastases at primary diagnosis are a prognostic key factor in breast cancer patients and play a central role in therapeutic decisions. To detect them, chest X-ray, abdominal ultrasound, and bone scintigraphy are performed as standard of care in Germany and many centers worldwide. Although FDG PET detects metastatic disease with high accuracy, its diagnostic value in breast cancer still needs to be defined. The aim of this study was to compare the diagnostic performance of FDG PET with conventional imaging. Patients, methods: a retrospective analysis of 119 breast cancer patients who presented for staging was performed. Whole-body FDG-PET (n = 119) was compared with chest X-ray (n = 106) and bone scintigraphy (n = 95). Each imaging modality was independently assessed and classified for metastasis (negative, equivocal and positive). The results of abdominal ultrasound (n = 100) were classified as negative and positive according to written reports. Imaging results were compared with clinical follow-up including follow-up imaging procedures and histopathology. Results: FDG-PET detected distant metastases with a sensitivity of 87.3% and a specificity of 83.3%. In contrast, the sensitivity and specificity of combined conventional imaging procedures was 43.1% and 98.5%, respectively. Regarding so-called equivocal and positive results as positive, the sensitivity and specificity of FDG-PET was 93.1% and 76.6%, respectively, compared to 61.2% and 86.6% for conventional imaging. Regarding different locations of metastases the sensitivity of FDG PET was superior in the detection of pulmonary metastases and lymph node metastases of the mediastinum in comparison to chest X-ray, whereas the sensitivity of FDG PET in the detection of bone and liver metastases was comparable with bone scintigraphy and ultrasound of the abdomen. Conclusions: FDG-PET is more sensitive than conventional imaging procedures for detection of distant breast cancer metastases and should be

  13. Improving the dose-myelotoxicity correlation in radiometabolic therapy of bone metastases with {sup 153}Sm-EDTMP

    Energy Technology Data Exchange (ETDEWEB)

    Pacilio, Massimiliano; Basile, Chiara [Azienda Ospedaliera San Camillo Forlanini, Rome (Italy). Dept. of Medical Physics; Ventroni, Guido; Mango, Lucio [Azienda Ospedaliera San Camillo Forlanini, Rome (Italy). Dept. of Nuclear Medicine; Ialongo, Pasquale [Azienda Ospedaliera San Camillo Forlanini, Rome (Italy). Dept. of Radiology; Becci, Domenico [University of Rome, Health Physics Postgraduate School, Rome (Italy)

    2014-02-15

    {sup 153}Sm-ethylene diamine tetramethylene phosphonic acid ({sup 153}Sm-EDTMP) is widely used to palliate pain from bone metastases, and is being studied for combination therapy beyond palliation. Conceptually, red marrow (RM) dosimetry allows myelotoxicity to be predicted, but the correlation is poor due to dosimetric uncertainty, individual sensitivity and biological effects from previous treatments. According to EANM guidelines, basic dosimetric procedures have been studied to improve the correlation between dosimetry and myelotoxicity in {sup 153}Sm-EDTMP therapy. RM dosimetry for 33 treatments of bone metastases from breast, prostate and lung tumours was performed prospectively (with {sup 99m}Tc-MDP) and retrospectively, acquiring whole-body scans early and late after injection. The {sup 153}Sm-EDTMP activity was calculated by prospective dosimetry based on measured skeletal uptake and full physical retention, with the RM absorbed dose not exceeding 3.8 Gy. Patient-specific RM mass was evaluated by scaling in terms of body weight (BW), lean body mass (LBM) and trabecular volume (TV) estimated from CT scans of the L2-L4 vertebrae. Correlations with toxicity were determined in a selected subgroup of 27 patients, in which a better correlation between dosimetry and myelotoxicity was expected. Skeletal uptakes of {sup 99m}Tc and {sup 153}Sm (Tc{sub %} and Sm{sub %}) were well correlated. The median Sm{sub %} was higher in prostate cancer (75.3 %) than in lung (60.5 %, p = 0.005) or breast (60.8 %, p = 0.008). PLT and WBC nadirs were not correlated with administered activity, but were weakly correlated with uncorrected RM absorbed doses, and the correlation improved after rescaling in terms of BW, LBM and TV. Most patients showed transient toxicity (grade 1-3), which completely and spontaneously recovered over a few days. Using TV, RM absorbed dose was in the range 2-5 Gy, with a median of 312 cGy for PLT in patients with toxicity and 247 cGy in those with no

  14. Targeting G-Protein Signaling for the Therapeutics of Prostate Tumor Bone Metastases and the Associated Chronic Bone Pain

    Science.gov (United States)

    2015-09-01

    and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202- 4302. Respondents should be aware that notwithstanding any...It is the major cause of mortality and morbidities, due to the development of bone pain, hypercalcemia, fractures , spinal cord compression and

  15. Single fraction versus multiple fraction radiotherapy for palliation of painful vertebral bone metastases: A prospective study

    Directory of Open Access Journals (Sweden)

    Dipanjan Majumder

    2012-01-01

    Conclusions: Different fractionation of radiation has same response and toxicity in treatment of vertebral bone metastasis. Single fraction RT may be safely used to treat these cases as this is more cost effective and less time consuming. Studies may be conducted to find out particular subgroup of patients to be benefitted more by either fractionation schedule; however, our study cannot comment on that issue.

  16. International consensus on use of focused ultrasound for painful bone metastases : Current status and future directions

    NARCIS (Netherlands)

    Huisman, Merel; ter Haar, Gail; Napoli, Alessandro; Hananel, Arik; Ghanouni, Pejman; Lövey, György; Nijenhuis, Robbert J; van den Bosch, Maurice A A J; Rieke, Viola; Majumdar, Sharmila; Marchetti, Luca; Pfeffer, Raphael M; Hurwitz, Mark D

    2015-01-01

    Focused ultrasound surgery (FUS), in particular magnetic resonance guided FUS (MRgFUS), is an emerging non-invasive thermal treatment modality in oncology that has recently proven to be effective for the palliation of metastatic bone pain. A consensus panel of internationally recognised experts in f

  17. A meta-analysis of {sup 18}FDG-PET, MRI and bone scintigraphy for diagnosis of bone metastases in patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Tao; Yang, Hui-Lin [The First Affiliated Hospital of Soochow University, Department of Orthopaedic Surgery, Suzhou (China); Cheng, Tao [Shanghai Jiaotong University School of Medicine, Department of Orthopaedic Surgery, Shanghai Sixth People' s Hospital, Shanghai (China); Xu, Wen [Public Health School of Soochow University, Department of Epidemiology and Biostatistics, Suzhou (China); Yan, Wei-Li [Shanghai Jiaotong University School of Medicine, Departments of Nuclear Medicine, Shanghai Renji Hospital, Shanghai (China); Liu, Jia [Shanghai Jiaotong University School of Medicine, Departments of Radiology, Shanghai Renji Hospital, Shanghai (China)

    2011-05-15

    To perform a meta-analysis comparing the diagnostic value of {sup 18}FDG-PET, MRI, and bone scintigraphy (BS) in detecting bone metastases in patients with breast cancer. MEDLINE, EMBASE, Scopus, ScienceDirect, SpringerLink, Web of Knowledge, EBSCO, and the Cochrane Database of Systematic Review databases were searched for relevant original articles published from January 1995 to January 2010. Inclusion criteria was as follows: {sup 18}FDG-PET, MRI or {sup 99m}Tc-MDP BS was performed to detect bone metastases (the number of published CT studies was inadequate for meta-analysis and therefore could not be included in this study); sufficient data were presented to construct a 2 x 2 contingency table; histopathological analysis and/or close clinical and imaging follow-up for at least 6 months were used as the reference standard. Two reviewers independently assessed potentially eligible studies and extracted relevant data. A software program called ''META-DiSc'' was used to obtain the pooled estimates for sensitivity, specificity, diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves, and the *Q index for each modality. Thirteen articles consisting of 23 studies fulfilled all inclusion criteria. On a per-patient basis, the pooled sensitivity estimates for MRI (97.1%) were significantly higher than those for PET (83.3%) and BS (87.0%; P <0.05). There was no significant difference between PET and BS (P <0.05). The pooled specificity estimates for PET (94.5%) and MRI (97.0%) were both significantly higher than those for BS (88.1%; P <0.05). There was no significant difference between PET and MRI (P >0.05). The pooled DOR estimates for MRI (298.5) were significantly higher than those for PET (82.1%) and BS (49.3%; P <0.05). There was no significant difference between PET and BS (P >0.05). The SROC curve for MRI showed better diagnostic accuracy than those for PET and BS. The SROC curve for PET was better than that for BS

  18. 放疗对乳腺癌骨转移后癌痛的疗效分析%Analysis of radiotherapy curative effects on pains of bone metastases of breast cancer

    Institute of Scientific and Technical Information of China (English)

    邹浩元; 郑广进; 张汉雄; 黎荣光

    2001-01-01

    Objective To investigate the radiotherapy curative effects on pains of bone metastases of breast cancer. Methods To analysis 32 patients retrospectively, in which 22 patients received radiotherapy(17 moderate pain, 5 severe pain, 6 dysfunction). Result 16 patients obtained complete remission with 6 cases partial response to radiation. Karnorfsky's score was improved and malfunction disappeared. Conclusion Radiotherapy is a simple and effective treatment on bone metastases of breast cancer with quick and persistent pain relieves.

  19. Samarium Sm 153 lexidronam for the palliation of painful bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Goeckeler, W.F. [Cytogen Corporation, Princeton, NJ (United States). Pharmaceutical Development

    1998-12-01

    Phosphorus-32 ({sup 32}P) and strontium-89 ({sup 89}Sr) have been used as systemically administered radiotherapeutic agents for the palliation of osteoblastic skeletal metastases. The use of each of these radionuclides may be limited as a result of less than desirable biochemical and/or nuclear properties. Samarium Sm 153 lexidronam (Quadramet) is a 1:1 complex of radioactive samarium and a tetraphosphonate chelator, ethylenediaminetetram- ethylenephosphonic acid (EDTMP). Samarium Sm 153 lexidronam has an affinity for skeletal tissue and concentrates in areas of enhanced osteoblastic activity. The radioisotope, with a half-life of 46.3 hours, emits a 103 keV gamma ray suitable for external imaging and a number of beta particles (average energy 233 keV) appropriate for localised radiotherapy. In a series of clinical trials, relief of pain has been observed after the intravenous administration of this drug, using both patient and physician rated instruments. The onset of pain relief was rapid and long lasting; the median duration of response being grater than 6 weeks. A mild and transient myelosuppression was the only significant adverse effect associated with the administration of Quadramet 8 refs., 1 tab., 2 figs.

  20. {sup 188}Rhenium-HEDP in the Treatment of Pain in Bone Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Gaudiano, J.; Savio, E.; Robles, A.; Muniz, S.; Leon, A.; Verdera, S.; Martinez, G.; Hermida, J.C.; Knapp, F.F., Jr.

    1999-01-18

    Systemic use of radiopharmaceuticals is a recognized alternative method for the treatment of pain in patients with multiple bone metastasis. A new option, {sup 188}Re-HEDP is proposed, using generator-obtained {sup 188}Rhenium ({beta} energy = 2.1 MeV, {gamma} energy = 155 keV, half-life = 16.9 hours). After establishing parameters of biodistribution, dosimetry and image acquisition in mice, rats and rabbits, Phase I and II studies were conducted on 12 patients with multiple metastasis from carcinomas, with pain surpassing other analgesic options. More than 50% pain relief was found in 91% of the patients, with total relief during a variable period in 41% of them allowing opiate and other analgesic drugs to be decreased or withdrawn, and showing a lower bone marrow contribution to total absorbed dose than that reported for other similar radiopharmaceuticals. Further study of this option is recommended in order to determine higher dose protocols without toxic bone marrow reaction possibilities.

  1. Clinical experience of [sup 123]I-IMP scintigraphy in detecting vertebral bone metastases of hepatocellular carcinoma. A comparison with bone scintigraphy with [sup 99m]Tc-MDP

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Iwamiya, T. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Tanigawa, N. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Shabana, M. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Ohta, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan))

    1994-03-01

    [sup 123]I-IMP and bone scintigraphy with [sup 99m]Tc-MDP were consecutively performed in patients with vertebral bone metastases from hepatocellular carcinoma and lumbar spondylosis deformans in a 7-day interval or shorter. The intensity of uptake was compared. Eighteen of the 20 metastatic lesions (90%) were classified as increased uptake areas in [sup 123]I-IMP scintigraphy. MDP-scintigraphy disclosed 16 metastatic lesions (80%), 9 as ''hot'' lesions (56%) and 7 as ''cold'' lesions (44%). [sup 123]I-IMP scintigraphy was negative in all 12 lesions of lumbar spondylosis deformans. Compared to MDP-scintigraphy, [sup 123]I-IMP scintigraphy was more sensitive in detecting vertebral bone metastases of hepatocellular carcinoma with smaller rates of false-positive and false-negative findings. (orig./MG).

  2. Combined use of zoledronic acid and 153Sm-EDTMP in hormone-refractory prostate cancer patients with bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Marnix G.E.H.; Rijk, Peter P. van [University Medical Center Utrecht, Department of Nuclear Medicine, P.O. Box 85500, Utrecht (Netherlands); Dahmane, Amel; Stevens, Wil H.M. [CIS bio International, Saclay (France); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Zonnenberg, Bernard A. [UMC Utrecht, Department of Internal Medicine, Utrecht (Netherlands)

    2008-04-15

    {sup 153}Sm-ethylenediaminetetramethylenephosphonic acid (EDTMP; Quadramet {sup registered}) is indicated for the treatment of painful bone metastases, whereas zoledronic acid (Zometa {sup registered}) is indicated for the prevention of skeletal complications. Because of the different therapeutic effects, combining the treatments may be beneficial. Both, however, accumulate in areas with increased osteoblastic activity. Possible drug interactions were investigated. Patients with hormone-refractory prostate cancer were treated with 18.5 MBq/kg {sup 153}Sm-EDTMP in weeks 1 and 3 and with 37 MBq/kg in week 15. Treatment with 4 mg zoledronic acid began in week 3 and continued every 4 weeks through week 23. In weeks 3 and 15, zoledronic acid was administered 2 days before {sup 153}Sm-EDTMP treatment. Urine was collected 48 h after injection of {sup 153}Sm-EDTMP, and whole-body images were obtained 6, 24 and 48 h post-injection. The effect of zoledronic acid on total bone uptake of {sup 153}Sm-EDTMP was measured indirectly by the cumulative activity excreted in the urine in weeks 1, 3 and 15. Biodistribution, safety, tolerability and effect on prostate-specific antigen level were also studied. The urinary excretion in week 3 divided by the urinary excretion in week 1 (baseline) times 100% was mean 98.4 {+-} 11.6% (median 96.2%). From week 1 to 15, after four zoledronic acid treatments, the mean ratio was 101.9 {+-} 10.7% (median 101.8%). Bioequivalence could be concluded by using a two-sample t test for both per-protocol (n = 13) and full-analysis sets (n = 18). Toxicity was comparable to of monotherapy with {sup 153}Sm-EDTMP. Zoledronic acid treatment does not influence {sup 153}Sm-EDTMP skeletal uptake. Combined treatment is feasible and safe. (orig.)

  3. Long-term Efficacy and Safety of Pamidronate Disodium in Treatment of Bone Metastases in Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Li-jun Di; Jun Ren; Ying Yan; Feng-ling Wan; Guo-gong Song; Jing Yu

    2009-01-01

    Objective: To evaluate the long-term efficacy and safety of pamidronate disodium in patients with bone lesions secondary to advanced breast carcinoma. Methods: A retrospective chart review was conducted of 62 patients receiving intravenous pamidronate disodium for metastatic breast cancer. The proportion of patients experiencing at least one skeletal related event (SRE) after 12 months of therapy was determined.Results: The proportion of patients who had an SRE was 29.00% (18 individuals) and the median time to first event was greater than 350 days. Radiotherapy(11 individuals)and pathologic fracture(6 individuals)were the most frequent type of SRE, while cord compression(1 individuals) and hypercalcaemia(0 individuals) were rare. A total of 37 individuals had transient hypocalcaemia without any clinical symptom. No significant creatinine abnormalities were encountered. There were no clinically relevant changes of calcium ,phosphate and creatinine before and after therapy.Conclusion: Long-term treatment with pamidronate disodium significantly reduces and delays skeletal morbidity from osteolytic metastases . Prolonged therapy was well tolerated. This study suggests that the rate of clinically relevant SREs is substantially lower than the event rate observed in phase III clinical trials.

  4. Radionuclide whole body bone imaging analysis of 189 cases of lung cancer patients with bone metastases%189例肺癌骨转移患者核素全身骨显像分析

    Institute of Scientific and Technical Information of China (English)

    吴国; 王朝晖; 李滢

    2011-01-01

    目的 探讨肺癌骨转移患者核素全身骨显像的临床诊断价值.方法 选取行核素全身骨显像分析的肺癌骨转移患者189例为研究对象,分析骨转移部位、发生率与肺癌病理类型的关系.结果 肺腺癌骨转移发生率较其他类型多;骨转移部位以胸部、中轴骨为主.结论 肺癌骨转移患者的核素全身骨显像分析可以准确判断骨转移的部位和发生率,具有较高的临床诊断价值.%Objective To analyze the result of radionuclide bone scan with whole body in 189 lung cancer patients with bone metastases. Methods 189 cases of lung cancer patients with bone metastasis in this hospital from January 2009 to March 2011 were selected for the study. Bone metastases and the relationship of lung cancer incidence and pathological types were analyzed. Results Bone metastasis of adenocaicinoma was more than the other pathological types of lung cancer. Bone metastatic was mainly concentrated in the chest or axial skeleton. Conclusion Analysis of radionuclide whole body bone imaging in lung cancer patients with bone metastases can accurately determine the site of bone metastasis, which has great clinical value.

  5. Appearance of untreated bone metastases from breast cancer on FDG PET/CT: importance of histologic subtype

    Energy Technology Data Exchange (ETDEWEB)

    Dashevsky, Brittany Z.; Parsons, Molly [Weill Cornell Medical College, Department of Radiology, New York, NY (United States); Goldman, Debra A.; Goenen, Mithat [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Corben, Adriana D. [Memorial Sloan-Kettering Cancer Center, Department of Pathology, New York, NY (United States); Jochelson, Maxine S.; Ulaner, Gary A. [Weill Cornell Medical College, Department of Radiology, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Hudis, Clifford A. [Memorial Sloan-Kettering Cancer Center, Department of Medicine, New York, NY (United States); Morrow, Monica [Memorial Sloan-Kettering Cancer Center, Department of Surgery, New York, NY (United States)

    2015-10-15

    To determine if the histology of a breast malignancy influences the appearance of untreated osseous metastases on FDG PET/CT. This retrospective study was performed under IRB waiver. Our Hospital Information System was screened for breast cancer patients who presented with osseous metastases, who underwent FDG PET/CT prior to systemic therapy or radiotherapy from 2009 to 2012. Patients with invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), or mixed ductal/lobular (MDL) histology were included. Patients with a history of other malignancies were excluded. PET/CT was evaluated, blinded to histology, to classify osseous metastases on a per-patient basis as sclerotic, lytic, mixed lytic/sclerotic, or occult on CT, and to record SUVmax for osseous metastases on PET. Following screening, 95 patients who met the inclusion criteria (74 IDC, 13 ILC, and 8 MDL) were included. ILC osseous metastases were more commonly sclerotic and demonstrated lower SUVmax than IDC metastases. In all IDC and MDL patients with osseous metastases, at least one was FDG-avid. For ILC, all patients with lytic or mixed osseous metastases demonstrated at least one FDG-avid metastasis; however, in only three of seven patients were sclerotic osseous metastases apparent on FDG PET. The histologic subtype of breast cancer affects the appearance of untreated osseous metastases on FDG PET/CT. In particular, non-FDG-avid sclerotic osseous metastases were more common in patients with ILC than in patients with IDC. Breast cancer histology should be considered when interpreting non-FDG-avid sclerotic osseous lesions on PET/CT, which may be more suspicious for metastases (rather than benign lesions) in patients with ILC. (orig.)

  6. Primary investigation of dose-effect relationship of 153Sm-EDTMP in treating multiple bone metastases%153Sm-EDTMP治疗多发骨转移瘤的剂量效应关系初步观察

    Institute of Scientific and Technical Information of China (English)

    Wei Fan; Lixin Chen; Xiaowei Liu; Qiang Tang; Shengfang Zhi; Zongyuan Zeng

    2007-01-01

    Objective: To calculate the focus absorption dose of 153Sm-EDTMP with the Monte Carlo (MC) EGS4 method for treatment of bone metastases from nasopharyngeal carcinoma or breast cancer, and investigate the relationship between the focus absorption dose and painkilling effect of 153Sm-EDTMP. Methods: Four patients with multiple bone metastases from nasopharyngeal or breast carcinoma and suffered from grade Ⅳ bone pain were treated with radionuclide internal irradiation of 153Sm-EDTMP. The absorption dose and dose distribution of bone metastases and other targeted organs were calculated with MC EGS4 program based on the time-order SPECT/CT scanning and the measurement of the radioactivity in the urine accumulation. The release of bone pain and the improvement of life quality were observed. Results: Bone pain of the patients was significantly alleviated to grade Ⅱ for 3-4 weeks after internal 153Sm-EDTMP irradiation. The 3-dimensional absorption dose distribution image of bone metastases and targeted organs showed that the dose distribution in bone metastases was not asymmetrical. After injection of 0.65 × 37 MBq/kg 153Sm-EDTMP, the highest absorption dose in bone lesions was about 4.9-5.9 Gy, and the dose in the lesion margin was about 2.0 Gy. Using the highest dose as reference dose point, the relative absorption dose values of bone marrow, vertebra and sex organ near lesions were 0.48-1.1 Gy, 0.51-0.85 Gy, and 0.01-0.14 Gy, respectively. Conclusion: The absorption dose of bone metastases is significantly lower than treatment dose of 30 Gy after single irradiation of 153Sm-EDTMP. The painkilling effect is limited and in accordance with clinical observation.

  7. Value analysis of ICTP as diagnostis in dicator of bone metastases%ICTP作为肿瘤骨转移诊断指标的价值分析

    Institute of Scientific and Technical Information of China (English)

    罗祖军; 王强; 林祺荣; 陈美才

    2013-01-01

    目的 统计并计算Ⅰ型胶原吡啶交联终肽(ICTP)作为诊断方法诊断肿瘤患者骨转移的灵敏度、特异度和准确性,分析ICTP作为肿瘤骨转移诊断指标的价值.方法 将2011年5月至2012年5月收治的肿瘤患者46例按照明确病理诊断和影像学诊断,分为肿瘤骨转移组即观察组和肿瘤未骨转移组即对照组,检测患者血清中ICTP的含量,ICTP值参考范围:1.5~4.3 μL,诊断患者是否已经发生了骨转移,统计取真率即灵敏度、弃伪率即特异度、正确诊断出肿瘤骨转移的概率与正确诊断出未发生肿瘤骨转移的概率之和即准确性,再通过独立样本资料的2×2列联表2检验,计算ICTP单独诊断肿瘤骨转移是否具有显著差异.结果 ICTP作为诊断指标诊断肿瘤患者骨转移的灵敏度为69.0%,特异度为29.4%,准确性为54.3%.通过独立样本资料的2×2列联表x2检验,ICTP单独诊断肿瘤骨转移不具有显著差异.结论 ICTP作为肿瘤骨转移诊断指标具有良好的灵敏度,但是单独作为诊断指标诊断肿瘤是否骨转移不具有显著性的差异,即单独诊断不具有良好的诊断效果,配合其他骨代谢的生化指标诊断肿瘤骨转移具有理想的效果,值得发展和推广.%Objective To statistics and calculation of collagen type Ⅰ pyridine end of the cross-linked peptide(ICTP) as a diagnostic method,the sensitivity,specificity,and accuracy of the diagnosis of cancer patients with bone metastases,analysis of the value of ICTP as a diagnostic indicator of bone metastases.Methods From May 2011 to May 2012,46 cases of cancer patients admitted to the hospital,the observation group and the tumor was not bone metastasis into bone metastases group as the control group,the detection of patients in accordance with a clear pathological diagnosis and imaging diagnosis serum ICTP content the ICTP value reference range:1.5-4.3μL diagnosis patients had happened bone metastases

  8. 乳腺癌骨转移临床相关因素的研究%Clinical factors related to bone metastases from breast cancer

    Institute of Scientific and Technical Information of China (English)

    张卫红; 田钢龙; 何继民; 周凤飞; 关宏霞; 高聪明; 吕平欣

    2010-01-01

    目的 研究乳腺癌骨转移的临床和影像学资料,寻找影响骨转移的相关因素,为早期诊断提供依据.方法 对334例乳腺癌患者全身骨显像、临床分期、病理、免疫组织化学及血清学检-查结果进行回顾性分析,并对数据行χ2检验.结果 有淋巴结转移者骨转移率71.0%(152/214),没有淋巴结转移者骨转移率为22.5%(27/120),两者比较差异有统计学意义(χ2=72.80,P=0.000);浸润性非特殊性癌骨转移率69.0%(203/294),浸润性特殊性癌骨转移率41.7%(5/12),两者比较差异有统计学意义(χ2=3.97,P=0.046);骨转移中碱性磷酸酶(ALP)升高者占28.5%(51/179),非骨转移中ALP升高者占14.9%(11/74),两者比较差异也有统计学意义(χ2=5.25,P=0.022);而骨转移中肿瘤标志物[癌胚抗原(CEA)、糖类抗原(CA)15-3、CA125、CA19-9]升高者占68.7%(123/179),非骨转移中肿瘤标志物升高者占27.0%(20/74)(χ2=37.03,P=0.000).结论 乳腺癌骨转移的发生率与原发灶的病理类型、发病时有无淋巴结转移有关,浸润性非特殊性癌或有淋巴结转移者骨转移率较高.动态监测血清ALP、CEA、CA15-3、CA125、CA19-9有助于早期诊断.%Objective To study the clinical and imaging features of patients with bone metastases from breast cancer and identify the factors related to the incidence of bone metastases. Methods Three hundred and thirty-four patients with breast cancer were recruited into this study. Whole-body 99Tcm-methylene disphosphonate (MDP) bone scan, clinical staging, pathological, immunohistochemical and serological test results were analyzed retrospectively. χ2 test was used for statistical analysis. Results The incidence rate of bone metastases for patients with and without lymph node metastases was 71% (152/214) and 22. 5% (27/120), respectively (χ2 =72.80, P =0.000). The incidence rate of bone metastases from infiltrated non-specified and specified breast cancer was 69% (203/294) and 41.7% (5

  9. Chondrogenic Potency Analyses of Donor-Matched Chondrocytes and Mesenchymal Stem Cells Derived from Bone Marrow, Infrapatellar Fat Pad, and Subcutaneous Fat

    Directory of Open Access Journals (Sweden)

    John Garcia

    2016-01-01

    Full Text Available Autologous chondrocyte implantation (ACI is a cell-based therapy that has been used clinically for over 20 years to treat cartilage injuries more efficiently in order to negate or delay the need for joint replacement surgery. In this time, very little has changed in the ACI procedure, but now many centres are considering or using alternative cell sources for cartilage repair, in particular mesenchymal stem cells (MSCs. In this study, we have tested the chondrogenic potential of donor-matched MSCs derived from bone marrow (BM, infrapatellar fat pad (FP, and subcutaneous fat (SCF, compared to chondrocytes. We have confirmed that there is a chondrogenic potency hierarchy ranging across these cell types, with the most potent being chondrocytes, followed by FP-MSCs, BM-MSCs, and lastly SCF-MSCs. We have also examined gene expression and surface marker profiles in a predictive model to identify cells with enhanced chondrogenic potential. In doing so, we have shown that Sox-9, Alk-1, and Coll X expressions, as well as immunopositivity for CD49c and CD39, have predictive value for all of the cell types tested in indicating chondrogenic potency. The findings from this study have significant clinical implications for the refinement and development of novel cell-based cartilage repair strategies.

  10. Chondrogenic Potency Analyses of Donor-Matched Chondrocytes and Mesenchymal Stem Cells Derived from Bone Marrow, Infrapatellar Fat Pad, and Subcutaneous Fat

    Science.gov (United States)

    Garcia, John; McCarthy, Helen S.; Roberts, Sally; Richardson, James B.

    2016-01-01

    Autologous chondrocyte implantation (ACI) is a cell-based therapy that has been used clinically for over 20 years to treat cartilage injuries more efficiently in order to negate or delay the need for joint replacement surgery. In this time, very little has changed in the ACI procedure, but now many centres are considering or using alternative cell sources for cartilage repair, in particular mesenchymal stem cells (MSCs). In this study, we have tested the chondrogenic potential of donor-matched MSCs derived from bone marrow (BM), infrapatellar fat pad (FP), and subcutaneous fat (SCF), compared to chondrocytes. We have confirmed that there is a chondrogenic potency hierarchy ranging across these cell types, with the most potent being chondrocytes, followed by FP-MSCs, BM-MSCs, and lastly SCF-MSCs. We have also examined gene expression and surface marker profiles in a predictive model to identify cells with enhanced chondrogenic potential. In doing so, we have shown that Sox-9, Alk-1, and Coll X expressions, as well as immunopositivity for CD49c and CD39, have predictive value for all of the cell types tested in indicating chondrogenic potency. The findings from this study have significant clinical implications for the refinement and development of novel cell-based cartilage repair strategies. PMID:27781068

  11. Dosimetry of bone metastases in targeted radionuclide therapy with alpha-emitting {sup 223}Ra-dichloride

    Energy Technology Data Exchange (ETDEWEB)

    Pacilio, Massimiliano [Azienda Ospealiera San Camillo Forlianini, Rome (Italy). Dept. of Medical Physics; Ventroni, Guido; Mango, Lucio [Azienda Ospealiera San Camillo Forlianini, Rome (Italy). Dept. of Nuclear Medicin; De Vincentis, Giuseppe; Di Castro, Elisabetta; Frantellizzi, Viviana; Follacchio, Giulia Anna; Garkavaya, Tatiana [Rome Univ. (Italy). Dept. of Radiological, Oncological and Anatomo Pathological Sciences; Cassano, Bartolomeo; Lorenzon, Leda [Rome Univ. (Italy). Postgraduate School of Medical Physics; Pellegrini, Rosanna; Pani, Roberto [Rome Univ. (Italy). Dept. of Molecular Medicine; Ialongo, Pasquale [Azienda Ospealiera San Camillo Forlianini, Rome (Italy). Dept. of Radiology

    2016-01-15

    Ra-dichloride is an alpha-emitting radiopharmaceutical used in the treatment of bone metastases from castration-resistant prostate cancer. Image-based dosimetric studies remain challenging because the emitted photons are few. The aim of this study was to implement a methodology for in-vivo quantitative planar imaging, and to assess the absorbed dose to lesions using the MIRD approach. The study included nine Caucasian patients with 24 lesions (6 humeral head lesions, 4 iliac wing lesions, 2 scapular lesions, 5 trochanter lesions, 3 vertebral lesions, 3 glenoid lesions, 1 coxofemoral lesion). The treatment consisted of six injections (one every 4 weeks) of 50 kBq per kg body weight. Gamma-camera calibrations for {sup 223}Ra included measurements of sensitivity and transmission curves. Patients were statically imaged for 30 min, using an MEGP collimator, double-peak acquisition, and filtering to improve the image quality. Lesions were delineated on {sup 99m}Tc-MDP whole-body images, and the ROIs superimposed on the {sup 223}Ra images after image coregistration. The activity was quantified with background, attenuation, and scatter correction. Absorbed doses were assessed deriving the S values from the S factors for soft-tissue spheres of OLINDA/EXM, evaluating the lesion volumes by delineation on the CT images. In 12 lesions with a wash-in phase the biokinetics were assumed to be biexponential, and to be monoexponential in the remainder. The optimal timing for serial acquisitions was between 1 and 5 h, between 18 and 24 h, between 48 and 60 h, and between 7 and 15 days. The error in cumulated activity neglecting the wash-in phase was between 2 % and 12 %. The mean effective half-life (T{sub 1/2eff}) of {sup 223}Ra was 8.2 days (range 5.5-11.4 days). The absorbed dose (D) after the first injection was 0.7 Gy (range 0.2-1.9 Gy). Considering the relative biological effectiveness (RBE) of alpha particles (RBE = 5), D{sub RBE} = 899 mGy/MBq (range 340-2,450 mGy/MBq). The

  12. Treatment of painful bone metastases by Quadramet: retrospective study in 77 patients 2-year experience; Traitement des metastases osseuses douloureuses par Quadramet: experience retrospective ches 77 patients sur 2 ans

    Energy Technology Data Exchange (ETDEWEB)

    Klingelschmitt, S.; Boulahdour, H.; Blagosklonov, O.; Rudenko, B.; Aubry, R.; Bidet, A.C.; Bosset, J.F.; Cardot, J.C. [Centre Hospitalier Universitaire, 25 - Besancon (France)

    2002-09-01

    Metabolic radiotherapy offers an alternative therapeutic tactic in patients with painful bone metastases. The efficacy and toxicity of Quadramet were evaluated in 77 patients. All patients received a 37 MBq/kg dose of Quadramet, and 13 patients received the dose twice. Then, the efficacy of treatment was evaluated according to WHO/OMS score, to pain relief and modification of opioid treatment. The WHO/OMS score was not changed or increased in 87.5 % (63172) of patients. The pain relief was observed in 77.8 % (56/72) of patients. The antalgic treatment decreased in 76.4 % (55/72) of patients. In patients with prostatic cancer, pain relief (79.2 % of patients) was more noticeable than in patients with breast cancer (76.9 % of patients). An opposite response was observed in 8.3 % (6/72) of patients. The rate of PSA decreased in 42.8 % (12/28) of patients with prostatic cancer. The only toxicity observed was myelo-toxicity. This toxicity was moderate and recovered by 8 weeks. After the second administration of Quadramet as well as after the first, we observed the pain relief in 76.9 % of patients. The results of our study confirm the efficacy and the safety of Quadramet in early painful bone metastases treatment. This treatment can be repeated without decrease of the efficacy. (authors)

  13. Mesenchymal stem cells from cortical bone demonstrate increased clonal incidence, potency, and developmental capacity compared to their bone marrow–derived counterparts

    Directory of Open Access Journals (Sweden)

    Daniel Blashki

    2016-08-01

    Full Text Available In this study, we show that matrix dense cortical bone is the more potent compartment of bone than bone marrow as a stromal source for mesenchymal stem cells as isolated from adult rats. Lineage-depleted cortical bone-mesenchymal stem cells demonstrated >150-fold enrichment of colony forming unit–fibroblasts per cell incidence. compared to lineage-depleted bone marrow-mesenchymal stem cells, corresponding to a 70-fold increase in absolute recovered colony forming unit–fibroblasts. The composite phenotype Lin−/CD45−/CD31−/VLA-1+/Thy-1+ enriched for clonogenic mesenchymal stem cells solely from cortical bone–derived cells from which 70% of clones spontaneously differentiated into all lineages of bone, cartilage, and adipose. Both populations generated vascularized bone tissue within subcutaneous implanted collagen scaffolds; however, cortical bone–derived cells formed significantly more osteoid than bone marrow counterparts, quantified by histology. The data demonstrate that our isolation protocol identifies and validates mesenchymal stem cells with superior clonal, proliferative, and developmental potential from cortical bone compared to the bone marrow niche although marrow persists as the typical source for mesenchymal stem cells both in the literature and current pre-clinical therapies.

  14. Mesenchymal stem cells from cortical bone demonstrate increased clonal incidence, potency, and developmental capacity compared to their bone marrow–derived counterparts

    Science.gov (United States)

    Blashki, Daniel; Murphy, Matthew B; Ferrari, Mauro; Simmons, Paul J; Tasciotti, Ennio

    2016-01-01

    In this study, we show that matrix dense cortical bone is the more potent compartment of bone than bone marrow as a stromal source for mesenchymal stem cells as isolated from adult rats. Lineage-depleted cortical bone-mesenchymal stem cells demonstrated >150-fold enrichment of colony forming unit–fibroblasts per cell incidence. compared to lineage-depleted bone marrow-mesenchymal stem cells, corresponding to a 70-fold increase in absolute recovered colony forming unit–fibroblasts. The composite phenotype Lin−/CD45−/CD31−/VLA-1+/Thy-1+ enriched for clonogenic mesenchymal stem cells solely from cortical bone–derived cells from which 70% of clones spontaneously differentiated into all lineages of bone, cartilage, and adipose. Both populations generated vascularized bone tissue within subcutaneous implanted collagen scaffolds; however, cortical bone–derived cells formed significantly more osteoid than bone marrow counterparts, quantified by histology. The data demonstrate that our isolation protocol identifies and validates mesenchymal stem cells with superior clonal, proliferative, and developmental potential from cortical bone compared to the bone marrow niche although marrow persists as the typical source for mesenchymal stem cells both in the literature and current pre-clinical therapies. PMID:27579159

  15. [The use of SPECT-CT with 99mTc-labeled phosphates in patients with suspected skeletal metastases in planar bone scintigraphy].

    Science.gov (United States)

    Krzhivitskiĭ, P I; Kanaev, S V; Novikov, S N; Zhukova, L A; Krivorot'ko, P V; Ponomareva, O I; Negustorov, Iu F

    2013-01-01

    We assessed the diagnostic capabilities of SPECT-CT in patients with unclear and suspicious on the secondary lesion with bone scintigraphy background in planar mode (227 patients (mean age - 57 years) with various primary malignancies). All patients underwent planar scintigraphy with 99mTc-labeled phosphates in the "whole body" mode and then - bizonal single-photon-emission computed tomography combined with X-ray computed tomography (SPECT-CT). In patients with the presence of lesions in the skeleton, suspicious on metastases, there was conducted comparison with the data of SPECT-CT. During planar investigation the suspicion on metastases was detected in 41 patients (18%). The use of SPECT-CT allowed excluding metastases in 29 (71%) and confirmed in 7 (17%) of them. In 5 (12%) cases the nature of the changes remained unclear. Thus, in cancer patients with revealed by planar bone scintigraphy unclear or suspicious for metastatic foci in the skeleton, the use of SPECT-CT allowed in most cases (88%) to clarify the nature of these changes.

  16. Validity of the recorded International Classification of Diseases, 10th edition diagnoses codes of bone metastases and skeletal-related events in breast and prostate cancer patients in the Danish National Registry of Patients

    Directory of Open Access Journals (Sweden)

    Annette Østergaard Jensen

    2009-07-01

    Full Text Available Annette Østergaard Jensen1, Mette Nørgaard1, Mellissa Yong2, Jon P Fryzek2, Henrik Toft Sørensen11Department of Clinical Epidemiology, Aarhus University hospital, Århus, Denmark; 2Global Epidemiology, Amgen inc., Thousands Oaks, CA, USAObjective: The clinical history of bone metastases and skeletal-related events (SREs secondary to cancers is not well understood. In support of studies of the natural history of bone metastases and SREs in Danish prostate and breast cancer patients, we estimated the sensitivity and specificity of hospital diagnoses for bone metastases and SREs (ie, radiation therapy to the bone, pathological or osteoporotic fractures, spinal cord compression and surgery to the bone in a nationwide medical registry in Denmark.Study design and setting: In North Jutland County, Denmark, we randomly sampled 100 patients with primary prostate cancer and 100 patients with primary breast cancer diagnoses from the National Registry of Patients (NRP, during the period January 1st, 2000 to December 31st, 2000 and followed them for up to five years after their cancer diagnosis. We used information from medical chart reviews as the reference for estimating sensitivity, and specificity of the NRP International Classification of Diseases, 10th edition (ICD-10 coding for bone metastases and SRE diagnoses. Results: For prostate cancer, the overall sensitivity of bone metastases or SRE coding in the NRP was 0.54 (95% confidence interval [CI]: 0.39–0.69, and the specificity was 0.96 (95% CI: 0.87–1.00. For breast cancer, the overall sensitivity of bone metastases or SRE coding in the NRP was 0.58 (95% CI: 0.34–0.80, and the specificity was 0.95 (95% CI: 0.88–0.99. Conclusion: We measured the validity of ICD-10 coding in the Danish NRP for bone metastases and SREs in prostate and breast cancer patients and found it has adequate sensitivity and high specificity. The NRP remains a valuable tool for clinical epidemiological studies of bone

  17. Computed tomography-guided percutaneous microwave ablation combined with osteoplasty for palliative treatment of painful extraspinal bone metastases from lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Zhigang; Ye, Xin; Yang, Xia; Zheng, Aimin; Huang, Guanghui; Wang, Jiao [Shandong Provincial Hospital Affiliated to Shandong University, Department of Oncology, Jinan, Shandong Province (China); Zhang, Kaixian [Teng Zhou Central People' s Hospital Affiliated to Jining Medical College, Department of Oncology, Tengzhou, Shandong Province (China)

    2015-10-15

    To retrospectively evaluate the efficacy and safety of microwave ablation (MWA) combined with osteoplasty in lung cancer patients with painful extraspinal bone metastases. From January 2011 to July 2014, 26 lung cancer patients with 33 painful extraspinal bone metastases underwent percutaneous MWA combined with osteoplasty. Effectiveness was evaluated by visual analog scale (VAS) and daily morphine dose with a follow-up of 6-months. Complications were also recorded. Mean VAS score and morphine dose pre-procedure were 7.4 ± 1.6 (range, 5-10) and 47.7 ± 30.1 mg (range, 20-120 mg), respectively. Technical success and pain relief were achieved in all patients. Mean VAS scores and daily morphine doses post-procedure were as follows: 48 h, 1.7 ± 1.2 (p < 0.001) and 29.6 ± 16.1 mg (p = 0.003); 7 days, 1.9 ± 1.7 (p < 0.001) and 16.1 ± 12.0 mg (p < 0.001); 1 month, 1.5 ± 0.9 (p < 0.001) and 10.8 ± 10.9 (p < 0.001); 3 months, 0.9 ± 0.7 (p < 0.001) and 8.4 ± 9.2 mg (p < 0.001); and 6 months, 1.2 ± 0.8 (p < 0.001) and 9.2 ± 12.3 mg (p < 0.001). Complications were observed in eight patients (28 %); among these, major complications were reported in two (7.7 %) patients, one with local infection and the other with a bone fracture. The minor complication rate was 23.1 % (6/26). MWA combination with osteoplasty appeared to be an effective and safe treatment for lung cancer patients with painful extraspinal bone metastases. (orig.)

  18. Use of Single- versus Multiple-Fraction Palliative Radiation Therapy for Bone Metastases: Population-Based Analysis of 16,898 Courses in a Canadian Province

    Energy Technology Data Exchange (ETDEWEB)

    Olson, Robert A., E-mail: rolson2@bccancer.bc.ca [BC Cancer Agency Centre for the North, Prince George, British Columbia (Canada); University of Northern British Columbia, Prince George, British Columbia (Canada); University of British Columbia, Vancouver, British Columbia (Canada); Tiwana, Manpreet S. [BC Cancer Agency Centre for the North, Prince George, British Columbia (Canada); University of Northern British Columbia, Prince George, British Columbia (Canada); Barnes, Mark [BC Cancer Agency Centre for the North, Prince George, British Columbia (Canada); Kiraly, Andrew; Beecham, Kwamena [BC Cancer Agency Centre for the North, Prince George, British Columbia (Canada); University of Northern British Columbia, Prince George, British Columbia (Canada); Miller, Stacy [BC Cancer Agency Centre for the North, Prince George, British Columbia (Canada); University of British Columbia, Vancouver, British Columbia (Canada); Hoegler, David [University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency Centre for the Southern Interior, Kelowna, British Columbia (Canada); Olivotto, Ivo [University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency Vancouver Centre, Victoria, British Columbia (Canada)

    2014-08-01

    Purpose: There is abundant evidence that a single fraction (SF) of palliative radiation therapy (RT) for bone metastases is equivalent to more protracted and costly multiple fraction courses. Despite this, there is low utilization of SFRT internationally. We sought to determine the utilization of SFRT in a population-based, publicly funded health care system. Methods and Materials: All consecutive patients with bone metastases treated with RT during 2007 to 2011 in British Columbia (BC) were identified. Associations between utilization of SFRT and patient and provider characteristics were investigated. Results: A total of 16,898 courses of RT were delivered to 8601 patients. SFRT was prescribed 49% of the time. There were positive relationships among SFRT utilization and primary tumor group (P<.001; most commonly in prostate cancer), worse prognosis (P<.001), increasing physician experience (P<.001), site of metastases (P<.001; least for spine metastases), and area of training (P<.001; most commonly for oncologists trained in the United Kingdom). There was wide variation in the prescription of SFRT across 5 regional cancer centers, ranging from 25.5% to 73.4%, which persisted after controlling for other, potentially confounding factors (P<.001). Conclusions: The large variability in SFRT utilization across BC Cancer Agency (BCCA) cancer centers suggests there is a strong cultural effect, where physicians' use of SFRT is influenced by their colleagues' practice. SFRT use in BC was similar to that in other Canadian and western European reports but strikingly higher than in the United States. Further work is needed to standardize SFRT prescribing practices internationally for this common indication for RT, with the potential for huge health system cost savings and substantial improvements in patients' quality of life.

  19. Quality of Life After Palliative Radiation Therapy for Patients With Painful Bone Metastases: Results of an International Study Validating the EORTC QLQ-BM22

    Energy Technology Data Exchange (ETDEWEB)

    Zeng Liang [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: edward.chow@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Bedard, Gillian; Zhang, Liying [Department of Radiation Oncology, Odette Cancer Centre, University of Toronto, Toronto, Ontario (Canada); Fairchild, Alysa [Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Vassiliou, Vassilios [Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia (Cyprus); Alm El-Din, Mohamed A. [Department of Clinical Oncology, Tanta University Hospital, Tanta Faculty of Medicine, Tanta (Egypt); Jesus-Garcia, Reynaldo [Department of Orthopedic Oncology, Federal University of Sao Paulo, Sao Paulo (Brazil); Kumar, Aswin [Division of Gynaecology and Genitourinary Oncology, Department of Radiation Oncology, Regional Cancer Center, Trivandrum (India); Forges, Fabien [Inserm CIE3, Saint Etienne University Hospital, Saint-Etienne (France); Unit of Clinical Research, Innovation, and Pharmacology, Saint Etienne University Hospital, Saint-Etienne (France); Tseng, Ling-Ming [Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan (China); Hou, Ming-Feng [Department of Gastroenterologic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (China); Chie, Wei-Chu [Department of Public Health and Institute of Epidemiology and Preventative Medicine, National Taiwan University, Taipei, Taiwan (China); Bottomley, Andrew [European Organisation for Research and Treatment of Cancer, EORTC Headquarters, Brussels (Belgium)

    2012-11-01

    Purpose: Radiation therapy (RT) is an effective method of palliating painful bone metastases and can improve function and reduce analgesic requirements. In advanced cancer patients, quality of life (QOL) is the primary outcome of interest over traditional endpoints such as survival. The purpose of our study was to compare bone metastasis-specific QOL scores among patients who responded differently to palliative RT. Methods and Materials: Patients receiving RT for bone metastases across 6 countries were prospectively enrolled from March 2010-January 2011 in a trial validating the QLQ-BM22 and completed the QLQ-BM22 and the core measure (QLQ-C30) at baseline and after 1 month. Pain scores and analgesic intake were recorded, and response to RT was determined according to the latest published guidelines. The Kruskal-Wallis nonparametric and Wilcoxon rank sum tests compared changes in QOL among response groups. A Bonferroni-adjusted P<.003 indicated statistical significance. Results: Of 79 patients who received palliative RT, 59 were assessable. Partial response, pain progression, and indeterminate response were observed in 22, 8, and 29 patients, respectively; there were no patients with a complete response. Patients across all groups had similar baseline QOL scores apart from physical functioning (patients who progressed had better initial functioning). One month after RT, patients who responded had significant improvements in 3 of 4 QLQ-BM22 domains (painful site, P<.0001; painful characteristic, P<.0001; and functional interference, P<.0001) and 3 QLQ-C30 domains (physical functioning, P=.0006; role functioning, P=.0026; and pain, P<.0001). Patients with progression in pain had significantly worse functional interference (P=.0007) and pain (P=.0019). Conclusions: Patients who report pain relief after palliative RT also have better QOL with respect to bone metastasis-specific issues. The QLQ-BM22 and QLQ-C30 are able to discriminate among patients with varying

  20. [{sup 11}C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer: comparison with bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Picchio, Maria [San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); National Research Council (IBFM-CNR), Institute for Bioimaging and Molecular Physiology, Milan (Italy); Spinapolice, Elena Giulia; Crivellaro, Cinzia [University of Milano-Bicocca, Center for Molecular Bioimaging, Milan (Italy); Fallanca, Federico; Gianolli, Luigi [San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); Giovacchini, Giampiero [University of Milano-Bicocca, Center for Molecular Bioimaging, Milan (Italy); University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); Messa, Cristina [National Research Council (IBFM-CNR), Institute for Bioimaging and Molecular Physiology, Milan (Italy); University of Milano-Bicocca, Center for Molecular Bioimaging, Milan (Italy); San Gerardo Hospital, Department of Nuclear Medicine, Monza (Italy)

    2012-01-15

    The aim of this study was to evaluate the clinical usefulness of [{sup 11}C]choline positron emission tomography (PET)/CT in comparison with bone scintigraphy (BS) in detecting bone metastases (BM) of patients with biochemical progression after radical treatment for prostate cancer (PCa). Seventy-eight consecutive patients with biochemical progression of PCa (mean prostate-specific antigen 21.1 ng/ml, range 0.2-500.0 ng/ml) referred for both [{sup 11}C]choline PET/CT and BS for restaging purposes were retrospectively analysed. The diagnostic accuracy of [{sup 11}C]choline PET/CT and BS was assessed by using morphological imaging and/or follow-up as standards of reference. As equivocal findings were found, the accuracy analysis was performed twice, once including them as positive and once as negative. A separate analysis was also performed in hormone-resistant patients and data compared with those of patients who did not receive anti-androgenic treatment. Equivocal findings occurred in 1 of 78 (1%) cases in [{sup 11}C]choline PET/CT and in 21 of 78 (27%) cases in BS. Depending on their attribution as either positive or negative, the ranges of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for [{sup 11}C]choline PET/CT were 89-89%, 98-100%, 96-100%, 94-96% and 95-96%, respectively. For BS they were 100-70%, 75-100%, 68-100%, 100-86% and 83-90%, respectively. Concordant findings between [{sup 11}C]choline PET/CT and BS occurred in 55 of 78 (71%) cases. The accuracy of [{sup 11}C]choline PET/CT did not significantly (p = 0.30) differ between hormone-resistant patients (97%) and those who did not receive anti-androgenic treatment (95%). In clinical practice, [{sup 11}C]choline PET/CT may not replace BS because of its lower sensitivity. However, for its high specificity, [{sup 11}C]choline PET/CT positive findings may accurately predict the presence of BM. Equivocal findings are more frequent in BS than [{sup 11}C]choline PET

  1. Diagnostic Significance of Lumbar Spine Bone Metastases by 64 Slice Spiral CT and Whole Body Bone Imaging%64层螺旋CT与全身骨显像对腰椎骨转移瘤的诊断意义

    Institute of Scientific and Technical Information of China (English)

    宋世祥

    2014-01-01

    目的:探讨64层螺旋CT与99Tcm-MDP全身骨显像对腰椎骨转移瘤的诊断意义。方法回顾性分析临床确诊腰椎骨转移瘤且资料完整的住院诊治27例患者49处腰椎骨转移瘤,总结分析27例患者的64层螺旋CT与99Tcm-MDP全身骨显像检查结果。比较两种检查结果的灵敏度及特异性。结果经64层螺旋CT检查示,27例患者有41处腰椎锥体破坏;经99Tcm-MDP全身骨显像检查示,23例患者有31处腰椎椎体放射性异常浓集,27例患者发现椎体外多发放射性异常浓集。64层螺旋CT检查的灵敏度为83.6%,特异性为98.6%;99Tcm-MDP全身骨显像检查的灵敏度为63.2%,特异性为96.7%。经64层螺旋CT检查示,有17例明确诊断为腰椎转移瘤,10例可疑为腰椎转移瘤;经99Tcm-MDP全身骨显像检查示,有20例明确诊断为腰椎转移瘤,7例可疑为腰椎转移瘤。结论64层螺旋CT对腰椎骨转移瘤的诊断较99Tcm-MDP全身骨显像具有更高的灵敏度,但多数患者经99Tcm-MDP全身骨显像可获得较为明确的诊断。%Objective To investigate the diagnostic significance of lumbar spine bone metastases by 64 slice spiral CT and 99Tcm-MDP whole body bone imaging. Methods 27 cases of lumbar spine bone metastases with 49 places by clinical diagnosis and with complete hospitalization data were retrospectively analyzed, and the examination results of 27 cases with 64 slice spiral CT and 99Tcm-MDP whole body bone imaging were summarized and analyzed. The sensitivity and specificity of two kinds of examination results were compared. Results The examination result of 64 slice spiral CT showed that 41 vertebrae were damaged in 27 patients, the sensitivity was 83.6%, 17 cases of lumbar spine bone metastases were confirmed by 64 slice spiral CT, 10 patients were suspected. The examination result of 99Tcm-MDP whole body bone imaging showed that 31 vertebrae had radioactive anomaly concentration in 27 patients, the

  2. Clinical application value of bone turnover markers in non-small-cell lung cancer patients with bone metastases%骨转换标志物在非小细胞肺癌骨转移临床应用价值的研究

    Institute of Scientific and Technical Information of China (English)

    Zhiyu Wang; Chen Yang; Yumei Yang; Zan Shen; Hui Zhao; Yang Yao

    2011-01-01

    Objective: The purpose of this study was to assess the clinical application value of bone turnover markers in non-small-cell lung cancer (NSCLC) patients with bone metastases. Including diagnosing bone metastases, detecting bone metastatic spread. Methods: Alkaline phosphatase (AKP), β-C-terminal telopeptide of type Ⅰ collagen (β-CTx), osteocalcin (OST) and bone alkaline phosphatase (BALP) were measured in 76 patients with bone metastases from NSCLC and 44 normal people. Results: The level of AKP, β-CTx and BALP in patients with bone metastasis was significantly higher than in the normal people. Significant correlation was observed among bone turnover markers. The levels of BALP and OST were significantly correlated with the extent of bone metastasis. The patients with high-level CTx and low-level BALP had higher risk of pathologic fracture. Conclusion: In NSCLC patients with bone metastases, bone turnover markers can help to make diagnosis and evaluate the severity. It will have a wide range of use in clinical practice.

  3. PET and PET/CT with {sup 18}F-fluoride in the diagnosis of bone metastases; PET und PET/CT mit {sup 18}F-Fluorid in der Diagnostik von Knochenmetastasen

    Energy Technology Data Exchange (ETDEWEB)

    Schmiedel, B.; Palmedo, H. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Bonn (Germany)

    2006-12-15

    The exact tumor stage needs to be determined with the help of the TNM classification before the optimal therapeutic procedure for the patient is proposed. If M-staging is under question bone metastases must be excluded or be proven. Bone scintigraphy plays a major role for bone metastases screening of patients with lung cancer, prostate and breast cancer in whom osseous disease is often present. The result of bone scintigraphy has a significant impact on further therapy e.g. whether curative treatment is possible, whether operative resection or chemotherapy must be performed. PET and PET/CT with {sup 18}F sodium fluoride are new imaging modalities for the detection of bone metastases. PET with {sup 18}F fluoride allows for cross sectional imaging with high resolution in a way that is not achievable by conventional bone scintigraphy. Pharmacokinetic properties of {sup 18}F fluoride are advantageous and lead to high tracer uptake and quick renal clearance. This allows the acquisition of high quality images as early as one hour after the injection. Compared with planar whole body scintigraphy, {sup 18}F fluoride is able to detect significantly more bone metastases (especially in the vertebral column). In comparison to bone SPECT, less additional metastatic lesions are detected by bone PET. This could be demonstrated in detail for lung and prostate cancers. In a small group of patients, {sup 18}F fluoride will diagnose osseous metastatic disease in spite of a negative planar whole body scintigraphy and a negative bone SPECT. However, specificity of bone SPECT is not markedly improved by {sup 18}F fluoride PET. It seems that new camera systems like PET/CT and SPECT/CT can enhance specificity impressively by adding the CT component to exactly localize a tracer accumulation. (orig.)

  4. Assessment of National Practice for Palliative Radiation Therapy for Bone Metastases Suggests Marked Underutilization of Single-Fraction Regimens in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Rutter, Charles E., E-mail: charles.rutter@yale.edu [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Yale Cancer Center, New Haven, Connecticut (United States); Yu, James B.; Wilson, Lynn D.; Park, Henry S. [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Yale Cancer Center, New Haven, Connecticut (United States)

    2015-03-01

    Purpose: To characterize temporal trends in the application of various bone metastasis fractionations within the United States during the past decade, using the National Cancer Data Base; the primary aim was to determine whether clinical practice in the United States has changed over time to reflect the published randomized evidence and the growing movement for value-based treatment decisions. Patients and Methods: The National Cancer Data Base was used to identify patients treated to osseous metastases from breast, prostate, and lung cancer. Utilization of single-fraction versus multiple-fraction radiation therapy was compared according to demographic, disease-related, and health care system details. Results: We included 24,992 patients treated during the period 2005-2011 for bone metastases. Among patients treated to non-spinal/vertebral sites (n=9011), 4.7% received 8 Gy in 1 fraction, whereas 95.3% received multiple-fraction treatment. Over time the proportion of patients receiving a single fraction of 8 Gy increased (from 3.4% in 2005 to 7.5% in 2011). Numerous independent predictors of single-fraction treatment were identified, including older age, farther travel distance for treatment, academic treatment facility, and non-private health insurance (P<.05). Conclusions: Single-fraction palliative radiation therapy regimens are significantly underutilized in current practice in the United States. Further efforts are needed to address this issue, such that evidence-based and cost-conscious care becomes more commonplace.

  5. 骨转移前列腺癌的临床诊治研究报道%Clinical features and management of prostate cancer with bone metastases: the first report of our Institute

    Institute of Scientific and Technical Information of China (English)

    Zhijian Shen; Honglin Xie; Chaojun Wang; Songliang Cai; Liping Xie; Suo Wang; Zhigen Zhang

    2008-01-01

    Objective: To summarize the experience of diagnosis and treatment outcomes for bone metastatic prostate cancer. Methods: A retrospective study with a total of 128 prostate cancer (Pca) was performed from 2000 to 2005, in our institute. We analyzed the clinical features and outcomes of patients with bone metastases and the data and follow-up of 63 bone metastases was collected by one registrar. Cochran Armitage trend test was used for statistic analysis and a P-value of < 0.05 was taken as statistically significant. Results: The mean age was 73 (range 55 to 87) years. The PSA level was from 0.083 ng/mL to 6462 ng/mL. Bone metastases morbidity had good relationship with PSA level. With the mean follow up of 30 (range 6 to 72) months for 52/63 (82.5%) patients, 15 (28.8%) died from Pea with a mean survival of 21 months and 1 patient with PSA less than 4 ng/mL at the time died from cerebrovascular suddenness 6 months post-treatment. Conclusion: The early effect of endocrine treatment for bone metastases is obvious, and palliative prostatectomy is satisfactory and able to improve the quality of life rapidly for patients with obstructive symptoms.

  6. Monitoring the response of bone metastases to treatment with Magnetic Resonance Imaging and nuclear medicine techniques: a review and position statement by the European Organisation for Research and Treatment of Cancer imaging group.

    Science.gov (United States)

    Lecouvet, F E; Talbot, J N; Messiou, C; Bourguet, P; Liu, Y; de Souza, N M

    2014-10-01

    Assessment of the response to treatment of metastases is crucial in daily oncological practice and clinical trials. For soft tissue metastases, this is done using computed tomography (CT), Magnetic Resonance Imaging (MRI) or Positron Emission Tomography (PET) using validated response evaluation criteria. Bone metastases, which frequently represent the only site of metastases, are an exception in response assessment systems, because of the nature of the fixed bony defects, their complexity, which ranges from sclerotic to osteolytic and because of the lack of sensitivity, specificity and spatial resolution of the previously available bone imaging methods, mainly bone scintigraphy. Techniques such as MRI and PET are able to detect the early infiltration of the bone marrow by cancer, and to quantify this infiltration using morphologic images, quantitative parameters and functional approaches. This paper highlights the most recent developments of MRI and PET, showing how they enable early detection of bone lesions and monitoring of their response. It reviews current knowledge, puts the different techniques into perspective, in terms of indications, strengths, weaknesses and complementarity, and finally proposes recommendations for the choice of the most adequate imaging technique.

  7. A dose-response relationship for time to bone pain resolution after stereotactic body radiotherapy (SBRT) for renal cell carcinoma (RCC) bony metastases

    Energy Technology Data Exchange (ETDEWEB)

    Jhaveri, Pavan M. [Dept. of Radiology, Section of Radiation Oncology, Baylor College of Medicine, Houston (United States); Teh, Bin S.; Paulino, Arnold C.; Blanco, Angel I.; Butler, E. Brian [Dept. of Radiation Oncology, The Methodist Hospital/The Methodist Hospital Research Inst., Houston (United States)], email: bteh@tmhs.org; Lo, Simon S. [Dept. of Radiation Oncology, Univ. Hospitals Seidman Cancer Center, Case Western Reserve Univ., Cleveland (United States); Amato, Robert J. [Dept. of Internal Medicine, Div. of Oncology, Univ. of Texas Health Sciences Center, Houston (United States)

    2012-05-15

    Background. To investigate the utility of stereotactic body radiotherapy (SBRT) in the treatment of painful renal cell carcinoma (RCC) bone metastases, and for a possible dose effect on time to symptom relief. Material and methods. Eighteen patients with 24 painful osseous lesions from metastatic RCC were treated with SBRT. The most common treatment regimens were 24 Gy in 3 fractions and 40 Gy in 5 fractions. The times from treatment to first reported pain relief and time to symptom recurrence were evaluated. Median follow-up was 38 weeks (1-156 weeks). Results. Seventy-eight percent of all patients had pain relief. Patients treated with a BED > 85 Gy achieved faster and more durable pain relief compared to those treated with a BED < 85 Gy. There was decrease in time to pain relief after a change in treatment regimen to 8 Gy x 5 fractions (BED = 86). There was only one patient with grade 1 skin toxicity. No neurological or other toxicity was observed. Conclusions. SBRT can safely and effectively treat painful RCC bony metastases. There appears to be a relationship between radiation dose and time to stable pain relief.

  8. Samario-153-Lexidronam (EDTMP en el tratamiento de las metástasis óseas Samarium-153-Lexidronam (EDTMP for the management of bone metastases

    Directory of Open Access Journals (Sweden)

    F. Torre

    2004-02-01

    Full Text Available Las metástasis óseas son una complicación frecuente en pacientes neoplásicos, en este sentido, el tejido óseo ocupa el tercer lugar de todos los órganos y sistemas con metástasis después del pulmón e hígado. Aproximadamente un 75% de los enfermos con metástasis óseas sufrirán dolor, siendo estas la causa más frecuente de dolor en pacientes con cáncer. El dolor óseo aumenta con los movimientos y a la presión, limitando la autonomía del enfermo y su calidad de vida. El tratamiento incluye varios abordajes terapéuticos complementarios entre sí, como AINE, opiáceos, bifosfonatos, radioterapia, radioisótopos, cirugía y técnicas intervencionistas. Presentamos dos casos clínicos, el primero una mujer diagnosticada de carcinoma de mama y el segundo un hombre con adenocarcinoma de próstata y carcinoma vesical, ambos casos con diseminación metastásica ósea. Ante la persistencia del dolor y la dificultad en su control fueron tratados con Samario-Lexidronam (Sm-153, Quadramet® con resultados satisfactorios. Se consiguió disminuir el dolor, también el descenso en el consumo de opiáceos a pesar de la progresión de la enfermedad. El Sm-153 es un radioisótopo emisor de radiaciones beta y gamma. Presenta una semivida física corta, una alta afinidad por el esqueleto óseo y una eliminación urinaria. El alivio del dolor es del 65-80%, el inicio de la analgesia es rápido y la duración de esta es de 8 a 12 semanas con escasos efectos secundarios.Bone metastases are a frequent complication in cancer patients. Bone tissue ranks third, after lung and liver, of all the organs and systems with metastases. Approximately 75 per cent of patients with bone metastases will suffer pain, this being the most frequent cause of pain in cancer patients. Bone pain increases with movement and pressure, restricting patient autonomy and quality of life. The treatment includes several complementary therapeutic regimes: NSAIs, opiates

  9. Comparison of diffusion-weighted whole body MRI and skeletal scintigraphy for the detection of bone metastases in patients with prostate or breast carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas; Doert, Aleksis; Froehlich, Johannes M.; Eckhardt, Boris P.; Meili, Andreas; Scherr, Patrick; Schmid, Daniel T.; Weymarn, Constantin A. von; Willemse, Edwin M.M.; Binkert, Christoph A. [Kantonsspital Winterthur, Department of Radiology, Winterthur (Switzerland); Graf, Nicole [University of Zurich, Clinical Trials Center, Center for Clinical Research, Zurich (Switzerland)

    2010-04-15

    To prospectively compare the diagnostic accuracy of diffusion-weighted whole body imaging with background whole body signal suppression (DWIBS) with skeletal scintigraphy for the diagnosis and differentiation of skeletal lesions in patients suffering from prostate or breast cancer. A diagnostic cohort of 36 patients was included in skeletal scintigraphy and 1.5 T DWIBS MRI. Based on morphology and signal intensity patterns, two readers each identified and classified independently, under blinded conditions, all lesions into three groups: (1) malignant, (2) unclear if malignant or benign and (3) benign. Finally, for the definition of the gold standard all available imaging techniques and follow-up over a minimum of 6 months were considered. Overall, 45 circumscribed bone metastases and 107 benign lesions were found. DWIBS performed significantly better in detecting malignant skeletal lesions in patients with more than 10 lesions (sensitivity: 0.97/0.91) compared to skeletal scintigraphy (sensitivity: 0.48/0.42). No statistical difference could be found between DWIBS (0.58/0.33) and skeletal scintigraphy (0.67/0.58) in the sensitivity values for malignant skeletal lesions in patients with less than 5 lesions. For benign lesions, scintigraphy scored best with a sensitivity of 0.93/0.87 compared to 0.20/0.13 for DWIBS. Interobserver agreement with Cohen's kappa coefficient was calculated as 0.784 in the case of scintigraphy and 0.663 for DWIBS. With respect to staging, in prostate and breast carcinoma, the DWIBS technique is not superior to skeletal scintigraphy, but ranks equally. However, in the cases with many bone lesions, markedly more metastases could be discovered using the DWIBS technique than skeletal scintigraphy. (orig.)

  10. Effect of a High Bone Turnover State Induced by Estrogen Deficiency on the Development and Progression of Breast Cancer Bone Metastases

    Science.gov (United States)

    2009-04-01

    Osteolysis and Implications for Therapy. Journal of Mammary Gland Biology and Neoplasia. 10(2):169-80. 3.Vessella RL, Guise TA, Susman ES, Suva LJ...JJ, Taylor SD et al. Evidence for a causal role of parathyroid hormone- related protein in the pathogenesis of human breast cancer-mediated osteolysis... parathyroid hormone-related protein and osteolytic metastases via Smad and mitogen-activated protein kinase signaling pathways. Journal of Biological

  11. 脊柱转移瘤的MRI与核素骨显像的对比研究%A Comparative Study of MRI and Bone Scintigraphy in Spinal Metastases

    Institute of Scientific and Technical Information of China (English)

    张岚; 程敬亮

    2013-01-01

      目的比较MRI与核素骨显像对脊柱转移瘤的敏感性与诊断价值。方法对51例经临床确诊的脊柱转移瘤分别行MRI和核素骨显检查,比较二者的阳性病例检出率和阳性病灶检出率。结果 MRI与骨显像对阳性病例的检出率无统计学差异,阳性病灶检出率MRI高于骨显像,有统计学差异。结论 MRI对脊柱转移瘤的检测比骨显像更为敏感,对病灶的检出能力高于骨显像,是诊断脊柱转移瘤最敏感的影像学检查方法。%Objective To compare the sensitivity and diagnostic value of MRI and bone scintigraphy in spinal metastases. Methods MRI and bone scintigraphy were performed in 51 patients with spinal metastases confirmed by clinic. The detection rate of positive case and positive lesion were compared. Results There was no difference between MRI and bone scintigraphy in detection rate of positive case. MRI was superior to bone scintigraphy in detection rate of positive lesion. Conclusion MRI was more sensitive than bone scintigraphy in detecting spinal metastases, and MRI was superior to bone scintigraphy in detection of lesions. So MRI is the most sensitive modality for diagnosis of spinal metastases.

  12. Combination of icotinib, surgery, and internal-radiotherapy of a patient with lung cancer severely metastasized to the vertebrae bones with EGFR mutation: a case report

    Directory of Open Access Journals (Sweden)

    Qu LL

    2015-06-01

    Full Text Available Li-Li Qu, Hai-Feng Qin, Hong-Jun Gao, Xiao-Qing Liu Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Science, Beijing, People’s Republic of China Abstract: A 48-year-old Chinese female was referred to us regarding EGFR-mutated advanced non-small cell lung cancer, and metastasis to left scapula and vertebrae bones which caused pathological fracture at T8 and T10 thoracic vertebrae. An aggressive combined therapy with icotinib, vertebrae operation, and radioactive particle implantation and immunotherapy was proposed to prevent paraplegia, relieve pain, and control the overall and local tumor lesions. No postoperative symptoms were seen after surgery, and the pain was significantly relieved. Icotinib merited a 31-month partial response with grade 1 diarrhea as its drug-related adverse event. High dose of icotinib was administered after pelvis lesion progression for 3 months with good tolerance. Combination therapy of icotinib, surgery, and internal radiation for metastases of the vertebrae bones from non-small cell lung cancer seems to be a very promising technique both for sufficient pain relief and for local control of the tumor, vertebrae operation can be an encouraging option for patients with EFGR positive mutation and good prognosis indicator. Keywords: lung cancer, spinal metastasis, pathological fracture, spinal canal stenosis, icotinib

  13. {sup 177}Lu-EDTMP for palliation of pain from bone metastases in patients with prostate and breast cancer: a phase II study

    Energy Technology Data Exchange (ETDEWEB)

    Agarwal, Krishan Kant; Singla, Suhas; Arora, Geetanjali; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India)

    2015-01-15

    The purpose of this study was to evaluate the efficacy and safety of {sup 177}Lu-EDTMP for pain palliation in patients with bone metastases from castration-resistant prostate and breast cancer. The secondary objective was to compare low-dose and high-dose {sup 177}Lu-EDTMP in bone pain palliation. Included in the study were 44 patients with documented breast carcinoma (12 patients; age 47 ± 13 years) or castration-resistant prostate carcinoma (32 patients; age 66 ± 9 years) and skeletal metastases. Patients were randomized into two equal groups treated with {sup 177}Lu-EDTMP intravenously at a dose of 1,295 MBq (group A) or 2,590 MBq (group B). Pain palliation was evaluated using a visual analogue score (VAS), analgesic score (AS) and Karnofsky performance score (KPS) up to 16 weeks. Toxicity was assessed in terms of haematological and renal parameters. The overall response rate (in all 44 patients) was 86 %. Complete, partial and minimal responses were seen in 6 patients (13 %), 21 patients (48 %) and 11 patients (25 %), respectively. A favourable response was seen in 27 patients (84 %) with prostate cancer and in 11 patients (92 %) with breast cancer. There was a progressive decrease in the VAS from baseline up to 4 weeks (p < 0.05). Also, AS decreased significantly from 1.8 ± 0.7 to 1.2 ± 0.9 (p < 0.0001). There was an improvement in quality of life of the patients as reflected by an increase in mean KPS from 56 ± 5 to 75 ± 7 (p < 0.0001). The overall response rate in group A was 77 % compared to 95 % in group B (p = 0.188). There was a significant decrease in VAS and AS accompanied by an increase in KPS in both groups. Nonserious haematological toxicity (grade I/II) was observed in 15 patients (34 %) and serious toxicity (grade III/IV) occurred in 10 patients (23 %). There was no statistically significant difference in haematological toxicity between the groups. {sup 177}Lu-EDTMP was found to be a safe and effective radiopharmaceutical for bone pain

  14. Differential diagnosis of osteoblastic metastases from bone islands in patients with lung cancer by single-source dual-energy CT: Advantages of spectral CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Yue, E-mail: dyy1026@sina.com [Department of Radiology, The First Affiliated Hospital of Dalian Medical University, LiaoNing 116011 (China); Zheng, Shaowei, E-mail: chouxiong@sohu.com [Department of Radiology, The First Affiliated Hospital of Dalian Medical University, LiaoNing 116011 (China); Machida, Haruhiko, E-mail: machira@dnh.twmu.ac.jp [Department of Radiology, Tokyo Women' s Medical University Medical Center East, Tokyo 116-8567 (Japan); Wang, Bing, E-mail: wangbing19831003@163.com [Department of Radiology, The First Affiliated Hospital of Dalian Medical University, LiaoNing 116011 (China); Liu, Ailian, E-mail: dmu_liuailian@126.com [Department of Radiology, The First Affiliated Hospital of Dalian Medical University, LiaoNing 116011 (China); Liu, Yijun, E-mail: yijunliu1965@126.com [Department of Radiology, The First Affiliated Hospital of Dalian Medical University, LiaoNing 116011 (China); Zhang, Xin, E-mail: zhhw2000@126.com [Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 (China)

    2015-05-15

    Highlights: • Spectral CT were useful for the follow-up of spinal lesions in patients with lung cancer. • Spectral CT were useful for more accurate differential diagnosis of OBMs and BIs. • 110 keV virtual monochromatic images were the optimal for providing this differentiation. - Abstract: Objectives: To evaluate the diagnostic efficacy of spectral CT for the differentiation of osteoblastic metastases (OBMs) from bone islands (BIs) in patients with lung cancer. Methods: In 94 patients with lung cancer who underwent spectral CT, focal hyperdense lesions in vertebral bodies were diagnosed as OBMs or BIs. Regions of interest were placed within each lesion to measure the mean CT value and its standard deviation (SD) on polychromatic single-energy CT (SECT) at 140 kVp and dual-energy virtual monochromatic spectral (VMS) images. The mean bone (D{sub bone(wa)}) and water densities (D{sub wa(bone)}) of each lesion were also measured. The slope (k) of the spectral curve was calculated. Independent-sample t-test was used to compare those values between OBMs and BIs. Receiver operator characteristic analysis was performed to compare the area under curve (AUC) for the differentiation of OBMs from BIs. Results: A total of 79 OBMs and 43 BIs were confirmed. The CT and SD values on SECT at 140 kVp and VMS images at 50–130 keV, k value, and D{sub bone(wa)} for OBMs were significantly lower than for BIs; D{sub wa(bone)} was significantly higher for OBMs than for BIs (p < 0.05 for all). The AUC for the SD value at 110 keV was the highest among those parameters. The optimal cut-off value for this differentiation was 68.6 HU for the SD value on VMS images at 110 keV with sensitivity of 93.0% and specificity of 93.3%. Conclusion: Spectral CT is helpful for the differentiation of OBMs from BIs in patients with lung cancer, particularly using SD of the CT value on high-energy VMS images.

  15. Whole-body MRI for detecting osseous metastases:comparison with bone scintigraphy%全身MRI与核素骨扫描对骨转移瘤诊断价值的对照研究

    Institute of Scientific and Technical Information of China (English)

    鲁珊珊; 王德杭; 李永军; 冯阳; 周敏林; 刘许慧

    2011-01-01

    Objective The aim of the study was to evaluate the reliability of whole-body MRI(WBMRI)in detecting osseous metastases.Methods Thirty patients verified with malignant tumor by histology were enrolled.All the patients underwent WB-MRI and bone scintigraphy(BS)with a two week interval.Clinical information,conventional MRI and CT images,and follow-up data were collected as gold standard for the diagnosis of bone metastases.The data of 30 patients and 270 segments as study unit respectively were analyzed.The sensitivity and specificity between WB-MRI and BS were compared with McNemar test.Resuits Bone metastases were confirmed in 27 of 30 patients by gold standard.Twenty-five patients with bone metastases were detected by WB-MRI and no false-positive cases.Twenty-seven patients with bone metastases were Nund by BS but having two false-positive oases.With patients as study unit,the diagnostic sensitivity of WB-MRI and BS were both 92.6%(25/27)and the specificity were 100%(3/3)and 33.3%(1/3),respectively.The area under ROC curve of WB-MRI and BS were 0.9630 and 0.6296,respectively(P>0.05).With segments as study unit,119 bone metastases segments were confirmed.The diagnostic sensitivity of WB-MRI and BS were 90.8%(108/119)and 70.6%(84/119)(P0.05).以病灶部位为单位统计显示全身MRI的敏感度、特异度分别为90.8%(108/119)、98.0%(148/151),高于骨扫描的70.6%(84/119)、90.7%(137/151)(P值均<0.01).全身MRI的ROC曲线下面积为0.9438,大于BS的0.8066(P<0.01).全身MRI同时发现3例患者存在脑转移,4例患者存在肺转移,4例患者存在肝转移.结论 全身MRI对骨转移瘤的综合诊断能力较Bs好,具有一定的临床应用价值.

  16. A Rare Case: Gastric Cancer; Involving Primery Thoracal Vertebral Metastases

    Directory of Open Access Journals (Sweden)

    Harun Arslan

    2013-06-01

    Full Text Available Primery bone metastases rarely occur in gastric cancer. Bone metastases indicate that the prognosis is bad. In that article we present a case that is diagnosed as a gastric cancer with primary bone metasteses that caused pathologic thoracal vertebral fracture seenby computer ised tomography.

  17. Prospective dosimetry with {sup 99m}Tc-MDP in metabolic radiotherapy of bone metastases with {sup 153}Sm-EDTMP

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, L.; Marzoli, L. [Azienda Ospedaliera ' ' Ospedale di Circolo di Busto Arsizio' ' , Struttura Complessa di Fisica Sanitaria, Busto Arsizio, Varese (Italy); Baroli, A. [A.O. ' ' Ospedale di Circolo di Busto Arsizio' ' , Struttura Complessa di Medicina Nucleare, Busto Arsizio, Varese (Italy); Verusio, C. [A.O. ' ' Ospedale di Circolo di Busto Arsizio' ' , Struttura Complessa di Oncologia Medica, Saronno, Varese (Italy); Chiesa, C. [Fondazione Istituto Nazionale Tumori Milano, Struttura Complessa di Medicina Nucleare, Milan (Italy); Pozzi, L. [Azienda Ospedaliera ' ' Ospedale di Circolo di Busto Arsizio' ' , Struttura Complessa di Fisica Sanitaria, Busto Arsizio, Varese (Italy)]|[Universita degli Studi di Milano, Scuola di Specializzazione di Fisica Sanitaria, Milan (Italy)

    2009-01-15

    On the basis of the encouraging results achieved in several clinical trials and its proven therapeutic efficacy, {sup 153}Sm-ethylene diamine tetramethylene phosphonic acid (EDTMP) has become widely used to palliate pain from bone metastases. The results reported in the literature have led the product suppliers (QUADRAMET registered, Schering) to suggest administering a fixed activity per kilogram (37 MBq/kg). However, considering the observed extreme inter-patient variability of skeletal uptake of {sup 153}Sm-EDTMP, a real therapy optimization would require the individualization of the activity to be administered on a dosimetric basis. This should be planned taking into account the generally accepted 2-Gy dose constraint to the haematopoietic red marrow, the critical organ in palliative treatments with beta-emitting, bone-seeking radiopharmaceuticals. Seven to 14 days before treatment with {sup 153}Sm-EDTMP, 44 patients underwent {sup 99m}Tc-methylene diphosphonate (MDP) total-body bone scan with two scans (the first within 10 min of injection, the second after 6 h). The percentage bone uptake (Tc{sub %}) was evaluated as the ratio between total counts at 6 h, adjusted for decay, and total counts at the first scan. Tc{sub %} was then compared to Sm{sub %} similarly derived from 10-min and 24-h whole-body scans. Tc{sub %} and Sm{sub %} were compared both with and without Brenner's method for soft tissue uptake. The correlation between Tc{sub %} and Sm{sub %} was R {sup 2} = 0.81 and R {sup 2} = 0.88 with and without soft tissue correction, respectively. The difference between their average values was statistically significant (Sm{sub %} = 64.3 {+-} 15.2, Tc{sub %} = 56.2 {+-} 16.0; p = 0.017) with soft tissue correction, while was not statistically significant (Sm{sub %} = 68.2 {+-} 15.5, Tc{sub %} = 66.9 {+-} 14.0; p = 0.670) without soft tissue correction. The rate of retention of {sup 99m}Tc-MDP in bone provides a reliable estimate of the {sup 153}Sm

  18. 153Sm-EDTMP治療肺癌多發性骨轉移的臨床應用78例%Clinical applications of 153 Sm-EDTMP in treatment of multiple bone metastases in 78 patients with lung cancer

    Institute of Scientific and Technical Information of China (English)

    肖國有; 李黨生; 梁藝華; 姚新娟

    2001-01-01

    Objective To evaluate the effect of 153Sm-EDTMP in treating patients with lung cancer and multiple bone metastases. Methods A dose of 18.5~25.9MBq/Kg ~Sm-EDTMP was administered once a month to each patient through vein injection according to disease severity and body weight. 3 injections made up one therapy cycle. Results Pain relieves were obtained in 65 patients, with an effective rate of 83.3%. Pain relief of grade Ⅰ was observed in 19 patients (24.3%), grade Ⅱ in 46 patients (59%) and grade Ⅲ in 13 patients (16.7%0),respectively. Lesions of bone metastases disappeared or shrunk in 9 patients, with a positive rate of 11.5 %. which included 3 cases of grade I and 6 cases of grade Ⅱ , respectively. Better effects were obtained in adenocarcinoma and squamous carcinoma than in small cell lung cancer. Conclusion 153Sm-EDTMP is safe and effective in treating patients with lung cancer and multiple bone metastases.

  19. Clinical Features and Misdiagnosis Analysis of Lung Cancer with Symptoms of Bone Metastases as the First Manifestation%以骨转移症状首发的肺癌临床特征及误诊分析

    Institute of Scientific and Technical Information of China (English)

    何玉明; 李良平; 张海琳; 黄忠达

    2012-01-01

    目的 探讨以骨转移症状首发的肺癌临床特点,分析误诊原因及预后.方法 回顾分析我院2001年6月~2010年6月诊治的50例以骨转移症状首发的肺癌临床资料.结果 50例均有骨痛,20例伴神经系统症状,6例发生病理性骨折.骨转移以多发、溶骨性骨破坏为主.本组初诊时误诊46例,误诊率92%,误诊时间3d~3个月,误诊疾病前3位为腰椎间盘突出症、椎体骨质增生和原发性骨肿瘤.经手术病理确诊46例,细胞学作出恶性肿瘤诊断但未明确分型2例,影像学确诊2例.本组1年生存率为10%,中位生存期为4个月.结论 以骨转移症状为首发表现的肺癌以多发性、溶骨性骨破坏为特征,腺癌骨转移发生率高,预后差,误诊率高.临床医生对此应高度重视,以减少误诊.%Objective To discuss the clinical features of lung cancer with symptoms of bone metastases as the first manifestation and analyze misdiagnosis and prognosis factors. Methods The clinical records of SO lung cancer patients with symptoms of bone metastases as the first manifestation during June 2001 and June 2010 in our hospital were retrospectively analyzed. Results All 50 patients had bone pain, 20 suffered from neurologic symptoms and 6 had pathologic bone fracture. The main clinical features of bone metastases were multiple locations and osteolytic bone destruction. 46 cases were initially misdiagnosed, with a misdiagnosis rate of 92% , and the duration of the misdiagnosis period varied from 3 days to 3 months- The top 3 misdiagnosed diseases were lumbar disc herniation( LDH) , hyperostosis and primary bone tumors. Among the 50 cases, 46 were pathologically diagnosed, 2 were cytological diagnosed as having malignant tumors and 2 were diagnosed by imaging tests. The 1 -year survival rate of 50 patients was 10% with a mediam survival time of 4 months. Conclusion The main clinical features of lung cancer with symptoms of bone metastases as the first

  20. 前列腺癌骨转移的相关因素分析%Factors of bone metastases in prostatic cancer

    Institute of Scientific and Technical Information of China (English)

    孙杨; 王绍平

    2013-01-01

    目的研究前列腺癌患者骨转移的相关因素。方法收集2005年6月—2006年6月1年间收治的58例前列腺癌患者进行回顾性分析和随访。对年龄,术前PSA水平,Gleason评分,是否伴血尿等因素进行统计学分析。计数资料比较采用χ2检验,计量资料比较采用方差分析。结果术前PSA水平和Gleason评分两个因素的组间差异存在统计学意义,术前PSA值和Gleason评分发生骨转移组明显高于无骨转移组。而术前是否伴血尿和年龄因素,差异无统计学意义。结论前列腺癌患者术前PSA水平和术后病理Gleason评分与发生骨转移与否有关。%Objective To identify factors of bone metastases in prostatic cancer patients. Methods Between 2005 and 2006,factors of 58 prostatic cancer patients were retrospectively analyzed, including age,Gleason’s score,level of PSA and hematuria. Results The results revealed that when the PSA level increased or Gleason’s score was high, the possibility of existing bone metastasis was extremely high. Conclusions In analysis,the PSA level and Gleason’s score were independent factors.

  1. SU-E-T-588: Optimization of Imaging Following 223Ra Administration in Targeted Alpha-Emitting Radionuclide Therapy of Bone Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Benabdallah, N; Bernardini, M [Hopital Europeen George Pompidou, Paris, Ile de France (France); Desbree, A [Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-roses, Ile-de-France (France); Labriolle-Vaylet, C de [Hopital Trousseau, Paris, Ile de France (France); Franck, D [Institut de Radioprotection et de Suretu Nucleaire, Fontenay Aux Roses, Ile de France (France)

    2015-06-15

    Purpose: With a growing demand of alpha-emitting radiopharmaceuticals, especially Xofigo ({sup 223}RaCl{sub 2}) which is used in the treatment of metastatic bone disease, the optimization of dosimetry becomes necessary. Indeed, in Europe, as stated on the council directive 2013/59/euratom, exposures of target volumes for radiotherapeutic purposes shall be individually planned taking into account that doses to non-target volumes and tissues shall be as low as reasonably achievable. To that aim, the possibility of imaging {sup 223}Ra was first investigated. Methods: The experiments were conducted at the Hopital Europeen Georges Pompidou with an Infinia Hawkeye 4 gamma camera, equipped with a medium-energy collimator. Imaging parameters, such as sensibility, spatial resolution and energy spectrum, were determined using several physical phantoms with a source of 6 MBq of {sup 223}Ra. Bone metastases were modeled with a NEMA Body Phantom to investigate image degradation based on the concentration of {sup 223}Ra. Results: The acquired energy spectrum allowed to visualize several photon peaks: at 85, 154 and 270 keV. Camera sensitivity measured from the phantom study was 102.3 cps/MBq for the 85 keV ± 20 %, 89.9 cps/MBq for the 154 ± 20 % window and 65.4 cps/MBq for the 270 ± 10 % window. The spatial resolution (full-width at half-maximum) was respectively 1.7, 1.9 and 1.8 cm for the three energy windows. SPECT/CT images of NEMA Body Phantom without and with attenuation have permitted to determine the best reconstruction parameters. Conclusion: This study has demonstrated that it is possible to obtain clinically relevant information from images of {sup 223}Ra. All these results will be valuable to analyze biodistribution imaging of the radiopharmaceutical in the patient body and go further in the reconstruction of patient images in order to personalize the dosimetry.

  2. Bone Marrow Suppression by c-Kit Blockade Enhances Tumor Growth of Colorectal Metastases through the Action of Stromal Cell-Derived Factor-1

    Directory of Open Access Journals (Sweden)

    Kathrin Rupertus

    2012-01-01

    Full Text Available Background. Mobilization of c-Kit+ hematopoietic cells (HCs contributes to tumor vascularization. Whereas survival and proliferation of HCs are regulated by binding of the stem cell factor to its receptor c-Kit, migration of HCs is directed by stromal cell-derived factor (SDF-1. Therefore, targeting migration of HCs provides a promising new strategy of anti-tumor therapy. Methods. BALB/c mice (=16 were pretreated with an anti-c-Kit antibody followed by implantation of CT26.WT-GFP colorectal cancer cells into dorsal skinfold chambers. Animals (=8 additionally received a neutralizing anti-SDF-1 antibody. Animals (=8 treated with a control antibody served as controls. Investigations were performed using intravital fluorescence microscopy, immunohistochemistry, flow cytometry and western blot analysis. Results. Blockade of c-Kit significantly enhanced tumor cell engraftment compared to controls due to stimulation of tumor cell proliferation and invasion without markedly affecting tumor vascularization. C-Kit blockade significantly increased VEGF and CXCR4 expression within the growing tumors. Neutralization of SDF-1 completely antagonized this anti-c-Kit-associated tumor growth by suppression of tumor neovascularization, inhibition of tumor cell proliferation and reduction of muscular infiltration. Conclusion. Our study indicates that bone marrow suppression via anti-c-Kit pretreatment enhances tumor cell engraftment of colorectal metastases due to interaction with the SDF-1/CXCR4 pathway which is involved in HC-mediated tumor angiogenesis.

  3. 肺癌骨转移单光子发射计算机断层显像术放射性核素骨显像特点分析%Characteristics of radionucilde bone imaging in patients of lung cancer with bone metastases

    Institute of Scientific and Technical Information of China (English)

    丁正强; 殷锴; 张将

    2010-01-01

    目的 分析肺癌核素骨显像的影像特征,评估单光子发射计算机断层显像术(SPECT)放射性核素骨显像诊断肺癌骨转移的临床价值.方法 177例确诊为肺癌的患者进行99mTc-MDP骨显像检查,对骨转移的症状、部位、数量与病理类型进行回顾性分析.结果 肺癌骨转移发生率为45.8%(81/177),其中多发性骨转移69例,占骨转移者的85.2%(69/81).腺癌骨转移发生率为69.0%(40/58),鳞癌为41.3%(19/46),小细胞癌为32.5%(13/40),未分化癌为27.3%(9/33),腺癌骨转移发生率与其他类型癌骨转移发生率比较差异有统计学意义(P<0.05);共发现转移灶526处,部位以胸部为最多,共212处(40.3%),其他依次为脊柱168处(31.9%)、盆腔73处(13.9%)、四肢62处(11.8%)、颅骨11处(2.1%).结论 肺癌骨转移以多发病灶较为常见,部位以胸部、脊柱多发.腺癌骨转移发生率最高.肺癌患者应常规进行放射性核素骨显像,这对疾病的分期、治疗方案的选择、预后评估均有重要意义.%Objective To explore radionuclide bone imaging characteristics of lung cancer patients and evaluate the clinical significance of bone imaging in the diagnosis of lung cancer patients with bone metastases.Methods One hundred and seventy-seven patients with diagnosed lung cancer were examined by 99mTc -MDP bone imaging,and the symptoms,sites,quantity and pathological types of bone metastases were reviewed and analyzed.Results Total bone metastases ratio of lung cancer was 45.8%(81/177),and 85.2 % (69/81) patients had multiple bone metastases.There was a statistical significance of bone metastases in adenocarcinoma patients (69.0%,40/58),compared with patients of other types of lung cancer[squamous cell cancer (41.3%,19/46),small cell cancer ( 32.5%,13/40),undifferentiated carcinoma ( 27.3%,9/33)](P<0.05).Bone metastases happened in 526 places: thoracic bones 212 places (40.3%),vertebras 168 places (31.9%),pelvic bones 73 places (13

  4. Evaluation of bone-seeking novel radiotracer {sup 68}Ga-NO2AP-Bisphosphonate for the detection of skeletal metastases in carcinoma breast

    Energy Technology Data Exchange (ETDEWEB)

    Passah, Averilicia; Tripathi, Madhavi; Ballal, Sanjana; Yadav, Madhav Prasad; Kumar, Rajeev; Chakraborty, Partha Sarathi; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, Ansari Nagar, New Delhi (India); Roesch, Frank; Meckel, Marian [Johannes-Gutenberg-University, Nuclear Chemistry, Mainz (Germany)

    2017-01-15

    The successful labelling of bisphosphonates (BP) with {sup 68}Ga using macrocyclic chelators such as the based triazacyclononane (NO2AP) is a step forward in the in-house availability of a novel bone-seeking PET radiopharmaceutical with dual advantage of PET/CT imaging and generator production. In this study, we compared the novel generator-based skeletal radiotracer {sup 68}Ga-1,4,7-triazacyclonone-1,4-diacetic acid ({sup 68}Ga-NO2AP-BP) with sodium fluoride ({sup 18}F-NaF) for the detection of skeletal metastases in breast cancer patients. In addition, dosimetric analysis of {sup 68}Ga-NO2AP-BP was performed in a subset of patients. This was a prospective study of histopathologically proven cases of breast cancer patients who were referred for bone scintigraphy and underwent positron emission tomography/computed tomography (PET/CT) with {sup 18}F-NaF and {sup 68}Ga-NO2AP-BP within a week in random order. The scans of each patient were compared both qualitatively for image quality and quantitatively for number of lesions and SUVmax of lesions. Dosimetric analysis was performed in five patients. Their PET/CT scans were acquired at multiple time points and urine and blood samples were collected. Dosimetric calculations were performed using OLINDA/EXM 1.1 software. Statistical analysis was done using Stata 13 (StataCorp) software package. An agreement analysis regarding number of lesions detected with the two skeletal radiotracers was carried out. The image quality of {sup 68}Ga-NO2AP-BP PET/CT scans were comparable to that of {sup 18}F-NaF. There was no statistically significant difference in the SUVmax of lesions, normal bone and lesion to background ratio between the two skeletal radiotracers. There was good agreement in the number of lesions detected by both skeletal radiotracers. The mean whole body effective dose for {sup 68}Ga-NO2AP-BP was 0.00583 mSv/MBq and the effective dose equivalent was 0.0086 mSv/MBq. The excellent lesion detection agreement between

  5. Correlational study on the levels of serum CA153 and CEA and bone metastases of breast cancer%血清CA153、CEA水平与乳腺癌骨转移的相关性研究

    Institute of Scientific and Technical Information of China (English)

    黎秀月; 张军一; 陈晓华; 陈旭坚; 曹小龙; 陈逢生; 罗荣城

    2012-01-01

    Objective To explore the predictive value of serum tumor levels of carbohrdyate antigen (CA) 153 and carcinoembryonic antigen (CEA) for bone metastases of breast cancer patients. Methods The serum levels of CA153 and CEA in 39 patients were determined before and after diagnosis of bone metastases by enzyme linked immunosorbent assay (ELISA). Results Serum levels of CA153 and CEA before and after metastases showed significant differences, which also showed significant correlation with bone metastases. Serum levels of CA153 in patients with human epidermal growth factor receptor 2 (HER - 2) ( - ), before menopause, stage Ⅲ - IV and bone metastatic regions>5 showed significant differences afier metastases (p5, ectosteal bone metastatic region5, epidermal receptor (ER)( - ), ER( + ), PR(-), PR( + ) were significantly increased, and showed significant correlation with bone metastases ( P < 0.05). Conclusion The increase of tumor serum levels of CA153 and CEA is correlated with the bone metastases of breast cancer and it is thus of predictive value.%目的 探索血清肿瘤标志物CA153、CEA对乳腺癌患者骨转移的预测价值.方法 采用酶联免疫吸附法,测定39例乳腺癌患者骨转移前后肿瘤标志物CA153、CEA的血清水平.结果 骨转移前后血清CA153、CEA水平有显著性差异,且与乳腺癌骨转移有显著的相关性.HER-2(-)、绝经前、Ⅲ~Ⅳ期、骨转移区域数>5乳腺癌患者骨转移后CA153水平显著升高(P<0.05).HER-2( -)、Ⅲ~Ⅳ期、骨转移区域数>5、骨外转移区域数<1、PR阴性乳腺癌患者血清CA153水平与骨转移有显著相关性(P<0.05).HER-2(-)、绝经后、Ⅱ期、滑转移区域数≤5、骨外转移区域数>5、ER阴性、ER阳性、PR 阴性、PR阳性乳腺癌患者,骨转移后CEA水平升高,且与骨转移有显著相关性(P<0.05).结论 血清肿瘤标志物CA153、CEA水平升高与乳腺癌骨转移有一定的相关性,对乳腺癌骨转移有一定的预测价值.

  6. Application of large field diffusion-weighted imaging in the detection of bone metastases of malignant tumors: comparison with bone scintigraphy%大范围扩散加权成像检测恶性肿瘤骨转移瘤:与骨扫描相对照

    Institute of Scientific and Technical Information of China (English)

    张春燕; 任转琴; 孙洪跃; 王霄英; 蒋学祥

    2009-01-01

    Objective To evaluate large field diffusion-weighted imaging (DWI) in detection of bone metastases of malignant tumors. Methods Eighteen patients with various malignant tumors were enrolled in this study. All the patients underwent large field DWI and 99mTc-MDP bone scintigraphy within one month. Results Fifteen of 18 patients were diagnosed as bone metastases with conventional MRI; 7 of them were found more than 10 bone metastases, and 23 bone metastases were confirmed in the other 8 patients. When seven patients with multiple bone metastases (>10) were excluded, and lesions in the residual 11 patients with or without bone metastases were counted, the diagnostic sensitivity of bone metastases with large field DWI and bone scintigraphy was both 100%, and specificity were 100% and 33.33%, respectively. ROC study showed the area under curve (AUC) of large field DWI and bone scintigraphy were 1.00 and 0.67, respectively (P=0.04). With lesion numbers as study unit, the diagnostic sensitivity of large field DWI and bone scintigraphy were 86.96% and 78.26%, and the specificity was both 60.00%. ROC study showed the AUC of large field DWI and bone scintigraphy was 0.74, 0.69, respectively; and no statistical difference was found. Conclusion Large field DWI can be used in screening the bone metastases of malignant tumors.%目的 评价大范围扩散加权成像(DWI)在恶性肿瘤骨转移瘤检测中的应用.方法 18例手术证实的各种恶性肿瘤患者纳入本研究.所有患者均在1个月内同时接受大范围DWI检查和99mTc-MDP骨扫描检查. 结果 18例患者中,15例经常规MRI证实存在骨转移瘤,其中7例为多发骨转移瘤(>10处),另8例共证实23处转移瘤;余3例未见转移瘤.除外7例全身多发骨转移瘤(>10处)患者,对其余11例有(8例)或无(3例)骨转移瘤患者计数病灶数,以患者为单位计算的大范围DWI和骨扫描诊断骨转移瘤的敏感性均为100%,特异性分别为100%、33.33%;

  7. Distribution Features of Skeletal Metastases: A Comparative Study between Pulmonary and Prostate Cancers.

    Directory of Open Access Journals (Sweden)

    Changyin Wang

    Full Text Available Bone scintigraphies are widely applied for detecting bone metastases. The aim of this study was to investigate distribution features of bone metastases in pulmonary and prostate cancers. Bone scintigraphies were performed in 460 patients with pulmonary cancer and 144 patients with prostate cancer. Patients were divided into three groups according to the total number of bone metastases: few bone metastases, moderate bone metastases, and extensive bone metastases. We compared the distribution of bone metastases in the two cancers, and analyzed the relationship between the distribution of metastatic lesions and their metastatic patterns. A total of 2279 and 2000 lesions of bone metastases were detected in 258 patients with pulmonary cancer and 102 patients with prostate cancer, respectively. In patients with few bone metastases, the distributions of metastatic lesions in the vertebrae (χ2 = 16.0, P = 0.000 and thoracic bones (χ2 = 20.7, P = 0.002 were significantly different between pulmonary and prostate cancers. In cases with moderate bone metastases, the distributions in the vertebrae (χ2 = 6.6, P = 0.010, pelvis (χ2 = 15.1 P = 0.000, and thoracic bones (χ2 = 38.8, P = 0.000 were also significantly different between the two cancers. However, in patients with extensive bone metastases, the distributions were very similar. As the total number of bone metastases increased, their distribution in pulmonary cancer did not noticeably change, but the distribution in the vertebrae and thoracic bones of prostate cancer patients significantly changed. Accordingly, the distribution characteristics of bone metastases differed in pulmonary and prostate cancers, mainly in the early stages of metastasis.

  8. Diagnostic value of whole-body MRI and bone scintigraphy in the detection of osseous metastases in patients with breast cancer - a prospective double-blinded study at two hospital centers; Diagnostischer Stellenwert der Ganzkoerper-MRT und der Skelettszintigrafie in der ossaeren Metastasendetektion bei Mammakarzinompatientinnen - eine prospektive Doppelblindstudie an zwei Klinikzentren

    Energy Technology Data Exchange (ETDEWEB)

    Ohlmann-Knafo, Susanne; Pickuth, D. [Caritasklinik St. Theresia, Akademisches Lehrkrankenhaus der Univ. des Saarlandes, Saarbruecken (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Kirschbaum, M. [Caritasklinik St. Theresia, Akademisches Lehrkrankenhaus der Univ. des Saarlandes, Saarbruecken (Germany). Klinik fuer Gynaekologie und Geburtshilfe, Brustzentrum Saar Mitte; Fenzl, G. [Knappschaftskrankenhaus Puettlingen (Germany). Inst. fuer Radiologie und Nuklearmedizin

    2009-03-15

    The purpose of this study was to compare the diagnostic accuracy of whole-body MRI (WB-MRI) and bone scintigraphy (BS) for the screening of bone metastases for the first time in a large and homogeneous patient collective with breast cancer in a systematic and controlled study. 213 breast cancer patients were evaluated for bone metastases under randomized, double-blinded and prospective conditions at two hospitals. All participants were examined by WB-MRI and BS over an average period of four days. The examinations were performed separately at two different locations. The WB-MRI protocol included T 1-TSE and STIR sequences. WB-MRI and BS were reviewed independently by experienced radiologists and nuclear medicine specialists in a consensus reading. In 66 % of cases bone metastases were excluded by both procedures, and bone metastases were detected concordantly in 2 % of cases. In 7 % of cases there were discrepant results: in 7 cases BS was false-positive when WB-MRI was negative. In 5 / 7 cases BS was negative when WB-MRI identified bone metastases. In 89 % of cases BS was uncertain when WB-MRI was true-negative. In 17 % of cases WB-MRI showed important (non-) tumor-associated findings. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy for WB-MRI were 90 %, 94 %, 82 %, 98 % and 99 % and for BS those were 40 %, 81 %, 36 %, 91 % and 93 %. (orig.)

  9. Inhibition of calcitonin gene-related peptide and insulin-like growth factor: a potential new therapeutic strategy to reduce bone pain in bone metastases of breast cancer%抑制降钙基因相关肽和胰岛素样生长因子:一种减轻乳腺癌骨转移患者骨痛的新策略

    Institute of Scientific and Technical Information of China (English)

    梁燕

    2010-01-01

    @@ 2009年圣·安东尼奥会议上,Teruhisa Sakurai等作了题名为"Inhibition of calcitonin gene-related peptide and insulin-like growth factor:a potential new therapeutic strategy to reduce bone pain in bone metastases of breastcancer"的报告.

  10. A practical approach for the validation of sterility, endotoxin and potency testing of bone marrow mononucleated cells used in cardiac regeneration in compliance with good manufacturing practice

    Directory of Open Access Journals (Sweden)

    Gola Mauro

    2009-09-01

    Full Text Available Abstract Background Main scope of the EU and FDA regulations is to establish a classification criterion for advanced therapy medicinal products (ATMP. Regulations require that ATMPs must be prepared under good manufacturing practice (GMP. We have validated a commercial system for the determination of bacterial endotoxins in compliance with EU Pharmacopoeia 2.6.14, the sterility testing in compliance with EU Pharmacopoeia 2.6.1 and a potency assay in an ATMP constituted of mononucleated cells used in cardiac regeneration. Methods For the potency assay, cells were placed in the upper part of a modified Boyden chamber containing Endocult Basal Medium with supplements and transmigrated cells were scored. The invasion index was expressed as the ratio between the numbers of invading cells relative to cell migration through a control insert membrane. For endotoxins, we used a commercially available system based on the kinetic chromogenic LAL-test. Validation of sterility was performed by direct inoculation of TSB and FTM media with the cell product following Eu Ph 2.6.1 guideline. Results and discussion The calculated MVD and endotoxin limit were 780× and 39 EU/ml respectively. The 1:10 and 1:100 dilutions were selected for the validation. For sterility, all the FTM cultures were positive after 3 days. For TSB cultures, Mycetes and B. subtilis were positive after 5 and 3 days respectively. The detection limit was 1-10 colonies. A total of four invasion assay were performed: the calculated invasion index was 28.89 ± 16.82% (mean ± SD. Conclusion We have validated a strategy for endotoxin, sterility and potency testing in an ATMP used in cardiac regeneration. Unlike pharmaceutical products, many stem-cell-based products may originate in hospitals where personnel are unfamiliar with the applicable regulations. As new ATMPs are developed, the regulatory framework is likely to evolve. Meanwhile, existing regulations provide an appropriate structure for

  11. Comparison of hybrid {sup 68}Ga-PSMA PET/MRI and {sup 68}Ga-PSMA PET/CT in the evaluation of lymph node and bone metastases of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Freitag, Martin T.; Roethke, Matthias; Schlemmer, Heinz-Peter [German Cancer Research Center, Department of Radiology, Heidelberg (Germany); Radtke, Jan P. [German Cancer Research Center, Department of Radiology, Heidelberg (Germany); University Hospital Heidelberg, Department of Urology, Heidelberg (Germany); Hadaschik, Boris A. [University Hospital Heidelberg, Department of Urology, Heidelberg (Germany); Kopp-Schneider, A. [German Cancer Research Center, Department of Bioinformatics and Statistics, Heidelberg (Germany); Eder, Matthias; Kopka, Klaus [German Cancer Research Center, Division of Radiopharmaceutical Chemistry, Heidelberg (Germany); Haberkorn, Uwe [University Hospital Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany); German Cancer Research Center, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); Afshar-Oromieh, Ali [University Hospital Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany)

    2016-01-15

    To evaluate the reproducibility of the combination of hybrid PET/MRI and the {sup 68}Ga-PSMA-11 tracer in depicting lymph node (LN) and bone metastases of prostate cancer (PC) in comparison with that of PET/CT. A retrospective analysis of 26 patients who were subjected to {sup 68}Ga-PSMA PET/CT{sub low-dose} (1 h after injection) followed by PET/MRI (3 h after injection) was performed. MRI sequences included T1-w native, T1-w contrast-enhanced, T2-w fat-saturated and diffusion-weighted sequences (DWI{sub b800}). Discordant PET-positive and morphological findings were evaluated. Standardized uptake values (SUV) of PET-positive LNs and bone lesions were quantified and their morphological size and conspicuity determined. Comparing the PET components, the proportion of discordant PSMA-positive suspicious findings was very low (98.5 % of 64 LNs concordant, 100 % of 28 bone lesions concordant). Two PET-positive bone metastases could not be confirmed morphologically using CT{sub low-dose}, but could be confirmed using MRI. In 12 of 20 patients, 47 PET-positive LNs (71.9 %) were smaller than 1 cm in short axis diameter. There were significant linear correlations between PET/MRI SUVs and PET/CT SUVs in the 64 LN metastases (p < 0.0001) and in the 28 osseous metastases (p < 0.0001) for SUV{sub mean} and SUV{sub max}, respectively. The LN SUVs were significantly higher on PET/MRI than on PET/CT (p{sub SUVmax} < 0.0001; p{sub SUVmean} < 0.0001) but there was no significant difference between the bone lesion SUVs (p{sub SUVmax} = 0.495; p{sub SUVmean} = 0.381). Visibility of LNs was significantly higher on MRI using the T1-w contrast-enhanced fat-saturated sequence (p = 0.013), the T2-w fat-saturated sequence (p < 0.0001) and the DWI sequence (p < 0.0001) compared with CT{sub low-dose}. For bone lesions, only the overall conspicuity was higher on MRI compared with CT{sub low-dose} (p < 0.006). Nodal and osseous metastases of PC are accurately and reliably depicted by hybrid PET

  12. The value analysis of bone metabolic markers CTx, OST, BAP and PINP for bone metastases in breast cancer patients%骨代谢标志物CTx、OST、BAP和PINP在乳腺癌骨转移患者血清中的变化

    Institute of Scientific and Technical Information of China (English)

    赵晖; 王智煜; 杨玉妹; 郑研; 宁琳琳; 李洪涛; 姚阳

    2012-01-01

    Background and purpose: The tumor cell of bone metastascs in cancer produces cell factors in The roie of The osteoblast and osteociasT, destroying The normal bone metabolism mechanism, cause bone metabolism index changes. To investigate the value of quantitative measurement of bone metabolism relevant markers in bone metastases of breast cancer .which is collagen type 1 C-telopeptide (CTx), procollagen type I N-terminal propeptide (PINP). bone specific alkaline phosphatase (BAP), and osteocalcin (OST). Methods; Collect serums of 51 cases breast cancer with bone metastases, 47 cases breast cancer without bone metastases and '14 normal controls. The blood concentrations of CTx, PINP, BAP and OST in patients with bone metastases and in control subjects were measured using radiolmmunoassay and immimochemiluminescent assay. Remits: The levels of CTx, PINP, BAP and OST increased significantly in The bone metastasis group. Results showed that there were no significant correlations between factors such as the number and nature of the bone metastases cancer and bone metabolic markers. The median survival Time was 42.90 months (95%C7: 38.02-47.78 months) for 5] patients until The end of follow-up. Time of onset of bone metastasis (since the diagnosis of breast cancer) was 63.65 month (95%C7: 37.26-90.43 months)after the diagnosis of breast cancer. Conclusion: The value of bone metabolic markers CTx, PiNP, BAP and OST were significantly higher in breast cancer patients with bone metastases, which can be used as reference index of clinical follow-up.%背景与目的:肿瘤骨转移时细胞因子作用于成骨和破骨细胞,破坏正常的骨代谢机制,导致骨代谢指标在恶性肿瘤骨转移中发生变化.本研究旨在探讨骨代谢标志物在乳腺癌骨转移患者血清中的变化,以期寻找较为可靠的临床随访指标.方法:收集51例乳腺癌骨转移患者,47例乳腺癌无骨转移患者及44例正常对照者的血清,采用放射免疫法和

  13. SPECT-CT融合图像评价原发性肝癌骨转移的增益价值%Incremental diagnostic value of SPECT­CT fusion imaging for bone metastases from primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    肇博; 左长京; 董爱生; 王小姣; 彭烨; 李晓红; 茅娟莉; 潘文舟; 徐登仁

    2014-01-01

    目的:探讨SPECT-CT融合图像评价原发性肝癌骨转移的增益价值。方法回顾性分析临床诊断为原发性肝癌、排除其他恶性肿瘤病史且行全身骨显像及局部SPECT-CT融合图像检查的254例患者的临床资料,根据患者综合表现诊断为肿瘤骨转移和无肿瘤骨转移,以手术病理或随访结果为最终诊断标准。分别计算并比较全身骨显像、SPECT-CT融合图像诊断的灵敏度、特异度、阳性预测值、阴性预测值和正确诊断百分率。结果254例患者中确诊肿瘤骨转移111例,无肿瘤骨转移143例。SPECT-CT融合图像诊断的灵敏度(93.6%)、特异度(93.7%)、阳性预测值(99%)、阴性预测值(100%)、正确诊断百分率(93.3%)均高于全身骨扫描(42.3%、74.8%、95.7%、92.5%、56.7%)。结论评价肝癌骨转移时,SPECT-CT融合图像较全身骨显像更具有增益价值。%ObjectiveTo investigate the incremental diagnostic value of SPECT-CT fusion imaging for bone metastases from primary liver cancer.MethodA total of 254 patients with primary liver cancer but without other malignancy, conifrmed by clinical, underwent routine whole-body bone scintigraphy and local SPECT-CT. Patients were divided into positive bone metastases group, negative bone metastases group and uncertain group according to the comprehensive manifestation. The ifnal diagnosis was conifrmed by clinical follow-up or surgical pathology. Sensitivity, speciifcity, positive predictive value, negative predictive value and diagnostic accuracy of WBBS and SPECT-CT for cases were computed and compared.ResultWithin 254 patients, 111 were diagnosed as positive bone metastases and other 143 patients were diagnosed as negative bone metastasis. Sensitivity, speciifcity, positive predictive value, negative predictive value, diagnostic accuracy of SPECT-CT for cases were 93.6%, 93.7%, 99.0%, 100.0%, 93.3%, respectively, much higher than those of WBBS (42

  14. SPECT/CT骨显像对肿瘤骨转移诊断的增益价值%The added diagnostic value of SPECT/CT imaging for bone metastases from malignant tumors

    Institute of Scientific and Technical Information of China (English)

    彭东; 刘学芬; 王荣辉; 黄德娟; 何燕; 潘科; 刘徽婷; 何润川

    2012-01-01

      Objective To evaluate the added diagnostic value of SPECT/CT imaging over routine planar whole body bone scintigraphy (WBBS) for bone metastases from malignant tumors. Methods Seventy eight cases with malignant tumors,who suspected for bone metastasis,underwent routine 99mTc-methylene diphosphonic acid(MDP) (740-1110MBq) WBBS, folowed by SPECT/CT imaging over the regions with indeterminate findings on WBBS. Both WBBS and bone SPECT/CT images were interpreted by two experienced nuclear medicine physicians in consensus as the positive,negative or uncertain bone metastases. The final diagnosis was comfirmed by pathology or clinical folow-up. Diagnosis was confirmed by pathology(n=8),more than two kinds of radiological imaging(MRI,CT,X-ray)(n=42) and clinical folow-up in one years(n=28). χ2-test was used to compare the differences between the two imaging methods. Results The foci of increased activity were 169 in 78 cases analyzed by WBBS. However,one of total 169 analyzed by SPECT/CT related to the contamination of 99mTc-MDP,23 related to the hyperosteogeny,10 related to the operation or external injury and 135 related to the bone lesions of the bone metastases. In 78 patients,WBBS of 55 cases matched the final diagnosis in which 22 had benign lesions and 23 had bone metastases,The definite coincidence rates were 81.8%(45/55);bone SPECT/CT images of 70 cases matched the final diagnosis in which 32 had benign lesions and 36 cases diagnosed as bone metastases,The definite coincidence rates were 97.1%(68/70). Difference in the definte coincidence rates of bone metastases between WBBS and bone SPECT/CT was statisticaly significant(χ2=4.767 , P<0.05). Conclusion bone SPECT/CT imaging provides incremental diagnostic value over routine WBBS for bone metastases from malignant tumors.%  目的探讨SPECT/CT骨显像在肿瘤骨转移诊断中的增益价值.方法对78例可疑肿瘤骨转移的患者行99mTc-MDP SPECT全身骨显像,对发现的阳性病灶

  15. Dental pulp-derived stromal cells exhibit a higher osteogenic potency than bone marrow-derived stromal cells in vitro and in a porcine critical-size bone defect model

    DEFF Research Database (Denmark)

    Jensen, Jonas; Tvedesøe, Claus; Rölfing, Jan Hendrik Duedal;

    2016-01-01

    INTRODUCTION: The osteogenic differentiation of bone marrow-derived mesenchymal stromal cells (BMSCs) was compared with that of dental pulp-derived stromal cells (DPSCs) in vitro and in a pig calvaria critical-size bone defect model. METHODS: BMSCs and DPSCs were extracted from the tibia bone...

  16. A prospective randomized trial: a comparison of the analgesic effect and toxicity of 153Sm radioisotope treatment in monotherapy and combined therapy including local external beam radiotherapy (EBRT) among metastatic castrate resistance prostate cancer (mCRPC) patients with painful bone metastases.

    Science.gov (United States)

    Baczyk, M; Milecki, P; Pisarek, M; Gut, P; Antczak, A; Hrab, M

    2013-01-01

    Bone metastases in prostate cancer constitute the most frequent cause of systemic failure in treatment, which results in numerous complications and finally leads to patient's death. Pain is one of the first and most important clinical symptoms of bone metastases and can be found among more than 80% of patients. Therefore, the most analgetic effective and simultaneously the least toxic treatment is an important point of therapeutic management in this group of patients. The aim of this prospective clinical trial was a comparison of analgetic effectiveness and toxicity of monotherapy with 153Sm isotope to combined therapy (153Sm + EBRT) among patients diagnosed with multiple painful bone metastases due to CRPC (mCRPC). 177 patients with mCRPC were included into the prospective randomised clinical trial in which 89 patients were assigned to the 153Sm isotope monotherapy, while 88 patients were assigned to the combined therapy including 153Sm isotope therapy and EBRT. All patients were diagnosed (bone scan and X-ray or/and CT or/and MRI) with painful bone metastases (bone pain intensity >= 6 according to VAS classification). The following additional inclusion criteria were established: histologically confirmed adenocarcinoma of prostate, multifocal bone metastases, no prior chemotherapy or palliative radiotherapy to bone. All patients signed informed consent.The combination of the isotope therapy with EBRT was more effective analgetic treatment than isotope therapy alone. The highest pain decline was noticed in the first weeks after treatment termination. In the whole group, a total or partial analgesic effect was observed among 154 (87%) patients while among 23 (13%) patients there was a lack of analgesic effect or even pain intensification. The results of this clinical trial demonstrated that for patients with multiple mCRPC it is recommended to combine the 153Sm isotope therapy with local EBRT because of a greater analgetic effect. It is important to note that

  17. 115例前列腺癌骨转移临床特征与预后因素分析%Clinical features and prognostic factors of patients with bone metastases from prostate cancer

    Institute of Scientific and Technical Information of China (English)

    何健; 曾昭冲; 杨平; 陈兵; 侯佳舟

    2009-01-01

    pros-tate cancer patents with bone metastases. The number of bone lesions, ALP level, Gleason's score, age and distant lymph node metastases are prognostic factors.%淋巴结转移(χ2 =12.45,P=0.000)的生存率有差异,余各项无差异.Cox模型多因素分析显示骨转移时ALP水平(χ2 =4.08,P=0.020)、诊断原发灶时Gleason评分(χ2 =4.57,P=0.044)和是否有非区域淋巴结转移(χ2 = 3.93,P=0.030)是影响预后的因素.结论 前列腺癌骨转移患者生存期较长,而骨转移时ALP水平、诊断原发灶时Glason评分和是否有非区域淋巴结转移与预后有关.

  18. BRAIN METASTASES FROM CARCINOMA OF UTERINE CERVIX

    Institute of Scientific and Technical Information of China (English)

    张国楠; 徐世强; 石宇; 樊英; 吴艳丽; 殷红; 余健; 陈毅男

    2002-01-01

    Objective: To study the mechanism, clinical characteristics, therapy regimens, and survival of cervical carcinoma metastases to the brain. Methods: We retrospectively analyzed 11 patients with brain metastases from cervical carcinoma. Results: Two cases were at stage lb, two at IIa, and seven at IIIb, respectively. Histologically, they were squamous cell carcinoma (6 cases), adeno-squamous carcinoma (2 cases), small cell carcinoma (2 cases), or adenocarcinoma (1 cases), poorly differentiated. Eight were accompanied with lung, liver, and bone metastases disease and three had no any other systemic metastases at the time of the brain metastases diagnosis. Two had controlled, and other nine were uncontrolled or progressive primary disease. The median interval from the diagnosis of the primary carcinoma to the detection of brain lesion was 14.6 months. Headache was the most common symptom of brain metastases. Eight of 11 patients developed multiple lesions and other 3 cases had a solitary lesion in brain. The patients were treated by combination of surgery and whole brain radiation therapy (WBRT) (3 cases), stereotactic radiosurgery (SRS) (3 cases), or WBRT (5 cases). The patients had a median survival of 6.6 months. Conclusion: Brain metastases are not always a late complication of cervical carcinoma. The development of the metastases is related to pathological type, poorly differentiation, and advanced stage. Surgery and SRS arc the appropriate therapy regimen for these patients.

  19. Study of radionuclide bone imaging in diagnosis of skeletal metastases in patients with lung cancer%核素骨显像对肺癌骨转移特点和规律的探讨

    Institute of Scientific and Technical Information of China (English)

    周润锁; 徐海峰; 张王峰; 刘瑶娟; 穆继珍

    2001-01-01

    AIM 99Tcm-MDP bone imaging was performe d in patients with lung cancer. Characteristics and regularity of skeletal metastases was investigated. METHODS Bone metastatic sites, quantity and different pathological types were analyzed in 140 cases of skeletal metastases patients with lung cancer in recent three years. RESULTS Total skeletal metastatic rate of lung cancer was 34.1%. Thoracic bones were the most frequent metastatic sites, spinal and pelvic bone were the next. The skeletal metastaese of adenocarcinoma, squamoca rcinoma was more easily than other types of cancer. The positive rate of bone metastasis dia g-nosed by radionuclide bone imaging was rather higher than that of X -ray and X-CT. CONCLUSION Radionuclide bone imaging should be routinely perfomerd in patients with lung cancer.%目的用99Tcm-亚甲基二膦酸盐(99Tcm-MDP)对肺癌患者进行全身核素骨显像,探讨肺癌骨转移的特点和规律. 方法收集我院近三年140例肺癌骨转移病例,对骨转移的部位、数量与病理类型进行回顾性分析. 结果肺癌骨转移率为34.1%,骨转移部位以胸部骨骼为最多,其次为脊柱和骨盆. 肺腺癌、鳞癌较其它类型肺癌更易发生骨转移.全身骨显像诊断肺癌骨转移的阳性率明显高于X线摄片与X-CT.结论全身核素骨显像对骨转移的诊断最有价值,肺癌患者应常规行全身骨显像随访.

  20. 18F-FDG PET-CT for the Detection of Bone Metastases in Patients with Non-small Cell Lung Cancer%18F-FDG PET-CT在非小细胞肺癌骨转移诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    王广丽; 杨涛; 张成琪; 宋吉清; 邓凯

    2011-01-01

    目的 探讨非小细胞肺癌(NSCLC)骨转移的的特点及 18F-脱氧葡萄糖正电子发射计算机断层摄影术(18F-FDG PET-CT)对NSCLC骨转移的诊断价值.资料与方法 回顾性分析114例经病理证实的NSCLC患者的临床资料和18F-FDG PET-CT显像结果,并与CT结果进行对比.结果 NSCLC骨转移率为25.44%(29/114),其中腺癌36.21%(21/58),鳞癌14.89%(7/47),混合癌14.29%(1/7),2例大细胞肺癌患者未发生骨转移;共有骨转移病灶103处,骨转移好发部位为肋骨(34.95%)和胸椎(33.98%),其次是骨盆(13.59%)和腰椎(13.59%).18F-FDG PET-CT显像发现101 处病灶,均呈放射性摄取增高,对NSCLC骨转移诊断的敏感性为98.06%;CT发现91处病灶,对NSCLC骨转移诊断的敏感性为88.35%;两者差别有统计学意义.结论 NSCLC中腺癌骨转移率最高,骨转移常见部位是肋骨和胸椎.18F-FDG PET-CT能发现CT所不能发现的早期NSCLC骨转移病灶,对NSCLC骨转移的正确诊断很有意义.%Objective To evaluate the clinical features of bone metastases of NSCLC and the clinical value of 1s F-FDG PET-CT in the diagnosis of bone metastases. Materials and Methods The clinical data and 18 F-FDG PET-CT imaging results of 114 cases with NSCLC were retrospectively analyzed. Results Total bone metastases ratio of NSCLC was 25.44% (29/114). Different ratios of bone metastases occurred in different histological classification of lung cancer:36.21%(21/58) in lung adenocarcinoma, 14.89% (7/47) in lung SCluamous cell carcinoma, 14.29% (1/7) in lung mixed tumor,no bone metastases has been found in the 2 case of big cell lurg cancer. There were 103 bone metastases. The most common metastatic sites were ribs(34.95% ) and thoracic vertebrae(33.98% ) ,followed with pelvis( 13.59% ) and lumber vertebrae( 13.59% ). The sensibility of18 F-FDG PET-CT and CT for detecting bone metastases were 98.06% ( 101/103) and 88.35% (91/103) respectively. The sensibility of PET CT was

  1. Potencies of oral contraceptives.

    Science.gov (United States)

    Edgren, R A; Sturtevant, F M

    1976-08-15

    Oral contraceptives are combinations of estrogens and progestogens or, in the case of the mini-pills, progestogens alone. With specific test procedures in laboratory animals or human subjects, it is possible to assign potency evaluations to the components relative to the progestational, estrogenic, or antiestrogenic activities of the progestogen or to the estrogenic potencies of the estrogenic component. It might even be possible to quantify the synergistic effects of the estrogen on the progestational agent. Unfortunately, however, it is impossible now to amalgamate such assay results into single estimates of the potencies of the combinations (either the combination products per se or the combination tablets of sequential products). For example, an over-all estrogenic potency of a combination preparation would involve the integration of contributions form the estrogen itself plus the estrogenic products of metabolism of the progestogen minus the antagonistic effect of the progestational agent, if any. These factors cannot now be quantified independently, much less merged into a single figure of clinical significance. Further, even if it were possible to produce such an estimate, it is unlikely that the evaluation would be meaningful in relation to any putative side effect or adverse reaction, i.e., the alleged thrombogenic effects of oral contraceptives cannot currently be related directly to any measure of potency that will allow prediction of these clinical conditions from laboratory models. Any evaluation of the potential of a given contraceptive to produce a specific side effect will depend upon data generated with specific regard to that adverse reaction and the individual product in question.

  2. The effects of ibandronate on OST and BAP in hepatic carcinoma with bone metastases patients%伊班膦酸钠对肝癌并骨转移骨钙素及骨碱性磷酸酶的影响

    Institute of Scientific and Technical Information of China (English)

    张囡囡; 李静; 杨舒; 曹忠书

    2016-01-01

    目的:探讨骨钙素(osteocalcin,OST)、骨碱性磷酸酶(bone alkaline phosphatase,BAP)对肝癌并骨转移的预测作用及其伊班膦酸钠对骨代谢的影响。方法收集肝癌并骨转移患者16例、肝癌并非骨转移患者22例及肝癌无转移患者20例,并予伊班磷酸钠治疗肝癌并骨转移组,检测各组及肝癌并骨转移治疗前、治疗28、56及84 d骨钙素、骨碱性磷酸酶水平,比较各组间及治疗前后其差异。结果肝癌并骨转移组、肝癌非骨转移组、无转移组血清骨钙素水平分别为31.12±4.18、13.00±6.92、10.23±1.34,骨碱性磷酸酶分别为20.11±1.65、11.41±1.25、10.78±1.35,其中骨转移组骨钙素及骨碱性磷酸酶水平较其他两组差异有统计学意义(P <0.05)。伊班膦酸钠注射液可降低肝癌骨转移组骨钙素及骨碱性磷酸酶水平,治疗后较治疗前差异有统计学意义( P <0.05)。结论骨钙素、骨碱性磷酸酶对肝癌并骨转移患者有较好的预测作用,伊班膦酸钠注射液可有效治疗骨转移瘤,机制可能与降低骨钙素及骨碱性磷酸酶相关。%Objective To investigate the prognosis of OST(osteocalcin)and BAP(bone alkaline phosphatase)for he-patic carcinoma with bone metastases patients and valuation of Ibandronate. Methods 16 patients of hepatic carcinoma with bone metastases,22 patients of hepatic carcinoma without bone metastases and 20 patients of hepatic carcinoma without metastases were collected. The hepatic carcinoma with bone metastases group was treated with Ibandronate. To observe the defferences of BAP and OST in three groups and treatment or not. Results The levels of serum OST in hepatic carcinoma with bone metastases group,hepatic carcinoma without bone metastases group and hepatic carcinoma without metastases group were 31. 12 ± 4. 18,13. 00 ± 6. 92,10. 23 ± 1. 34,respectively;And the levels of BAP in three groups were 20. 11 ± 1. 65,11. 41

  3. Dental pulp-derived stromal cells exhibit a higher osteogenic potency than bone marrow-derived stromal cells in vitro and in a porcine critical-size bone defect model

    Directory of Open Access Journals (Sweden)

    Jensen Jonas

    2016-01-01

    Full Text Available Introduction: The osteogenic differentiation of bone marrow-derived mesenchymal stromal cells (BMSCs was compared with that of dental pulp-derived stromal cells (DPSCs in vitro and in a pig calvaria critical-size bone defect model. Methods: BMSCs and DPSCs were extracted from the tibia bone marrow and the molar teeth of each pig, respectively. BMSCs and DPSCs were cultured in monolayer and on a three-dimensional (3D polycaprolactone (PCL – hyaluronic acid – tricalcium phosphate (HT-PCL scaffold. Population doubling (PD, alkaline phosphatase (ALP activity, and calcium deposition were measured in monolayer. In the 3D culture ALP activity, DNA content, and calcium deposition were evaluated. Six non-penetrating critical-size defects were made in each calvarium of 14 pigs. Three paired sub-studies were conducted: (1 empty defects vs. HT-PCL scaffolds; (2 PCL scaffolds vs. HT-PCL scaffolds; and (3 autologous BMSCs on HT-PCL scaffolds vs. autologous DPSCs on HT-PCL scaffolds. The observation time was five weeks. Bone volume fractions (BV/TV were assessed with micro-computed tomography (μCT and histomorphometry. Results and discussion: The results from the in vitro study revealed a higher ALP activity and calcium deposition of the DPSC cultures compared with BMSC cultures. Significantly more bone was present in the HT-PCL group than in both the pure PCL scaffold group and the empty defect group in vivo. DPSCs generated more bone than BMSCs when seeded on HT-PCL. In conclusion, DPSCs exhibited a higher osteogenic potential compared with BMSCs both in vitro and in vivo, making it a potential cell source for future bone tissue engineering.

  4. The added diagnostic value of SPECT/CT imaging for bone metastases from lung cancer%SPECT/CT骨显像对肺癌骨转移诊断的增益价值

    Institute of Scientific and Technical Information of China (English)

    张一秋; 石洪成; 顾宇参; 陈曙光; 修雁; 李蓓蕾; 朱玮珉; 余浩军

    2011-01-01

    Objective To investigate the added diagnostic value of SPECT/CT imaging over routine planar whole-body bone scintigraphy (WBBS) for bone metastases from lung cancer. Methods One hundred and forty-six patients with lung cancer, confirmed by pathological examination, underwent routine 99Tcm-MDP (1110 MBq) WBBS, followed by SPECT/CT over the regions with indeterminate findings on WBBS. Both WBBS and bone SPECT/CT images were interpreted by two experienced nuclear medicine physicians in consensus as the positive, negative or uncertain bone metastases. The final diagnosis was comfirmed by pathology or clinical follow-up. x2 test was used to compare the differences between the two imaging methods. Results Finally, 45 patients were diagnosed as positive bone metastases and the other 101 as negative. The diagnostic sensitivity of bone SPECT/CT for bone metastases from lung cancer was 93.3%(42/45), singnificantly higher than that of WBBS (64.4%, 29/45) (x2 = 19.944, P<0.05). The diagnostic accuracy of bone SPECT/CT was 89.7% ( 131/146), much higher than that of WBBS (44.5%,65/146) ( x2 = 69. 598,P < 0.05). The uncertain and incorrect diagnostic rates of bone SPECT/CT and WBBS were 10.3% ( 15/146, raging from 5.3% to 15.2% with 95% confidence interval (CI) ) and 55.5% (81/146, raging from 47. 4% to 63.5% with95% CI), respectively. Conclusion BoneSPECT/CT provides incremental diagnostic value over routine WBBS for bone metastases from lung cancer.%目的 探讨SPECT/CT骨显像在肺癌骨转移诊断中的增益价值.方法 146例病理证实为肺癌的患者,静脉注射99Tcm-MDP1110 MBq,3~6 h后按常规方法行全身骨显像.由1位资深核医学科医师分析全身骨显像图像后,决定是否行SPECT/CT显像以及显像视野范围,然后采集SPECT和CT图像.由2位核医学科医师先对全身骨显像的平面图像进行分析,然后分析SPECT/CT融合图像并诊断,诊断分为肿瘤骨转移、无肿瘤骨转移和不能确定.根据术后病

  5. Psychology and related factor in bone metastases cancer with pain%多发骨转移癌疼痛患者心理调查及相关因素研究

    Institute of Scientific and Technical Information of China (English)

    杨胜利; 袁彬; 平焕侠; 孙英; 许建林; 施常备

    2014-01-01

    Objective:To explore the psychology and intervention of the bone metastases patients with pain.Meth-ods:All 101 patients with bone metastases cancer were investigated by SAS(Self-Rating Anxiety Scale)and SDS (Self-Rating Depression Scale ).Results:All patients have tension and depression.Pure pain:SAS:81.20%, 89.70%,95.30%,SDS:87.10%,92.30%,97.50%.Spinal cord injury paresthesia to feel abnormal activities:SAS:71.00%,SDS:89.70%.Conclusion:All patients with bone metastases cancer have obvious problems of psycho-analy,particuly those with pain,spinal cord injury paresthesia to feel abnormal activities.%目的:探讨多发骨转移癌疼痛患者的心理状况。方法:采用临床焦虑自评量表(SAS)及抑郁量表(SDS)调查101例多发骨转移癌患者的心理状况。结果:所有多发骨转移患者均不同程度存在焦虑和抑郁。其中单纯疼痛者轻、中、重度分别为SAS:81.20%、89.70%、95.30%,SDS:87.10%、92.30%、97.50%。伴有脊髓损伤感觉异常和行动障碍者SAS:71.00%,SDS:89.70%。结论:多发骨转移癌患者存在明显心理障碍,尤其是存在疼痛、感觉异常和肢体活动障碍者,更应给予心理帮助和指导。

  6. Cost-Effectiveness Analysis of Single Fraction of Stereotactic Body Radiation Therapy Compared With Single Fraction of External Beam Radiation Therapy for Palliation of Vertebral Bone Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hayeon, E-mail: kimh2@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Rajagopalan, Malolan S.; Beriwal, Sushil; Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania (United States); Smith, Kenneth J. [Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (United States)

    2015-03-01

    Purpose: Stereotactic body radiation therapy (SBRT) has been proposed for the palliation of painful vertebral bone metastases because higher radiation doses may result in superior and more durable pain control. A phase III clinical trial (Radiation Therapy Oncology Group 0631) comparing single fraction SBRT with single fraction external beam radiation therapy (EBRT) in palliative treatment of painful vertebral bone metastases is now ongoing. We performed a cost-effectiveness analysis to compare these strategies. Methods and Materials: A Markov model, using a 1-month cycle over a lifetime horizon, was developed to compare the cost-effectiveness of SBRT (16 or 18 Gy in 1 fraction) with that of 8 Gy in 1 fraction of EBRT. Transition probabilities, quality of life utilities, and costs associated with SBRT and EBRT were captured in the model. Costs were based on Medicare reimbursement in 2014. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and effectiveness was measured in quality-adjusted life years (QALYs). To account for uncertainty, 1-way, 2-way and probabilistic sensitivity analyses were performed. Strategies were evaluated with a willingness-to-pay (WTP) threshold of $100,000 per QALY gained. Results: Base case pain relief after the treatment was assumed as 20% higher in SBRT. Base case treatment costs for SBRT and EBRT were $9000 and $1087, respectively. In the base case analysis, SBRT resulted in an ICER of $124,552 per QALY gained. In 1-way sensitivity analyses, results were most sensitive to variation of the utility of unrelieved pain; the utility of relieved pain after initial treatment and median survival were also sensitive to variation. If median survival is ≥11 months, SBRT cost <$100,000 per QALY gained. Conclusion: SBRT for palliation of vertebral bone metastases is not cost-effective compared with EBRT at a $100,000 per QALY gained WTP threshold. However, if median survival is ≥11 months, SBRT costs ≤$100

  7. Bone Metastases of Differentiated Thyroid Carcinoma: Could 99mTc-bone Scintigraphy be Substituted with Whole-body 18F-FDG SPECT%分化型甲状腺癌骨转移:18F-FDG SPECT显像能否取代全身骨显像

    Institute of Scientific and Technical Information of China (English)

    叶智轶; 王辉; 杜学亮; 傅宏亮

    2012-01-01

    Objective The purpose of this study was to compare 18 F-FDG SPECT and 99mTc-bone scintigraphy in the detection of bone metastases of DTC. Methods In this retrospective study, 17 bone metastastic DTC patients treated by radioiodine from January 2005to January 2009 were reviewed. 8 males and 9 females, age range 46 ~82. 8 had papillary carcinoma and 9 had follicular carcinoma. 7 were proved clinically or pathologically to have bone metastases only and 10 have bone metastases with lymph node and/or pulmonary metastases as well. All the patients underwent both 18 F-FDG SPECT and 99m Tc-bone scintigraphy from 2to10 days before the ra-dioiodine therapy to detect bone metastases. Statistical analysis was performed with SPSS11.0, and Chi-square test was used. Results There were overall 70 bone metastastic lesions confirmed in 17 patients. In evaluating the detection of bone metastases, 18F-FDG SPECT showed 71.34% (50/70) sensitivity, 97.76% (131/134) specificity and 88. 73% (181/204) accuracy, compared with 62.86% (44/70) , 91.04% (122/134) and 81.37% (166/204) , respectively, for bone scintigraphy. The sensitivity of 18F-FDG SPECT was similar to that of bone scintigraphy, this difference was not statistically significant( t = 1.17,P>0.05). While the specificity and accuracy of 18F-FDG SPECT were statistically significantly higher than those of bone scintigraphy(t =5.72,P<0.05)and(t = 4.34,P <0.05)individually. Conclusion This study suggested that "F-FDG SPECT has a higher specificity and a better accuracy than that of bone scintigraphy to detect bone metastases in patients with DTC. But bone scintigraphy was superior to 18F-FDG SPECT in tne detection of osteoblastic lesions. Thus bone scintigraphy should play a complementary role in detecting bone metastaaes with 18F-FDG SPECT and could not be replaced by it.%目的:比较18F-脱氧葡萄糖(FDG)SPECT显像和全身骨显像对于分化性甲状腺癌(DTC)骨转移灶检测能力的区别.方法:回顾性分析2005年1

  8. Clinical significance of ALP and CT in monitoring bone metastases of lung cancer%血清 ALP、CT监测肺癌骨转移的临床意义

    Institute of Scientific and Technical Information of China (English)

    韩亮

    2014-01-01

    目的:通过对肺癌患者血清碱性磷酸酶( ALP)、降钙素( CT)水平的测定,分析肺癌骨转移患者血清ALP、CT水平的变化,并评价其监测肺癌骨转移的临床意义。方法:对80例经病理或穿刺活检证实为肺癌的患者行99m锝-亚甲基二磷酸盐(99mTc-MDP)全身骨显像,根据骨转移诊断标准将肺癌患者分为未骨转移组(48例)和骨转移组(32例),并对80例肺癌患者及30例肺部良性疾病患者进行血清ALP、CT水平测定,比较各组患者间血清ALP、CT水平的变化,并通过受试者工作特征曲线( Receiver operator characteristic curve,ROC曲线)及联合检测来评价其监测肺癌骨转移的临床意义。结果:肺癌组患者血清ALP、CT水平明显高于肺部良性病变组(P<0.01);肺癌骨转移组患者血清ALP、CT水平明显高于未骨转移组(P<0.01);患者血清ALP、CT的曲线下面积(Area under the ROC curves,AUC)分别为0.715、0.760,患者血清ALP的敏感性为69.400%,特异性为79.600%,血清CT的敏感性为61.900%,特异性为84.600%;通过联合检测可将敏感度提高至85.000%,特异度提高至93.333%。结论:血清ALP、CT可作为肺癌骨转移的初筛及监测方法。%Objective:To analyze change of serum alkaline phosphatase ( ALP) and calcitonin ( CT) levels in patients with bone metastases of lung cancer and evaluate clinical significance of ALP and CT in monitoring bone metastases by measuring the levels of serum ALP and CT. Methods:80 lung cancer patients confirmed by pathology or needle biopsy were underwent 99mTc-MDP whole body bone images, and divided into non-bone metastasis group (48 persons) and bone metastasis group (32 persons) according to the criteria for the diagnosis of bone metastases. The levels of ALP and CT of 80 patients with lung cancer and 30 patients with benign lung diseases were detected and compared. The clinical significance of ALP and CT in monitoring bone metastases was evaluated by receiver

  9. Usefulness of competitive inhibitors of protein binding for improving the pharmacokinetics of {sup 186}Re-MAG3-conjugated bisphosphonate ({sup 186}Re-MAG3-HBP), an agent for treatment of painful bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, Kazuma [Kyoto University, Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto (Japan)]|[Kanazawa University, Advanced Science Research Center, Kanazawa (Japan); Mukai, Takahiro [Kyoto University, Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto (Japan)]|[Kyushu University, Graduate School of Pharmaceutical Sciences, Fukuoka (Japan); Kawai, Keiichi [Kanazawa University, Graduate School of Medical Sciences, Kanazawa (Japan)]|[University of Fukui, Biomedical Imaging Research Center, Yoshida, Fukui (Japan); Takamura, Norito [Kyushu University of Health and Welfare, School of Pharmaceutical Sciences, Nobeoka (Japan); Hanaoka, Hirofumi; Saji, Hideo [Kyoto University, Department of Patho-Functional Bioanalysis, Graduate School of Pharmaceutical Sciences, Kyoto (Japan); Hashimoto, Kazuyuki [Japan Atomic Energy Agency, Tokai-mura, Ibaraki (Japan); Shiba, Kazuhiro; Mori, Hirofumi [Kanazawa University, Advanced Science Research Center, Kanazawa (Japan)

    2009-01-15

    We have developed a {sup 186}Re-mercaptoacetylglycylglycylglycine complex-conjugated bisphosphonate ({sup 186}Re-MAG3-HBP) for the treatment of painful bone metastases. We assumed competitive inhibitors of protein binding to be useful for procuring a favorable biodistribution of {sup 186}Re-MAG3-HBP for the palliation of bone pain because it has been reported that the concurrent administration of {sup 99m}Tc-MAG3 and drugs with high affinity for serum protein produced competitive displacement at specific binding sites and enhanced total clearance and tissue distribution. The displacement effects of several protein-binding inhibitors on the protein binding of {sup 186}Re-MAG3-HBP were investigated. Biodistribution experiments were performed by intravenously administering {sup 186}Re-MAG3-HBP into rats with ceftriaxone as a competitive protein-binding inhibitor or saline. The protein binding of {sup 186}Re-MAG3-HBP in rat serum, human serum, and a human serum albumin solution was significantly decreased by the addition of ceftriaxone, which has high affinity for binding site I on serum albumin. In the biodistribution experiments, pretreatment with ceftriaxone enhanced the clearance of the radioactivity of {sup 186}Re-MAG3-HBP in blood and nontarget tissues but had no effect on accumulation in bone. The findings suggested that the use of protein-binding competitive inhibitors would be effective in improving the pharmacokinetics of radiopharmaceuticals with high affinity for serum protein. (orig.)

  10. The curative effect of zoledronic acid and pamidronic acid on treating ostealgia in malignant tumor with bone metastases and its side effects on serum calcium and phosphorus*%双膦酸盐对骨转移癌骨痛治疗及血清钙磷影响

    Institute of Scientific and Technical Information of China (English)

    Yuedi Dai; Meixing Wang; Li Tao; Anqi Li; Haixia Wu; Mi Xiao

    2011-01-01

    Objective: Bisphosphonates were widely used with the rate of malignant tumor with bone metastases increasing rapidly. The aim of this study was to evaluate zoledronic acid and pamidronic acid on treating ostealgia of malignant tumor with bone metastases and serum calcium, phosphorus and alkaline phosphorus movement. Methods: One Hundred cancer patients with bone metastases were diagnosed according to pathological and imaging methods. After zoledronic acid or pamidronic acid intravenous infusion one and two months, ostealgia degree, serum calcium, serum phosphorus and alkaline phosphorus were observed before bisphosphonates treatment, one and two months after treatment, respectively. Results:Ostealgia degree did not change significantly after diphosphonates treatment from one to two months (P > 0.05). The linear correlation between serum calcium and serum phosphorus on bone metastases cancer patients before therapy was dismissed after bisphosphonates treatment one month and did not recover in two months. The incidence of hypo-calcium after diphosphonate treatment one month (54%) and two months (56%) were significantly increased than that before treatment (36%) (x2 = 6.55, P = 0.011; x2 = 8.05, P = 0.005). Serum calcium and serum phosphorus were both decreased after treatment one month (t = 4.39, P = 0.000; t = 2.50, P = 0.014) and two months (t = 4.32, P = 0.000; t = 2.49, P = 0.010). There had no difference between zoledronic acid and pamidronic acid on treating of ostealgia and serum calcium and phosphorus changing.Conclusion: Zoledronic acid and pamidronic acid can relief ostealgia of cancer patients with bone metastases and induce hypo-calcium, break the linear relationship between calcium and phosphorus. There have no difference between zoledronic acid and pamidronic acid on treating ostealgia and inducing hypo-calcium and hypo-phosphorus.

  11. Usefulness of {sup 99m}Tc-depreotide scintigraphy for the diagnosis of bone metastases in non-small cell lung cancer stage 3-4; Apport de la scintigraphie au {sup 99m}Tc-depreotide pour le diagnostic de lesions osseuses secondaires dans le cancer bronchopulmonaire non a petites cellules stade 3-4

    Energy Technology Data Exchange (ETDEWEB)

    Costo, S.; Dunet, V.; Agostini, D.; Bouvard, G. [CHU Cote de Nacre, Service de Medecine Nucleaire et Isotopes, 14 - Caen (France); Halley, A. [Centre Havrais d' Imagerie Nucleaire, 76 - Montivilliers (France); Bergot, E.; Porret, E.; Zalcman, G. [CHU Cote de Nacre, Service de Pneumologie, 14 - Caen (France)

    2009-02-15

    Objective In non-small cell lung cancer (NSCLC), metastatic bone involvement is usually assessed using conventional {sup 99m}Tc-HMDP bone scintigraphy, which has a high sensitivity but a poor specificity. The purpose of this study was to assess the usefulness of the {sup 99m}Tc-D scintigraphy for the detection of malignant bone metastases in patients with NSCLC stage III or IV and to compare these results with {sup 99m}Tc-HMDP bone scan findings. Methods Nineteen patients (13 M and 6 F, mean age 59 years) with proven NSCLC, suspected to have stage III or IV were enrolled prospectively. All patients underwent whole body {sup 99m}Tc-HMDP and {sup 99m}Tc-D scintigraphy to detect bone metastases within a mean interval of 14 days. Each focal uptake of {sup 99m}Tc-D or {sup 99m}Tc-HMDP was considered benign or malignant, leading to positive or negative diagnosis for bone involvement. The final diagnosis of bone metastases was established by a lung specialist, on the basis of additional imaging modalities and of 12 months follow-up. Results Twelve bone lesions were identified by {sup 99m}Tc-D scintigraphy, 10 were classified as bone metastases and two were classified as inflammatory bone lesions. Four patients were metastatic. Fifty eight bone lesions were detected by {sup 99m}Tc-HMDP scintigraphy, 26 of whom were considered malignant, eight patients were thus considered metastatic. Thereby, the two nuclear medicine modalities were concordant for 13 patients, that is 68% of cases and were discordant for six patients, representing 32% of cases. Diagnostic sensitivity, specificity and accuracy of depreotide scintigraphy and {sup 99m}Tc-HMDP bone scintigraphy were 75% for both, 93.3 and 73.3%, and 89.5 and 73.3% respectively. Conclusion Our data suggest that depreotide scintigraphy with the same sensitivity, a better accuracy and specificity than those of {sup 99m}Tc-HMDP bone scan can detect metastatic bone lesions in patients with NSCLC suspected to have stage III or IV

  12. Rapid bone repair in a patient with lung cancer metastases to the spine using a novel herbal medicine: A case report

    OpenAIRE

    2016-01-01

    The prognosis of lung carcinoma with metastasis to the bone, particularly to the spine, is poor. Chemotherapy and radiotherapy are established treatments for metastatic bone disease, but their effectiveness is unsatisfactory and bone repair following their use is slow and difficult. Medicine prepared from herbal extracts may be an alternative treatment option. The present study discusses the case of a 59-year-old patient diagnosed with squamous cell lung cancer (T2N3M1) in which first-line ch...

  13. [Lymph node and distant metastases of thyroid gland cancer. Metastases in the thyroid glands].

    Science.gov (United States)

    Schmid, K W

    2015-11-01

    The different biological features of the various major entities of thyroid cancer, e.g. papillary, follicular, poorly differentiated, anaplastic and medullary, depend to a large extent on their different metastatic spread. Papillary thyroid cancer (PTC) has a propensity for cervical lymphatic spread that occurs in 20-50 % of patients whereas distant metastasis occurs in thyroid cancer (FTC) has a marked propensity for vascular but not lymphatic invasion and 10-20 % of FTC develop distant metastases. At the time of diagnosis approximately one third of medullary thyroid cancer (MTC) cases show lymph node metastases, in 10-15 % distant metastases and 25 % develop metastases during the course of the disease. Poorly differentiated (PDTC) and anaplastic thyroid cancer (ATC) spread via both lymphatic and vascular invasion. Thus distant metastases are relatively uncommon in DTC and when they occur, long-term stable disease is the typical clinical course. The major sites of distant metastases are the lungs and bone. Metastases to the brain, breasts, liver, kidneys, muscle and skin are relatively rare or even rare. The thyroid gland itself can be a site of metastases from a variety of other tumors. In autopsy series of patients with disseminated cancer disease, metastases to the thyroid gland were found in up to 10 % of cases. Metastases from other primary tumors to the thyroid gland have been reported in 1.4-3 % of patients who have surgery for suspected cancer of the thyroid gland. The most common primary cancers that metastasize to the thyroid gland are renal cell (48.1 %), colorectal (10.4 %), lung (8.3 %) and breast cancer (7.8 %) and surprisingly often sarcomas (4.0 %).

  14. Usefulness of the dimercapto succinic pentavalent acid ({sup 99m} Tc- Dmsa-V) in the diagnostic of the bone metastases illness; Utilidad del acido dimercapto succinico pentavalente ({sup 99m} Tc- DMSA-V) en el diagnostico de la enfermedad osea metastasica

    Energy Technology Data Exchange (ETDEWEB)

    Ortega L, N

    2005-07-01

    The objective of this study was to determine the utility of {sup 99m} Tc-(V)- Dmsa whole body planar scan in the diagnostic of skeletal metastases. Nineteen patients were studied, having a recent {sup 99m} Tc-HDP bone scan reporting different pathologies (3 normal scans, 5 equivocal scans and 11 with disseminated bone metastases). 72 hours later, a whole body planar scan was obtained at 3 and 24 hours after the i.v. administration of {sup 99m} Tc-(V)-Dmsa. Counts per pixel were determined in regions of interest drawn over metastases sites and in normal tissue, and were correlated with the bone scan. Statistical analysis was carried out by using the Kruskal-Wallis analysis of variance followed by Mann Whitney U test. Other comparisons were done with Momios, chi square and t Student tests. 273 lesions were studied in the whole body bone scan and 184 lesions in the {sup 99m} Tc-(V)-Dmsa scintigraphy (t Student test n.s.). The tumor to normal tissue ratios were 3.3 (+/- 0.521) and the soft to normal tissue ratios were 1.01 (+/- 0.01), Mann Whitney p< 0.01. The study sensitivity was 92% an overall specificity was 97%. As conclusions we have that {sup 99m} Tc-(V)-Dmsa scintigraphy is an useful choice in the diagnostic of bone metastases when the whole body planar bone scan ({sup 99m} Tc- HDP) is equivocal or abnormal. It also points out other lesions such as in bone and in soft tissue. (Author)

  15. Significance of serum CaN and PTHrP in lung cancer with bone metastases%血清中CaN和PTHrP测定在肺癌骨转移诊断和疗效判定中的意义

    Institute of Scientific and Technical Information of China (English)

    王华贝; 庞海林; 马丽; 刘理礼; 张贺龙

    2012-01-01

    目的:探讨血清中钙调神经磷酸酶( calcineurin,CaN)和甲状旁腺激素相关蛋白(parathyroid hormone-related protein,PTHrP)的测定对肺癌骨转移患者的诊断及临床疗效评价的意义.方法:应用ELISA法检测患者血清CaN和PTHrP浓度,并比较其浓度在肺癌骨转移未治疗患者,非骨转移患者及骨转移治疗患者中的差异.结果:骨转移未治疗组患者血清CaN和PTHrP水平均明显高于非骨转移组(P<0.01),并高于骨转移治疗组(P<0.01).结论:血清CaN和PTHrP的测定对肺癌患者骨转移的诊断及疗效评价可能具有重要意义.%Objective;To explore the clinical significance of serum Calcineurin and serum parathyroid hormone -related protein in diagnosing bone metastases of lung carcinoma and the treatment in bone metastasis of lung carcinoma. Methods: EUSA was used to detect the levels of serum CaN and PTHrP in 3 groups of lung cancer patients, without bone metastasis, before and after treatment with bone metastasis. Results;The levels of serum CaN and PTHrP in patients with bone metastases untreated were significantly increased compared with patients without bone metastases (P<0.01, and the levels of serum CaN and PTHrP in patients with bone metastases untreated were significantly higher than patients with bone metastases treated (P < 0. 01). Conclusion :The detection of serum CaN and PTHrP may be important in diagnosing bone metastasis and evaluating the effectiveness of treatment in bone metastasis of lung carcinoma.

  16. High-fat diet enhances and monocyte chemoattractant protein-1 deficiency reduces bone loss in mice with pulmonary metastases of Lewis lung carcinoma

    Science.gov (United States)

    Bone is adversely affected by metastasis and metastasis-associated complications. Obesity is a risk factor for both bone and cancer. Adipose tissue is an endocrine organ that produces pro-inflammatory adipokines, such as monocyte chemotactic protein-1 (MCP-1), that contribute to obesity and obesit...

  17. The Placorhen study : A double-blind, placebo-controlled, randomized radionuclide study with Re-186-etidronate in hormone-resistant prostate cancer patients with painful bone metastases

    NARCIS (Netherlands)

    Han, SH; de Klerk, JMH; Tan, S; van het Schip, AD; Derksen, BH; van Dijk, A; Kruitwagen, CLJJ; Blijham, GH; van Rijk, PP; Zonnenberg, BA

    2002-01-01

    Re-186-1,1-hydroxyethylidene diphosphonate (etidronate) can be used for the palliative treatment of metastatic bone pain. A randomized, placebo-controlled study using Re-186-etidronate was conducted on end-stage prostate cancer patients with metastatic bone pain. Methods: Pain relief was assessed us

  18. Evaluation of genotoxic and cytotoxic effects of {sup 153} Sm-EDTMP in peripheral blood lymphocytes of bone metastasis patients; Avaliacao dos efeitos genotoxico e citotoxico do {sup 153} Sm-EDTMP em linfocitos perifericos de pacientes com metastase ossea

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Miriam Fussae

    2003-07-01

    In this study the cellular damage in peripheral lymphocytes after exposure to {sup 153} Sm-EDTMP (Samarium-153 ethylene-diamine-tetramietylene-phosphonate) was determined using the technique of micronuclei analysis and differential coloration.{sup 153} Sm-EDTMP is a radiopharmaceutical used for pain relief in patients with bone metastases. The analysis of the frequency of micronuclei in patient blood samples obtained one hour after endovenous administration of radiopharmaceutical (41 MBq/kg) showed no statistical difference in relation to basal values in binucleated cells. However the analysis of damage distribution in mononucleated cells, showed that the patients without previous radiotherapy treatment presented a significant increase in the frequency of cells with one micronucleus and in those who had taken previous radiotherapy treatment, in cells with two or more micronuclei. The in vitro experiments conducted with the exposition of total blood to three radiation concentrations of {sup 153} Sm-EDTMP (0.370, 0.555 and 1.110 MBq/mL) during one hour showed an increase in the frequency of micronuclei and necrotic and apoptotic cells with increasing radiation dose. Dose-response curves for healthy donors and patients with bone metastasis without previous radiotherapy treatment were constructed. The comparison of the curves showed that patients presented higher radiosensitivity, either micronuclei or dead cell (necrotic or apoptotic) percentages, than healthy donors. (author)

  19. Contemporary radiooncological management of bone metastases from breast cancer: factors associated with prescription of different fractionation regimens (short or long course) in a rural part of North Norway with long travel distance

    Science.gov (United States)

    Nieder, Carsten; Dalhaug, Astrid; Haukland, Ellinor; Mannsåker, Bård; Pawinski, Adam

    2017-01-01

    ABSTRACT The aim of this study was to reduce barriers that prevent implementation of evidence-based recommendations about single-fraction palliative radiotherapy (PRT) and to demonstrate that single-fraction PRT yields similar outcomes as long-course treatment (≥10 fractions) in patients with bone metastases from breast cancer. This retrospective study (2007–2014) included 118 Norwegian female patients. All patients received guideline-conform systemic therapy including bone-targeting agents. Median survival was 12.7 months. Long-course PRT was prescribed in 60% of patients, while 21% had PRT with a single fraction of 8 Gy to at least one target. Reirradiation rate was not significantly higher after 8 Gy (9%, compared to 5% after long-course PRT and 6% after 4 Gy x5). Patients with favorable baseline characteristics such as younger age and good performance status (PS) were significantly more likely to receive long-course PRT. Biological subtype and comorbidity did not correlate with fractionation. Prognosis was influenced by biological subtype, extra-skeletal disease extent, severe anemia and abnormal CRP. The limited need for reirradiation after single fraction PRT might encourage physicians to prescribe this convenient regimen, which would improve resource utilization. Even patients with PS3 had a median survival of 3 months, which indicates that they could experience worthwhile clinical benefit.

  20. Prevalence of Prostate Cancer Metastases after Intravenous Inoculation Provides Clues into the Molecular Basis of Dormancy in the Bone Marrow Microenvironment

    Directory of Open Access Journals (Sweden)

    Younghun Jung

    2012-05-01

    Full Text Available Bone is the preferred metastasis site of advanced prostate cancer (PCa. Using an in vivo murine model of human PCa cell metastasis to bone, we noted that the majority of animals that develop skeletal metastasis have either spinal lesions or lesions in the bones of the hindlimb. Much less frequently, lesions develop in the bones of the forelimb. We therefore speculated whether the environment of the forelimb bones is not permissive for the growth of PCa. Consequently, data on tumor prevalence were normalized to account for the number of PCa cells arriving after intravascular injection, marrow cellularity, and number of hematopoietic stem cell niches. None of these factors were able to account for the observed differences in tumor prevalence. An analysis of differential gene and protein levels identified that growth arrest specific-6 (GAS6 levels were significantly greater in the forelimb versus hindlimb bone marrow. When murine RM1 cells were implanted into subcutaneous spaces in immune competent animals, tumor growth in the GAS6-/- animals was greater than in GAS6+/+ wild-type animals. In an osseous environment, the human PC3 cell line grew significantly better in vertebral body transplants (vossicles derived from GAS6-/- animals than in vossicles derived from GAS6+/+ animals. Together, these data suggest that the differences in tumor prevalence after intravascular inoculation are a useful model to study the molecular basis of tumor dormancy. Importantly, these data suggest that therapeutic manipulation of GAS6 levels may prove useful as a therapy for metastatic disease.

  1. Palliative treatment of osseous metastases; Traitement palliatif des metastases osseuses

    Energy Technology Data Exchange (ETDEWEB)

    Resche, I.; Bodere, F.; Rousseau, C.; Chatal, J.F. [Centre Regional de Lutte Contre le Cancer Rene-Gauducheau, Service de Medecine Nucleaire, 44 - Nantes (France)

    2001-11-01

    Currently, two radiopharmaceuticals are available in France to treat painful bone metastases Metastron for prostate cancers and Quadramet whatever is the primitive tumour. Efficacy is high since 70% of response is observed with 30% of complete response, allowing diminution and even withdrawal of antalgic medication. Toxicity is purely hematologic and is predictable in time, moderate and always transient. The interest is to use internal radiotherapy very early in the course of disease, as soon as there is one painful osseous site (and several metastatic localizations on bone scan), to treat pain, to prevent pain on other sites, and to delay recourse to other forms of therapy (such as morphinic with their side effects) and thus to ensure adequate quality of life for as long as possible. (author)

  2. The Clinical Value of 99mTc-MDP Bone Scintigraphy in the Diagnosis of Bone Metastases%99mTc-MDP全身骨显像在骨转移瘤诊断中的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    张婷; 姚昊; 王志忠; 何宝明

    2013-01-01

    目的:探讨在骨转移瘤临床诊断中99mTc-MDP全身骨显像的诊断价值。方法:选取2011年1月至2012年12月间于我院临床诊断为恶性肿瘤患者330例,所有患者均进行CT及99mTc-MDP全身骨显像检查确认是否存在骨转移瘤,并将两种检查结果采用统计学软件进行对比分析。结果:330例恶性肿瘤患者中确诊恶性肿瘤骨转移者277例,CT检查诊断280例,误诊率为11.55%,漏诊率为10.11%,准确率为81.82%,敏感性为89.89%,特异性为88.45%,阳性预测值为86.28%,阴性预测值为22.64%,99mTc-MDP检查诊断242例,误诊率为4.69%,漏诊率为5.78%,准确率为91.21%,敏感性为94.22%,特异性为95.31%,阳性预测值为87.36%,阴性预测值为39.62%,两组患者敏感性、特异性及准确率间差异均比较明显,在统计学上有意义(P<0.05)。结论:99mTc-MDP全身骨显像是早期诊断骨转移瘤的安全、有效检查方法,对于恶性肿瘤患者的分期、治疗、预后具有重要意义,值得推广。%Objective:To investigate the diagnostic value in the clinical diagnosis of bone metastases, 99mTc-MDP bone scintigraphy. Methods: Selected 330 cases of patients with malignant tumors in our hospital from January 2011 to December 2012, all patients underwent CT and 99mTc-MDP whole body bone scintigraphy to confirm the presence of bone metastases, and two test results were analyzed using statistical software. Results:330 patients with malignant tumors diagnosed with bone metastases of malignant tumors in 277 cases, CT examination diagnosis of 280 cases, the misdiagnosis rate was 11.55%, missed diagnosis rate was 10.11%, the accuracy rate of 81.82%, a sensitivity of 89.89%and a specificity of 88.45%, positive predictive value of 86.28%, negative predictive value of 22.64%, 99mTc-MDP check diagnosis of 242 cases, the misdiagnosis rate was 4.69%, the misdiagnosis rate was 5.78%, the accuracy was 91.21%, the sensitivity was 94.22%, specificity resistance of 95

  3. Diagnosic Clinical Value of Serum PINP, PICP and ICTP Contents in Cancer Patients with Bone Metastases%血清Ⅰ型前胶原氨基端前肽、Ⅰ型前胶原羧基端前肽、Ⅰ型胶原羧基端肽在骨转移性癌诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    王抒; 张军宁; 乔田奎

    2011-01-01

    Objective:To study the clinical value of determination of serum procollagen I N-terminal propeptide (PINP), pro-collagen I carboxy-terminal propeptide (PICP) and carboxyterminal telopeptide of type I collagen (ICTP) contents in cancer patients with bone metastases for diagnosis . Methods- Serum PINP, PICP and ICTP contents were measured in 41 patients with bone metastases and 39 controls without bone metastases. The patients with bone metastases consisted of Group A, Group B and Group C. The comparison of bone turnovers among patients with different bone loads were analyzed. Results.- Serum PICP, ICTP contents was significantly greater in patients with bone metastases than without bone metastases(P<0. 01). With the increase of the extent of bone metastases, serum PINP, PICP and ICTP contents elevated. Levels of PICP correlated well to the number of foci(P<0. 01) , Levels of ICTP, PINP correlated to the number of foci(P<0. 05). Levels of PINP correlated well to ICTP. Conclusions: The determinations of serum PINP, PICP and ICTP can reflect the clinical status of metastases size (PICP and ICTP more sensitive); Levels of PICP correlat well to the number of foci.%目的;探讨血清Ⅰ型前胶原氨基端前肽( PINP)、Ⅰ型前胶原羧基端前肤(PICP)、Ⅰ型胶原羧基端肽(ICTP)在骨转移癌诊断中的临床价值.方法:将80例肿瘤患者分为骨转移组41例和无骨转移组(对照组)39例,采用Soloway分级标准,将骨转移组患者再分为A、B、C3个亚组,所有患者空腹抽取静脉血.分析血清PINP、PICP、ICTP与骨转移程度之间的相关性及其彼此之间的相关性.结果:骨转移癌患者血清PINP、PICP、ICTP水平较对照组均升高,其中PICP、ICTP水平与对照组有显著差异(P<0.01);PINP、PICP、ICTP水平在A、B、C3组均依次递增;血清PICP水平与骨转移灶数目相关性良好(P<0.01),ICTP、PINP水平与骨转移灶数目呈一定相关(P<0.05);血清ICTP水平与PINP水平呈

  4. Bone

    Science.gov (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  5. Cutaneous metastases of hepatocellular carcinoma.

    Science.gov (United States)

    Lazaro, M; Serrano, M L; Allende, I; Ratón, J A; Acebo, E; Diaz-Perez, J L

    2009-12-01

    Cutaneous metastases are an unusual finding that may present as the first sign of an internal neoplasia. A case of cutaneous metastases of hepatocellular carcinoma, which may often involve other organs but very rarely metastases to the skin, is reported.

  6. Regional Distributions of Distant Metastases Detected in Differentiated Thyroid Cancers

    Directory of Open Access Journals (Sweden)

    Ebuzer Kalender

    2016-01-01

    Full Text Available Aim: The aim of our multicenter study is to determine retrospectively the regional distributions of distant metastases which are detected in differentiated thyroid cancers (DTC. Material and Method: Thirty-two of 960 patients with distant metastases who were given radioiodine (RAI treatment in Gaziantep University School of Medicine and Mustafa Kemal University School of Medicine were included to study. Six of patients were male, 26 of them were female. Mean age was 52±15.4. Hystopathological diagnoses were reported as papillary thyroid cancer in 23 patients and folliculary thyroid cancer in 9 patients. The distant metastasis ratio, metastasis regions and distributions were determined. Results: It was observed only lung metastasis in 18 (56.25 %, only bone metastasis in 6 (18.75 %, combination of lung and bone metastases in 3 (9.4 %, other organ metastases accompanying to bone and lung metastases in 3 (9.4 % (liver, soft tissue, mediastinum and multipl organ involvoment in 2 (6.2 % of patients. It was determined single metastasis region in 24 (75 %, 2 metastasis regions in 6 (18.75 % and multipl metastasis regions in 2 (6.25 % of patients. Discussion: Distant metastases are the biggest problem in treatment and follow-up of DTCs. It is very important to diagnosis of metastases and determine the regions of involvoment in these patients.

  7. How Effective Are Clinical Pathways With and Without Online Peer-Review? An Analysis of Bone Metastases Pathway in a Large, Integrated National Cancer Institute-Designated Comprehensive Cancer Center Network

    Energy Technology Data Exchange (ETDEWEB)

    Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Rajagopalan, Malolan S.; Flickinger, John C.; Rakfal, Susan M. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Rodgers, Edwin [Via Oncology, Pittsburgh, PA (United States); Heron, Dwight E. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)

    2012-07-15

    Purpose: Clinical pathways are an important tool used to manage the quality in health care by standardizing processes. This study evaluated the impact of the implementation of a peer-reviewed clinical pathway in a large, integrated National Cancer Institute-Designated Comprehensive Cancer Center Network. Methods: In 2003, we implemented a clinical pathway for the management of bone metastases with palliative radiation therapy. In 2009, we required the entry of management decisions into an online tool that records pathway choices. The pathway specified 1 or 5 fractions for symptomatic bone metastases with the option of 10-14 fractions for certain clinical situations. The data were obtained from 13 integrated sites (3 central academic, 10 community locations) from 2003 through 2010. Results: In this study, 7905 sites were treated with 64% of courses delivered in community practice and 36% in academic locations. Academic practices were more likely than community practices to treat with 1-5 fractions (63% vs. 23%; p < 0.0001). The number of delivered fractions decreased gradually from 2003 to 2010 for both academic and community practices (p < 0.0001); however, greater numbers of fractions were selected more often in community practices (p < 0.0001). Using multivariate logistic regression, we found that a significantly greater selection of 1-5 fractions developed after implementation online pathway monitoring (2009) with an odds ratio of 1.2 (confidence interval, 1.1-1.4) for community and 1.3 (confidence interval, 1.1-1.6) for academic practices. The mean number of fractions also decreased after online peer review from 6.3 to 6.0 for academic (p = 0.07) and 9.4 to 9.0 for community practices (p < 0.0001). Conclusion: This is one of the first studies to examine the efficacy of a clinical pathway for radiation oncology in an integrated cancer network. Clinical pathway implementation appears to be effective in changing patterns of care, particularly with online clinical

  8. 射频消融在骨转移癌姑息治疗中的应用%A application of radiofrequency ablation in the palliative treatment of bone metastases

    Institute of Scientific and Technical Information of China (English)

    鱼锋; 张清; 赵海涛; 徐立辉; 牛晓辉

    2014-01-01

    目的:探讨射频消融在骨转移癌治疗中的安全性和有效性。方法2008年11月至2012年12月,我科应用射频消融治疗骨转移癌19例,男10例、女9例,平均年龄57(41~76)岁,原发病灶分别是:肺癌11例,肾癌2例,乳腺癌、甲状腺癌、直肠癌、胃癌、肝癌各1例,原发不明1例。19例共消融21处病灶,病灶分别位于股骨(9处)、骨盆(6处)、肱骨(5处)、胫骨(1处)。手术方法:16处病灶行射频消融后肿瘤刮除,重建骨连续性;另外5处病灶只行经皮射频消融,其中3处股骨干病灶行髓内针固定。术后进行随访,并用疼痛评分及功能评分进行疗效评价、检查有无复发及手术的安全性。评价方法:(1)术前和术后疼痛评分(数字分级法)对比;(2)长期(>6个月)存活患者的功能评定(MSTS评分)。结果平均随访10(1~32)个月。死亡15例,平均存活9.7(1~32)个月,疼痛评分术前平均8.1分,术后1周平均2.2分,术后3个月平均2.7分,术前和术后比较,差异有统计学意义(P<0.01)。对术后存活超过6个月的12例进行功能评定,优良率为83.3%。1例术后6个月消融处再次疼痛,口服止疼药物治疗,11个月后原发病进展死亡。1例术中在止血带处发生热损伤。1例术后皮缘坏死。结论射频消融治疗骨转移癌是一种安全有效的方法,对局部病灶可以缓解疼痛,控制肿瘤进展。%Objective To investigate the safety and effectiveness of radiofrequency ablation ( RFA ) in the treatment of bone metastases. Methods From November 2008 to December 2012, 19 patients with bone metastases were treated with RFA in our department. There were 10 males and 9 females with an average age of 57 years old ( range;41-76 years ). Lung carcinoma was the most common primary tumor ( n=11 ), followed by kidney carcinoma ( n=2 ), breast carcinoma ( n=1 ), thyroid carcinoma ( n=1 ), rectal carcinoma ( n=1

  9. Osteogenic sarcoma with skeletal muscle metastases

    Energy Technology Data Exchange (ETDEWEB)

    Peh, W.C.G. [Department of Diagnostic Radiology, The University of Hong Kong, Queen Mary Hospital (Hong Kong); Shek, T.W.H. [Department of Pathology, The University of Hong Kong, Queen Mary Hospital (Hong Kong); Wang Shihchang [Department of Diagnostic Imaging, National University of Singapore, National University Hospital (Singapore); Wong, J.W.K.; Chien, E.P. [Department of Orthopaedic Surgery, The University of Hong Kong, Queen Mary Hospital (Hong Kong)

    1999-05-01

    Two cases of osteogenic sarcoma with skeletal muscle metastases are described. A 40-year-old woman presented with progressive swelling of both calves and a soft tissue back lump. She had been diagnosed with mandibular chondroblastic osteogenic sarcoma 6 years earlier. Radiographs showed calcified masses. MRI scans and bone scintigraphy revealed multiple soft tissue masses in both calves. Bone scintigraphy also showed uptake in the back lump, right thigh and left lung base. Biopsy confirmed metastatic chondroblastic osteogenic sarcoma, which initially responded well to chemotherapy. However, the metastatic disease subsequently progressed rapidly and she died 21 months after presentation. The second case concerns a 20-year-old man who presented with a pathologic fracture of the humerus, which was found to be due to osteoblastic osteogenic sarcoma. He developed cerebral metastases 17 months later, followed by metastases at other sites. Calcified masses were subsequently seen on radiographs of the abdomen and chest. CT scans confirmed the presence of densely calcified muscle metastases in the abdominal wall, erector spinae and gluteal muscles. The patient`s disease progressed rapidly and he died 30 months after presentation. (orig.) With 6 figs., 29 refs.

  10. Comparative study between characteristics of the lung cancer, breast cancer and esophageal cancer distal bone metastases%肺癌、乳腺癌、食道癌远端骨转移特点的对比研究

    Institute of Scientific and Technical Information of China (English)

    佟丽娟; 王明泽; 王丽梅

    2011-01-01

    目的 对比研究肺癌、乳腺癌、食道癌患者骨转移灶分布特点.方法 对肺癌、乳腺癌、食道癌患者454例进行 99Tcm-亚甲基二膦酸盐(99Tcm-MDP)SPECT全身骨显像,以上肢中远端和(或)骨盆、下肢部位发生骨转移为纳入条件,分析骨转移灶的分布特点及其在病种间的区别.结果 454例肿瘤患者中,上肢中远端和(或)骨盆、下肢有异常放射性浓聚者120例,共发现骨转移灶1303个,其中,肺癌共有839个转移灶(64.4%),乳腺癌共有361个转移灶(27.7%),食道癌共有103个转移灶(7.9%).在股骨的浓聚灶中,各病种发生在大小转子区的放射性浓聚灶所占比例较大.结论 99Tcm-MDP全身骨显像显示,肺癌、乳腺癌、食道癌骨转移灶的分布在不同部位有所不同.%Objective To compare the characteristics of the distribution of bone metastases in lung cancer,breast cancer and esophageal cancer.Methods SPECT bone imaging of the entire body was performed after the injection of 99Tcm-methylene diphosphonate(99Tcm-MDP)in 454 cases.Analyzed the distribution of metastatic bone lesions in upper limbs'middle and distal or the pelvis and lower limbs and the distinction of metastatic bone lesions between different diseases were distinguished.Results Of all the 454 patients,120 cases showed abnormal radionuclide concentration in the region of upper limbs'middle and distal or the pelvis and lower limbs.One thousand three hundreds and three metastatic bone lesions were found in all the patients[893 were in lung cancer(64.4%),36 1 were in breast cancer(27.7%)and 103 were in esophageal cancer(7.9%)].Radioactive uptake in rotor area of femur lesions in these diseases was demonstrated to be of large proportion.Conclusions The result of 99Tcm-MDP bone imaging shows that the distribution of the metastatic bone lesions in lung cancer,breast cancer and esophageal cancer vary from place to place.

  11. Primary hemangiosarcoma of the spleen with angioscintigraphic demonstration of metastases

    DEFF Research Database (Denmark)

    Hermann, G G; Fogh, J; Graem, N

    1984-01-01

    99mTc-methylene-diphosphonate (MDP) bone scintigraphy, which showed only a few minor focal changes in the spine and ribs, angioscintigraphy with in vitro labeled 99mTc-erythrocytes revealed extensive pathologic accumulations throughout the spine, femurs, and the liver, indicating the presence...... of extremely vascular metastases. Autopsy 15 months later confirmed the scintigraphic findings. Angiography with 99mTc-labeled erythrocytes seems to be useful for monitoring metastases from hemangiosarcomas....

  12. 经皮骨成形术治疗椎外转移性骨肿瘤的应用%Application of percutaneous osteoplasty in treating extraspinal bone metastases

    Institute of Scientific and Technical Information of China (English)

    田庆华; 吴春根; 顾一峰; 何煜; 李明华; 程永德

    2012-01-01

    Objective To evaluate the safety and efficacy of DSA-guided percutaneous ostetoplasty (POP) in treating symptomatic extraspinal bone metastases. Methods POP was carried out in 63 patients with extraspinal bone metastases (91 lesions). The clinical data were retrospectively analyzed. Additional radiofrequency ablation (RFA) was performed in 38 patients. The treatment was indicated for patients who had a pain intensity score > 3 on the visual analogue scale (VAS) and were partially or totally refractory to analgesic medication. All the patients were followed up for at least three months. Based on the preoperative and postoperative VAS scores as well as the used dose of analgesics the clinical efficacy was evaluated. Results Technical success was achieved in all patients. Mean VAS scores dropped from preoperative 7.2 ± 1.4 (range of 4 - 10) to 2.4 ± 1.9 (range of 0 - 9) in 24 hours after the treatment. Three months and six months after POP, the VAS scores were further decreased to 1.9 ± 1.7 and to 1.6 ± 1.7 respectively. After POP the pain was completely relieved in 10 patients (15.9%). The analgesic medication was no more needed in 36 patients (57.1%), and only reduced dose of analgesics or lower grade analgesics were needed in 23 patients (36.5%). Four patients showed no relief in pain, of whom three patients (4.8%) took the same dose of analgesics as before the treatment, and one patient (1.6%) had to take higher grade of analgesics. No statistically significant difference in the relief of pain was found between the patients receiving POP only and the patients receiving POP together with RFA (P = 0.892, P > 0.05). PMMA leakage into the tumor-neighbouring soft tissue was seen in 13 patients (20.6%), and clinically the patients showed no obvious symptoms. One patient with metastases in femoral diaphysis experienced a pathologic fracture three months after the treatment. Conclusion For the treatment of painful extraspinal bone metastases, DSA-guided POP is very

  13. Breast carcinoma metastases.

    Science.gov (United States)

    Bodzin, G A; Staren, E D; Faber, L P

    1998-02-01

    With careful selection of patients, complete resection of pulmonary metastases from breast carcinoma may be a useful therapeutic option. Such a treatment appears to offer a significant survival benefit when compared with medical treatment alone, or with incomplete resection.

  14. Stereotactic radiosurgery for spinal metastases: a literature review; Radiocirurgia estereotaxica para metastases de coluna vertebral: revisao de literatura

    Energy Technology Data Exchange (ETDEWEB)

    Joaquim, Andrei Fernandes; Ghizoni, Enrico; Tedeschi, Helder; Pereira, Eduardo Baldon; Giacomini, Leonardo Abdala, E-mail: andjoaquim@yahoo.com [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil)

    2013-04-15

    Objective: The spine is the most common location for bone metastases. Since cure is not possible, local control and relief of symptoms is the basis for treatment, which is grounded on the use of conventional radiotherapy. Recently, spinal radiosurgery has been proposed for the local control of spinal metastases, whether as primary or salvage treatment. Consequently, we carried out a literature review in order to analyze the indications, efficacy, and safety of radiosurgery in the treatment of spinal metastases. Methods: We have reviewed the literature using the PubMed gateway with data from the Medline library on studies related to the use of radiosurgery in treatment of bone metastases in spine. The studies were reviewed by all the authors and classified as to level of evidence, using the criterion defined by Wright. Results: The indications found for radiosurgery were primary control of epidural metastases (evidence level II), myeloma (level III), and metastases known to be poor responders to conventional radiotherapy - melanoma and renal cell carcinoma (level III). Spinal radiosurgery was also proposed for salvage treatment after conventional radiotherapy (level II). There is also some evidence as to the safety and efficacy of radiosurgery in cases of extramedullar and intramedullar intradural metastatic tumors (level III) and after spinal decompression and stabilization surgery. Conclusion: Radiosurgery can be used in primary or salvage treatment of spinal metastases, improving local disease control and patient symptoms. It should also be considered as initial treatment for radioresistant tumors, such as melanoma and renal cell carcinoma. (author)

  15. Prostate Cancer Presenting with Parietal Bone Metastasis

    Science.gov (United States)

    Pare, Abdoul Karim; Abubakar, Babagana Mustapha; Kabore, Moussa

    2017-01-01

    Bone metastases from prostate cancer are very common. They are usually located on the axial skeleton. However, cranial bone metastases especially to the parietal bone are rare. We report a case of metastatic prostate cancer presenting with left parietal bone metastasis in a patient with no urological symptoms or signs. We should consider prostate cancer in any man above 60 years presenting unusual bone lesions.

  16. Value of SPECT/CT imaging for follow-up of bone metastases%SPECT/CT显像在肿瘤骨转移同一病灶动态随访中的价值

    Institute of Scientific and Technical Information of China (English)

    董科; 石洪成; 刘江; 张一秋; 陈曙光; 蔡良

    2013-01-01

    Objective To retrospectively evaluate the value of SPECT/CT imaging for follow-up of bone metastases.Methods A total of 178 patients with bone metastases (387 lesions) underwent 2 or more events of whole-body bone scintigraphy (WBS) and SPECT/CT imaging.Sequential images were analyzed by 2 experienced,nuclear medicine physicians.Each lesion was interpreted as progressive,remissive or stable in WBS or SPECT/CT independently.Reasons for the discordance between WBS and SPECT/CT results were analyzed.The results of clinical follow-up,including clinical symptoms,tumor markers,serum ALP,radiograph,CT and MRI,were likewise classified as progressive,remissive or stable.The x2 test was used to compare the differences between the two imaging methods.Results The follow-up results of the two imaging methods were consistent in 313 (80.88%,313/387) lesions,including 208 in progression and 105 in remission or stable condition.Among the 74(19.12%,74/387) lesions showing discordance,48 showed remission or stable conditions on WBS but progression on SPECT/CT (64.86%,48/74) ; while 26 showed progression on WBS but remission or stable condition on SPECT/CT (35.14%,26/74).There was a statistically significant difference of the follow-up results between WBS and SPECT/CT (x2 =6.54,P <0.05).Conclusion SPECT/CT is more valuable than WBS for follow-up of bone metastases.%目的 探讨SPECT/CT显像在肿瘤骨转移同一病灶动态随访中的价值.方法 回顾性分析178例行2次或2次以上全身骨显像(WBS)和SPECT/CT显像的肿瘤骨转移患者(总计387个骨转移病灶)的影像资料.由2位核医学科医师共同对随访病灶的WBS和SPECT/CT显像结果进行动态评判,结果均分为进展、好转或稳定;分析评判结果不一致的原因.临床随访(临床表现、肿瘤标志物、ALP、X线、CT、MRI等)结果也分为进展、好转或稳定.WBS和SPECT/CT显像随访结果差异的比较采用配对资料x2检验.结果 SPECT/CT显像随

  17. Detectability of metastatic bone tumor by Ga-67 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Koizumi, Kiyoshi; Uchiyama, Guio; Araki, Tsutomu; Hihara, Toshihiko; Ogata, Hitoshi; Monzawa, Shuichi; Kachi, Kenji; Matsusako, Masaki

    1989-03-01

    Ga-67 scintigrams in patients with malignant diseases sometimes reveal uptake of the tracer in the bone metastases. Detectability of Ga-67 scintigraphy for metastatic bone tumors and benign bone lesions was compared with that of Tc-99m bone scintigraphy. Countable bone metastases detected by bone scintigraphy were evaluated whether the lesion showed apparent, faint, or negative Ga-67 uptake. Of 47 lesions 23 (49%) showed apparent uptake and 17 (36%) showed negative uptake, only 7 (10%) mostly fracture/osteotomy, showed apparent uptake of the tracer. Uptake in the other benign lesions such as trauma of the ribs, spondylosis deformans, and arthrosis deformans was rather faint. In patients with multiple bone metastases, 9 patients (82%) out of 11 showed more prominent abnormal findings in Tc-99m MDP bone scintigraphy than in Ga-67 scintigraphy; that is, Ga-67 scintigraphy was not able to reveal all metastatic bone lesions. In patients with untreated or recurrent tumors, relation between Ga-67 uptake in the tumors and that in the bone metastases was evaluated. Of 7 patients with negative Ga-67 uptake in the bone metastases; that is, there seemed to be little relation between Ga-67 affinity to the primary tumors and that to the bone metastases. Mechanisms of the Ga-67 uptake in the bone metastases were discussed. Not only the tumor cells or tissues in the bone metastases but also bone mineral or osteoclasts might be the deposition sites of Ga-67.

  18. ECT联合血ALP、血钙的检测对肺癌骨转移的诊断价值%Diagnostic Value of ECT plus Serum ALP, Calcium Detection in Lung Cancer Patients with Bone Metastases

    Institute of Scientific and Technical Information of China (English)

    高莹; 谢家政

    2016-01-01

    目的:回顾分析行骨扫描(ECT)的肺癌患者生化检测项中血清碱性磷酸酶(ALP)、血钙水平,评价两者监测肺癌骨转移的临床价值。方法:收集81例肺癌骨转移、43例肺癌无骨转移患者血ALP、血钙水平和ECT检查结果,比较2组血ALP、血钙水平变化;将肺癌骨转移组分级,分析各级的血ALP、血钙水平;通过受试者工作特征(ROC)曲线及联合检测来评价其监测肺癌骨转移的临床价值。结果:(1)肺癌骨转移组血ALP、血钙水平高于肺癌无骨转移组(P0.05) . (3) The area under the curve (AUC) of blood ALP, calcium in lung cancer patients were 0.715, 0.769, respectively, when detection was combined, the sensitivity increased to 70.4%, and specificity remained at a high level. Conclusion:ECT combined with blood ALP, calcium has a diagnostic value in the detection of bone metastases in lung cancer patients, and can be used as a screening and monitoring methods.

  19. Sjælden metastase fra sjælden hjernetumor

    DEFF Research Database (Denmark)

    Aabenhus, Kristine; Hahn, Christoffer Holst

    2014-01-01

    This case report presents the story of a patient with an oligodendroglioma metastasizing to the bone marrow and to lymph nodes of the neck. The patient had undergone primary brain surgery 13 years prior to the discovery of metastases and radiotherapy directed at the brain tumour two months prior...

  20. Recurrent, multiple, calcified soft tissue metastases from osteogenic sarcoma without pulmonary involvement

    NARCIS (Netherlands)

    Wolf, R; Wolf, RFE; Hoekstra, HJ

    1999-01-01

    Osteosarcoma (osteogenic sarcoma) metastasizes primarily to the lung. With the introduction of neoadjuvant chemotherapy as part of the treatment, the overall and disease-free survival rates have dramatically improved. In this case report, a young man with multiple soft tissue and bone metastases, in

  1. Inguinal metastases from testicular cancer

    DEFF Research Database (Denmark)

    Daugaard, Gedske; Karas, Vladimir; Sommer, Peter

    2006-01-01

    To evaluate the incidence of inguinal metastases in patients with testicular cancer and relapse after initial stage I disease.......To evaluate the incidence of inguinal metastases in patients with testicular cancer and relapse after initial stage I disease....

  2. 四肢骨转移癌126例手术疗效分析%Clinical results in surgical treatment of bone metastases in limbs: 126 cases report

    Institute of Scientific and Technical Information of China (English)

    吴宗明; 唐献忠; 杨庆诚

    2015-01-01

    目的 回顾性分析手术治疗四肢骨转移癌126例的临床疗效.方法 2007年1月至2012年12月,我院收治四肢转移性肿瘤患者126例,男69例,女57例,年龄41~92 (平均65.8) 岁.其中肿瘤假体人工关节置换42例,单纯人工关节置换14例,骨水泥加带锁髓内钉内固定38例,骨水泥加钢板固定19例,瘤段灭活加钢板内固定4例,肢体短缩加钢板固定3例,外固定支架固定6例.对患者术前及术后1个月采用视觉模拟评分法 (visual analogue scale,VAS) 评分法进行疼痛评分;术前及术后3个月的生活质量 (quality of life,QOL) 采用SF-36评分系统进行评估;术后肢体功能按照美国肌肉骨骼肿瘤学会评分系统标准 (American musculo-skeletal tumor society system,MSTS) 于术后3个月进行评价.结果手术均顺利进行,无手术相关死亡病例,11例出现术后并发症,包括急性呼吸窘迫综合征1例、应激性溃疡 1例、轻度脑梗塞2例、深静脉血栓 3 例、急性肾功能衰竭1例、伤口感染 1例、髋关节脱位2例,给予相应治疗后均好转.126例均获3~60(平均32) 个月随访.术后生存期3~12个月45例,13~24个月32例,25~36个月26例,另有23例存活超过3年.术后疼痛明显改善,VAS 评分由术前的 (6.85±3.11) 分下降至术后1个月的 (1.26±0.81) 分 (t=9.978,P<0.001 ).术后生活质量明显改善,术前QOL评分平均为 (38.30±13.05) 分提高至术后3个月的(65.78±10.65)分 (t=-18.550,P<0.001 ).在肢体功能方面,术后 MSTS 评分范围 17~30分,平均为 (23.32±3.03) 分 (t=-1.450,P=0.016).结论 手术治疗四肢骨转移癌可以有效缓解疼痛、提高患者生存质量、改善肢体功能.%Objective To retrospectively analyze the clinical results in surgical treatment of bone metastases in limbs in 126 cases.Methods The data of 126 patients with bone metastases in limbs who were admitted from January 2007 to December 2012 were retrospectively analyzed

  3. Evaluation of the efficiency of FDG PET/CT in detection and characterization of skeletal metastases

    Directory of Open Access Journals (Sweden)

    Ahmed Wafaie

    2014-03-01

    Conclusion: Fused PET/CT was highly efficient in evaluation of skeletal metastases with superior performance in: detection of early bone marrow infiltration not apparent on CT, resolution of metabolic activity before definite signs of complete healing on CT, detection of missed sclerotic metastases on PET due to their relatively low metabolic activity, detection of intra and extra osseous recurrence and differentiation of benign from malignant bone lesions.

  4. Comparison of 18F-fluorodeoxyglucose dual-head tomography with coincidence and 99mTc-methylenediphosphonate bone scintigraphy in diagnosis and therapeutic evaluation of bone metastases%18F-FDG符合探测显像与99mTc-MDP骨显像评价肿瘤骨转移的对比研究

    Institute of Scientific and Technical Information of China (English)

    武新宇; 高永举; 闫新慧

    2014-01-01

    Objective To compare the value of 18F-fluorodeoxyglucose (18F-FDG) dual-head tomography with coincidence (DHTC) and 99mTc-methylenediphosphonate (99mTc-MDP) bone scintigraphy (BS) in diagnosis and therapeutic evaluation of bone metastases. Methods A total of 42 cases with cancer bone metastases, averagely aged (53.62±12.48) years old, were enrolled in this study. 18 cases did not receive any treatment, and 11 patients received inspection 2-5 times for assessment of therapeutic effects. 18F-FDG DHTC and 99mTc-MDP BS were performed within one week in all patients. The sensitivity, specificity and accuracy of 18F-FDG DHTC and 99mTc-MDP BS were compared. Results Of the 42 patients with bone metastases, 36 cases were correctly detected by 18F-FDG DHTC, and 32 were correctly detected by 99mTc-MDP BS. The difference of the sensitivity was not significant (χ2=1.25,P=0.320). Among 18 patients who did not receive any treatment, all got correct diagnosis by 18F-FDG DHTC, and 12 were positive on 99mTc-MDP BS. The difference of the diagnostic accuracy was significant (χ2=4.17,P<0.05). The result of 18F-FDG DHTC was strongly correlated with the clinical therapeutic evaluation(r=0.834,P<0.02). Conclusion 18F-FDG DHTC offers an advantage in diagnosis and therapeutic evaluation of bone metastases over 99mTc-MDP BS.%目的:比较18F-脱氧葡萄糖(18F-FDG)符合探测显像及99mTc-亚甲基二膦酸盐(99mTc-MDP)骨显像在肿瘤骨转移诊断及疗效评价中的价值。方法收集本院行18F-FDG符合探测显像及99mTc-MDP骨显像的骨转移患者42例,平均年龄(53.62±12.48)岁。其中未进行任何治疗患者18例,另11例治疗后多次(2~5次)行18F-FDG符合探测显像及99mTc-MDP全身骨显像。两种检查在1周内完成。比较两种方法在肿瘤骨转移诊断及疗效评价中的价值。结果18F-FDG符合探测显像有36例明确诊断,99mTc-MDP骨显像有32例明确诊断,两种方法的诊断准确率

  5. Reflections on the therapeutic use of {sup 223}RaCl{sub 2} for bone metastases resulting from prostate cancer resistant to castration; Reflexiones sobre el uso terapeutico de {sup 223}RaCl{sub 2} para metastasis osea derivada de cancer de prostata resistente a la castracion

    Energy Technology Data Exchange (ETDEWEB)

    Astudillo V, A. J.; Paredes G, L., E-mail: armando.astudillo@inin.gob.mx [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico)

    2015-10-15

    In January 2014 the Comision Federal para la Proteccion contra Riesgos Sanitarios of the Ministry of Health in Mexico, authorize the use of {sup 223}RaCl{sub 2} as the first radiopharmaceutical emitter α for therapeutic purposes in cases of bone metastases resulting from prostate cancer resistant to castration. The paper analyzes the main variables that affect the metrological traceability using activity meters to evaluate the gamma activity of {sup 223}RaCl{sub 2} in hospitals, because it has a chain of complex decay with alpha, beta and gamma emitters, so was important to verify if a gamma activity measurement for a multiple emitter is reliable to determine the total alpha absorbed dose to bone in a patient. (Author)

  6. Wnt Signaling in Prostate Cancer Bone Metastases

    Science.gov (United States)

    2015-09-01

    Department of Defense, Washington Headquarters Services , Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Ace-1-Dkk-1, a canine prostate cancer overexpressing Dkk-1 is used in this study to investigate how...Dirksen, Thomas Rosol. The Ohio State University, Columbus, OH, USA Washington, DC Marriott Wardman Park Hotel June 22–26, 2014 33rd

  7. Bone-targeted agents: preventing skeletal complications in prostate cancer.

    Science.gov (United States)

    Morgans, Alicia K; Smith, Matthew R

    2012-11-01

    In men, prostate cancer is the most common non-cutaneous malignancy and the second most common cause of cancer death. Skeletal complications occur at various points during the disease course, either due to bone metastases directly, or as an unintended consequence of androgen deprivation therapy (ADT). Bone metastases are associated with pathologic fractures, spinal cord compression, and bone pain and can require narcotics or palliative radiation for pain relief. ADT results in bone loss and fragility fractures. This review describes the biology of bone metastases, skeletal morbidity, and recent advances in bone-targeted therapies to prevent skeletal complications of prostate cancer.

  8. SPECT/CT融合图像与全身骨显像对骨转移瘤诊断的价值分析%The Diagnosis Value Analysis of SPECT/CT Fusion Images and Whole Body Bone Imaging for Bone Metastases

    Institute of Scientific and Technical Information of China (English)

    王东; 孟宪平; 陈则君; 靳激扬

    2016-01-01

    Objective To investigate the comparison of SPECT/CT fusion image and whole body bone imaging(whole-body ipads scintigraphy, WBBS) in bone metastasis value.Methods retrospective analysis of 80 cases of suspected tumor bone metastatic disease underwent whole-body bone imaging and SPECT/CT fault image fusion in our hospital, all the results are confirmed by pathology and further follow-up and otherwise. Calculate and compare the two results of cases and lesions diagnosed degree of sensitivity, specific percentage, positive predictive value, negative predictive value, the correct diagnosis.Results 80 patients, 61 cases of bone metastases, 19 cases were benign, 258 lesions, the bone metastases, 202 benign lesions is 56. The sensitivity of WBBS for diagnosis of patients and lesions were 82% and 89.1%, the specificity was 42.1% and 31.7% respectively, the positive predictive value were 82% and 84.7%, and negative predictive values were 42.1% and 40.6%, the percentage of correct diagnosis was 72.5% and 78.1%. The sensitivity of SPECT/CT for diagnosis of patients and lesions were 98.4% and 98%, the specificity was 52.6% and 76.8% respectively, the positive predictive value were 87% and 93.8%, and negative predictive values were 90.9% and 91.5%, the percentage of correct diagnosis was 87.5% and 83.4%.Both sets of data after the χ2 test, P<0.05. Conclusion In the diagnosis of bone metastasis, SPECT/CT fusion image is more obvious than WBBS has diagnostic value.%目的:探讨SPECT/CT融合图像与全身骨显像(whole-body bone scintigraphy,WBBS)对骨转移瘤的价值比较。方法回顾性分析我院80例可疑肿瘤骨转移性病变患者行WBBS及SPECT/CT断层图像融合,所有结果都通过病理或进一步随访等方式确诊。分别计算并比较两种结果对病例及病灶诊断的灵敏度、特异度、阳性预测值、阴性预测值、正确诊断百分率。结果80例患者骨转移61例,19例为良性病例,258

  9. Evaluation of bone metastases with {sup 18} F- Sodium fluoride PET/CT; initial experience; Evaluacion de metastasis oseas con {sup 18} F-Fluoruro de sodio PET/CT; experiencia inicial

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez C, N.; Serna M, J.A.; Quiroz C, O.; Quinzanos, F.; Valenzuela, J.; Ramirez A, J.L. [Hospital Angeles del Pedregal, Mexico D.F. (Mexico)

    2007-07-01

    The study of NaF-18 PET/CT is the modality with bigger sensitivity and specificity for the bony metastases detection. This additional value of the NaF-18 PET/CT can have a beneficent impact in the clinical handling of the patients with prostate cancer with high risk. (Author)

  10. Ablative Approaches for Pulmonary Metastases.

    Science.gov (United States)

    Boyer, Matthew J; Ricardi, Umberto; Ball, David; Salama, Joseph K

    2016-02-01

    Pulmonary metastases are common in patients with cancer for which surgery is considered a standard approach in appropriately selected patients. A number of patients are not candidates for surgery due to a medical comorbidities or the extent of surgery required. For these patients, noninvasive or minimally invasive approaches to ablate pulmonary metastases are potential treatment strategies. This article summarizes the rationale and outcomes for non-surgical treatment approaches, including radiotherapy, radiofrequency and microwave ablation, for pulmonary metastases.

  11. ANTIOXIDANT POTENCY OF WATER KEFIR

    Directory of Open Access Journals (Sweden)

    Muneer Alsayadi M.S.

    2013-06-01

    Full Text Available Reactive oxygen species (ROS have strong relationship with several diseases. Many fermented foods were reported to be important sources for antioxidant compounds. Antioxidant activity of water kefir never reported in the scientific literature. The objective of this study was to detect and investigate the antioxidant potency of water kefir. Water kefir was prepared by fermentation of sugar solution with kefir grains for 24h. Antioxidant activity of fresh water kefir drink and its extract with (0.125–5 mg/ml was evaluated using 2,2,-diphenyl-1-pricrylhydrozyl (DPPH scavenging method, and inhibition of ascorbate autoxidation and the reducing power of water kefir were determined, Butylated hydroxyanisole (BHA and ascorbic acid were used for comparison. Water kefir demonstrated great ability to DPPH scavenging ranged (9.88-63.17%. And inhibit ascorbate oxidation by (6.08-25.57% increased in consequent with concentration raising. These results prime to conclude that water kefir could be promisor source of natural antioxidants with good potency in health developing.

  12. Clinical Value of Whole-body Magnetic Resonance Diffusion Weighted Imaging on Detection of Malignant Metastases

    Institute of Scientific and Technical Information of China (English)

    Cheng Li; Zhen-sheng Liu; Xian-mao Du; Ling He; Jian Chen; Wei Wang; Fei Sun; Fang Du; Zhi-gang Luo; Zhen-long Xue; Yi Zhao; Chang-wu Zhou

    2009-01-01

    To evaluate the value of whole-body diffusion weighted imaging (WB-DWI) on detection of malignant metastasis.Methods Forty-six patients with malignant tumors underwent WB-DWI examinations between April 2007 and August 2007 in our hospital. Before WB-DWI examination, the primary cancers of all the patients were confirmed by pathology, and the TNM-stage was assessed with conventional magnetic resonance imaging (MRI) or computed tomography (CT). WB-DWl was performed using short TI inversion recovery echo-planar imaging (STIR-EPI) sequence. Abnormal high signal intensities on WB-DWI were considered as metastases. The results of WB-DWI were compared with other imaging modalities. For the assessment of the diagnostic capability of WB-DWl, WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases, and with conventional MRI for demonstrating metastases in other locations.Results WB-DWI demonstrated 143 focuses, 14 of which were diagnosed to he benign lesions in routine imaging. The number of bone metastases depicted on WB-DWI and routine imaging was 85 and 86; lymph node metastases was 17 and 18; liver metastases was 14 and 14; lung metastases was 4 and 8; and brain metastases was 6 and 8, respectively. WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases, 4 lung metastases, 3 mediastinal lymph node metastases, and 2 brain metastases. Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone, all of which evolved greatly during clinical follow-up for more than 6 months. WB-DWI had higher detection rates for metastatic lesions in liver, bone, and lymph nodes than those in lung and brain (X2=30, P<0.001).Conclusions WB-DWI could detect most of metastatic lesions that were diagnosed with conventional MRI and CT. The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mediastinal lymph node, brain, and

  13. 肿瘤骨转移疼痛患者对188Re-HEDP的耐受性研究%The tolerance to 188Re-HEDP treatment in patients with bone pain from osseous metastases

    Institute of Scientific and Technical Information of China (English)

    程爱萍; 陈绍亮; 刘文官; 陈雪芬; 许长德

    2011-01-01

    Objective To study the tolerance to 188Re-1-hydroxy-1 ,1-ethylidene disodium phosphonate(HEDP) in patients with bone pain caused by osseous metastases. Methods Thirty-one patients(10with prostate cancer, 9 with breast cancer, 3 with lung cancer, 5 with liver cancer, 2 with rectal cancer, 1with esophageal cancer and 1 with renal cancer) received a single injection dose of 188Re-HEDP. The patients were divided into four groups according to the injection dose: 20 MBq/kg (6 patients), 30 MBq/kg(6 patients), 40 MBq/kg (9 patients), and 50 MBq/kg (10 patients). Haematological toxicity (WHO grading) of grade Ⅲ- Ⅳ was considered unacceptable. Vital signs and adverse effects after injection were recorded for 8 weeks. Blood counts were measured weekly during a period of 8 weeks. Biochemical parameters and electrocardiogram were assayed at week 4 and 8. Statistical analysis was performed for per-protocol (pp) population (t-test). Results Twenty-seven patients belonged to PP population with 5 in the group of 20 MBq/kg, 5 in the group of 30 MBq/kg, 8 in the group of 40 MBq/kg and 9 in the group of 50 MBq/kg.No obvious adverse effects and no significant change of vital signs, electrocardiogram, liver and renal function were found after injection. Alkaline phosphatase was slightly higher than baseline at week 4 and 8 after therapy, but the difference was not statistically significant. In the 20 MBq/kg group, reversible grade Ⅰ leucopenia was noted in 1 patient. In the 30 MBq/kg group, 2 patients showed reversible grade Ⅰ leucopenia including 1 alone with reversible grade Ⅲ thrombopenia. In the 40 MBq/kg group, reversible grade Ⅰ leucopenia and thrombopenia was observed in 1 patient and reversible grade Ⅱ leucopenia and thrombopenia in another patient. In the .50 MBq/kg group, 3 patients showed reversible grade Ⅱ leucopenia. The lowest level of thrombopenia was at week 4(143.5 × 109/L), leucopenia at week 6 (5.4 × 109/L) and anaemia at week 8(t = 3.1325, 3

  14. Diagnostic value for extrahepatic metastases of hepatocellular carcinoma in positron emission tomography/computed tomography scan

    Institute of Scientific and Technical Information of China (English)

    Ji Eun Lee; Jae Young Jang; Soung Won Jeong; Sae Hwan Lee; Sang Gyune Kim; Sang-Woo Cha; Young Seok Kim

    2012-01-01

    AIM:To evaluated the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) scan in diagnosis of hepatocellular carcinoma (HCC) and extrahepatic metastases.METHODS:A total of 138 patients with HCC who had both conventional imaging modalities and 18F-FDG PET/CT scan done between November 2006 and March 2011 were enrolled.Diagnostic value of each imaging modality for detection of extrahepatic metastases was evaluated.Clinical factors and tumor characteristics including PET imaging were analyzed as indicative factors for metastases by univariate and multivariate methods.RESULTS:The accuracy of chest CT was significantly superior compared with the accuracy of PET imaging for detecting lung metastases.The detection rate of metastatic pulmonary nodule ≥ 1 cm was 12/13(92.3%),when < 1 cm was 2/10 (20%) in PET imaging.The accuracy of PET imaging was significantly superior compared with the accuracy of bone scan for detecting bone metastases.In multivariate analysis,increased tumor size (≥ 5 cm) (P =0.042) and increased average standardized uptake value (SUV)uptake (P =0.028) were predictive factors for extrahepatic metastases.Isometabolic HCC in PET imaging was inversely correlated in multivariate analysis (P =0.035).According to the receiver operating characteristic curve,the optimal cutoff of average SUV to predict extrahepatic metastases was 3.4.CONCLUSION:18F-FDG PET/CT scan is invaluable for detection of lung metastases larger than 1 cm and bone metastases.Primary HCC having larger than 5 cm and increased average SUV uptake more than 3.4should be considered for extrahepatic metastases.

  15. Extraneural metastases in medulloblastoma

    Directory of Open Access Journals (Sweden)

    V M F Muoio

    2011-01-01

    Full Text Available Medulloblastoma is the most common childhood malignant tumor of central nervous system, but it may also occur in adults. It presents high invasive growth with spreading of tumor cells into the leptomeningeal space along the neuroaxis early in the course of the disease. Extraneural metastases are rare but frequently lethal, occurring only in 1 to 5% of patients, and are related, in the most of cases, to the presence of ventriculoperitoneal shunt. Here we characterize the clinical profile of five cases of medulloblastoma with systemic spreading of tumor cells, also comparing them to cases already described in the literature.

  16. Treatment of choroid metastases.

    Science.gov (United States)

    Dobrowsky, W

    1988-02-01

    Sixteen patients with choroid secondary tumours were treated with irradiation consisting of 40-50 Gy in 3-5 weeks. There were 14 female patients with breast cancer, one male patient with prostatic cancer and one male patient with cancer of unknown origin. In four cases bilateral ocular metastases were seen. Ten out of 20 treated eyes showed complete response to treatment, seven out of 20 showed partial response and three out of 20 were not influenced by irradiation. Survival of patients, all having widespread metastatic disease, was 3-48 months (median 20 months). All patients responding to treatment showed increased quality of life.

  17. 背景信号抑制全身扩散加权成像在骨转移瘤诊断中的应用进展%Whole Body DiffusionWeighted Imaging with Background Suppression for Diagnosing Bone Metastases

    Institute of Scientific and Technical Information of China (English)

    赵晖

    2011-01-01

    Bone metastasis is one of the most common complications of malignant tumors, and early detection and diagnosis have great significance in choosing the best treatment plan.With the rapid development of magnetic resonance, the application and study of whole body diffusion weighted imaging with background suppression (WB-DWIBS) in diagnosing bone metastases from malignant tumors has been performed by researchers both in China and overseas.The sensitivity and accuracy of WB-DWIBS in diagnosing the bone metastases of malignant tumors, and the advantages of the technology compared with x-ray imaging, computed tomography, magnetic resonance imaging, electrical capacitance tomography, and positron emission tomography are reviewed.Since the technique was first reported by Takahara et al.in 2004, studies over the past few years have indicated that WB-DWIBS under low background signal highlights the manifestation of the lesion, thereby greatly increasing the detection ratio for diseased tissues, especially bone metastases.Moreover, the technique was found to have a higher sensitivity and accuracy for detecting bone metastasis in malignant tumors compared with PET.At the same time, DWIBS can also be used to detect primary lesions and metastases in visceral organs and lymph nodes.Therefore, this technique can provide more useful information for determining the best treatment plan.WB-DWIBS is rapid and emits no radiation.It is a new technology for detecting malignant tumors that has the potential to replace PET.As a new technique, WB-DWIBS still has some limitations.With the rapid development of magnetic resonance, WB-DWIBS will show its unique value in application and the prospect of generalized diagnosis of osseous metastatic tumors.%骨转移瘤是恶性肿瘤最常见的并发症,其早期检测和诊断对选择最佳治疗方案有重要意义.随着磁共振技术的迅速发展,国内外研究人员相继开展背景信号抑制全身扩散加

  18. The head and neck metastases from clear cell carcinoma of the kidney; Przerzut raka jasnokomorkowego nerki do glowy i szyi

    Energy Technology Data Exchange (ETDEWEB)

    Szlenk, Z.; Osuch-Wojcikiewicz, E.; Janczewski, G. [Akademia Medyczna, Warsaw (Poland)

    1994-12-31

    The kidney carcinoma is the commonest tumor to metastasize to the head and neck. The majority of renal metastases occur in the nose and paranasal sinuses. This paper presents 4 cases of metastatic tumor in the nasal cavities, paranasal sinuses, frontal bone and piriform fossa. The difficulties in diagnosis and management was also presented. (author)

  19. 唑来膦酸联合化疗治疗恶性肿瘤骨转移32例临床分析%Clinical efficacy of zoledronic acid combined with chemotherapy in the treatment of malignant tumor with bone metastases

    Institute of Scientific and Technical Information of China (English)

    李学超

    2014-01-01

    目的:观察唑来膦酸联合化疗对恶性肿瘤骨转移的临床疗效及不良反应。方法:将64例恶性肿瘤骨转移患者随机分为2组,其中对照组32例单用化疗;治疗组32例接受唑来膦酸联合化疗,2组化疗方案相同。结果:治疗组疼痛总有效率81.3%,对照组为46.9%。治疗组骨病灶控制总有效率62.5%,对照组为28.1%;治疗组均优于对照组(P<0.01)。2组无严重不良反应发生。结论:唑来膦酸联合化疗治疗恶性肿瘤骨转移疗效确切,优于单用化疗,且不良反应少,患者依从性好。%Objective:To investigate the effects and adverse reactions of zoledronic acid combined with chemotherapy in the treatment of malignant tumor with bone metastases. Methods:Sixty-four malignant tumor patients with bone metastases were randomly divided into the control group and trial group(32 cases each group). The control group and trial group were treated with single chemotherapy and zoledronic acid combined with chemotherapy,respectively. The chemotherapy regimens of two groups were the same. Results:The totally effective rates of curing pain in trial group and control group were 81. 3% and 46. 9%, respectively. The totally effective rates of controlling bone metastases in trial group and control group were 62. 5% and 28. 1%,respectively. The treatment effect in trial group was better than that in control group(P<0. 01),no serious adverse reaction in two groups was found. Conclusions:The therapeutic effect of zoledronic acid combined with chemotherapy is better than that of single chemotherapy. The adverse reaction of zoledronic acid combined with chemotherapy is slight,and the patient is well-tolerated.

  20. Burden of metastatic bone disease from genitourinary malignancies.

    Science.gov (United States)

    Mulders, Peter F; Abrahamsson, Per-Anders; Bukowski, Ronald M

    2010-11-01

    Bone metastases are common among patients with stage IV genitourinary cancers. Most patients with bone metastases develop at least one debilitating and potentially life-limiting skeletal-related event. These events are associated with increased medical expenses and decreased quality of life. Current guidelines recommend screening for bone metastases in men with high-risk prostate cancer, but guidance for screening and treatment of bone metastases from genitourinary cancers varies by country and setting. Several bisphosphonates have been evaluated in the advanced genitourinary cancer setting. Zoledronic acid has demonstrated efficacy in significantly reducing the risk of skeletal-related events in patients with bone metastases from a broad range of solid tumors including prostate, renal and bladder cancers, and is recommended for preserving bone health.

  1. Breast metastases from rectal carcinoma

    Institute of Scientific and Technical Information of China (English)

    LI Jia; FANG Yu; LI Ang; LI Fei

    2011-01-01

    Metastases to the breast from extramammary neoplasms are very rare, constituting 2.7% of all malignant breast tumours. The most common primary tumor metastatic to the breast is primary breast cancer. Rectal cancer metastasizing to the breast is extremely rare. We report a case of aggressive rectal carcinoma with metastasis to the breast.

  2. [Cardiac myxoma with cerebral metastases].

    Science.gov (United States)

    Bazin, A; Peruzzi, P; Baudrillard, J C; Pluot, M; Rousseaux, P

    1987-01-01

    A 56 year old woman developed multiple metastases in the cerebrum and cerebellum, four years after cardiac intervention on a left atrial myxoma. The absence of stroke is noteworthy. Multiple high density lesions with contrast enhancement were seen by CT scan, suggesting metastatic neoplasms. Histological examination confirmed the diagnosis of metastases of cardiac myxoma. Only four cases were recorded in the literature.

  3. Umbilical metastases: current viewpoint

    Directory of Open Access Journals (Sweden)

    Egidi Federico

    2005-02-01

    Full Text Available Abstract Background Umbilical metastases from a malignant neoplasm, also termed Sister Mary Joseph's nodule, are not commonly reported in the English literature, and they have usually been considered as a sign of a poor prognosis for the patient. The present article reports on the current view point on umbilical metastasis besides discussing the epidemiology, clinical presentation, pathophysiology and treatment. Method A search of Pubmed was carried out using the term 'umblic*' and 'metastases' or metastasis' revealed no references. Another search was made using the term "Sister Joseph's nodule" or sister Joseph nodule" that revealed 99 references. Of these there were 14 review articles, however when the search was limited to English language it yielded only 20 articles. Articles selected from these form the basis of this report along with cross references. Results The primary lesions usually arise from gastrointestinal or genitourinary tract malignancies and may be the presenting symptom or sign of a primary tumour in an unknown site. Conclusion A careful evaluation of all umbilical lesions, including an early biopsy if appropriate, is recommended. Recent studies suggest an aggressive surgical approach combined with chemotherapy for such patients may improve survival.

  4. Isolated mandibular condylar metastases: An uncommon manifestation of recurrent cervical cancer

    Directory of Open Access Journals (Sweden)

    Ameya D Puranik

    2013-01-01

    Full Text Available Bone metastases from recurrent cervical cancer is a rare scenario, with commonly involved sites being lumbar spine and pelvic bones report an extremely rare manifestation of cervical cancer recurrence presenting as a painful jaw swelling due to metastasis to the mandibular condyle.

  5. Sinais de hipervascularização em imagens de ressonância magnética em metástases ósseas de carcinoma de células renais Signs of hypervascularization at magnetic resonance imaging in bone metastases from renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Leonir Terezinha Feltrin

    2009-06-01

    Full Text Available OBJETIVO: Avaliar a frequência de hipervascularização pela visualização de vasos no interior ou ao redor de metástases ósseas de carcinoma de células renais. MATERIAIS E MÉTODOS: Foram avaliados, retrospectivamente, exames de ressonância magnética de 13 pacientes com diagnóstico de carcinoma de células renais, com 15 lesões ósseas metastáticas, que não haviam sido submetidos a nenhum tratamento. RESULTADOS: Foram encontrados sinais de hipervascularização em 12 das 15 lesões (80%, sendo 6 na coluna lombar, 3 na bacia, 1 na coluna torácica, 1 na ulna e 1 na tíbia. CONCLUSÃO: A alta frequência de hipervascularização em metástases ósseas de carcinoma de células renais encontrada neste trabalho pode sugerir a etiologia renal, tornando-se muito útil na apresentação clínica usual de lesão óssea única com neoplasia primária desconhecida.OBJECTIVE: To evaluate the frequency of hypervascularization by visualizing vascular structures inside or around bone metastases from renal cell carcinoma. MATERIALS AND METHODS: Magnetic resonance imaging studies of 13 untreated patients with diagnosis of renal cell carcinoma and 15 metastatic bone lesions were retrospectively evaluated. RESULTS: Signs of hypervascularization were found in 12 of the 15 bone lesions (80%, 6 of them localized in the lumbar spine, 3 in the hip, 3 in the thoracic spine, 1 in the ulna and 1 in the tibia. CONCLUSION: The high frequency of hypervascularization of bone metastases from renal cell carcinoma found in the present study may suggest that the renal etiology is a useful parameter in the evaluation of a usual clinical presentation of a single bone lesion with unknown primary neoplasm.

  6. 131I treatment for brain metastases from differentiated thyroid carcinoma

    Institute of Scientific and Technical Information of China (English)

    YU Yong-Li; LU Han-Kui; ZHU Rei-Sen; MA Ji-Xiao

    2004-01-01

    To assess the clinical value of treatment with 131I for brain metastases from differentiated thyroid cancer (DTC), we have observed 8 cases of brain metastases from DTC who received follow-up after 131I therapy (2male, 6 female, aged 12~65 years). The results of 131I therapy were evaluated with clinical presentation, imaging scan and survival analysis. The main results are as follows. (1) All cases had been survival for 2~35 years in follow-up. (2)A space-occupying lesion in right cerebellum was reduced after taking 20.65 GBq and disappeared after 23.61 GBq,demonstrated by computed tomography. (3) The sequences and doses of 131I therapy were clearly decreased for the cases with total thyroidectomy in comparison with those with semithyroidectomy (p<0.01). (4) The brain metastases with lung and/or bone metastasis from DTC were 75% (6/8) and it was difficult to cure these metastases at the same time. It is concluded that the postoperative treatment of 131I for brain metastases from DTC after undergoing thyroidectomy may improve clinical symptoms and life quality, reduce lesions, and prolong survival.

  7. Osteopoikilosis: A Sign Mimicking Skeletal Metastases in a Cancer Patient

    Directory of Open Access Journals (Sweden)

    Hamid Nasrolahi

    2011-01-01

    Full Text Available Osteopoikilosis is a rare benign osteosclerotic bone disorder that may be misdiagnosed as skeletal metastases. Here we describe a case of coincidental breast cancer and osteopoikilosis mimicking skeletal metastases. A 41-year-old woman underwent right modified radical mastectomy in April 2007. Twenty-eight months after initial treatment,the patient complained of bilateral knee and foot pain. Plain X-rays of the feet and knees showed multiple well-defined osteosclerotic lesions. According to the radiographic appearance, the most likely differential diagnoses included skeletal metastases from breast cancer and osteopoikilosis. A whole-body bone scintigraphy showed no increase in uptake by the sclerotic lesions, and serum lactic dehydrogenase, carcinoembryonic antigen, alkaline phosphatase and cancer antigen 15-3 were not elevated. We therefore diagnosed the patient’s skeletal lesions as osteopoikilosis. This case and ourliterature review suggest that the radiographic appearance of osteopoikilosis may mimic or mask skeletal metastases, potentially leading to misdiagnosis in patients with cancer.

  8. Crosstalk between Metastatic Cancer Cells and Bone Microenvironments

    Institute of Scientific and Technical Information of China (English)

    Toshiyuki YONEDA

    2009-01-01

    @@ Bone is one of the most preferential target sites for cancers such as breast, prostate and lung cancers to metastasize. Although the mechanism under-lying this organ preference still needs to be elucidated, observations that specific inhibitors of osteoclasts such as bisphosphonates inhibit bone metastases suggest a critical role of osteoclasts.

  9. Burden of metastatic bone disease from genitourinary malignancies.

    NARCIS (Netherlands)

    Mulders, P.F.A.; Abrahamsson, P.A.; Bukowski, R.M.

    2010-01-01

    Bone metastases are common among patients with stage IV genitourinary cancers. Most patients with bone metastases develop at least one debilitating and potentially life-limiting skeletal-related event. These events are associated with increased medical expenses and decreased quality of life. Current

  10. Evaluation of diagnostic procedures such as plain-film scintigraphy and MR imaging for spinal metastases in relation to biological characteristics in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Hiroya; Nagao, Kazuharu; Nishimura, Reiki; Matsuda, Kazumasa; Baba, Kenichiro; Matsuoka, Yukio; Fukuda, Makoto; Higuchi, Akihiro; Saeki, Takahito [Kumamoto City Hospital (Japan)

    1995-09-01

    The relationship between spinal metastases diagnosed by plain-film, bone scintigraphy, and MR imaging and biological characteristics in 26 patients with breast cancer was investigated retrospectively. It was found that bone scintigraphy is useful for detecting metastases in case with slow-growing tumors determined by DNA polymerase {alpha} or with estrogen-receptor (ER) positivity. In contrast, cases with rapidly growing tumors showed false-negative plain-film or bone scintigraphy results, including cases with ER-negative tumors or DNA polymerase {alpha} of more than 20%. MR imaging was found to be highly sensitive in detecting spinal metastases even in aggressive cases. MR imaging was found to have greater reliability in detecting spinal metastases of breast cancer compared to bone scintigraphy. In conclusion, it may be important to consider the degree of malignancy of each case with spinal metastases of breast cancer in evaluating imaging diagnosis. (author).

  11. Subtrochanteric Femoral Insufficiency Fracture Following Bisphosphonate Therapy for Osseous Metastases

    OpenAIRE

    Bush, Lisabeth A.; Chew, Felix S.

    2015-01-01

    We present the case of an insufficiency fracture of the femoral shaft in a 61-year-old man who had received bisphosphonate therapy to reduce the fracture risk from lytic renal cell carcinoma metastases to the spine. Approximately 1.5 years after beginning monthly intravenous infusions of zoledronic acid (Zometa), the patient complained of persistent thigh pain. Radionuclide bone scan showed mildly increased activity in the lateral subtrochanteric cortex of the right femur, where there was foc...

  12. Expression level of C-erbB-2、Ki67、P53、CA15-3 and AKP in breast cancer patients with bone metastases and its correlation%C-erbB-2、Ki67、P53、CA15-3、AKP在乳腺癌骨转移患者中的表达水平及其相关性

    Institute of Scientific and Technical Information of China (English)

    王会琴; 高美华

    2015-01-01

    Objective:Analysis of bone metastasis in breast cancer, the Ki67, P53, C-erbB-2 expression level and CA15-3, AKP levels in the blood, and to explore its clinical application in breast cancer with bone metastasis. Methods:49 cases of breast cancer patients with bone metastases were selected as experimental group, 29 cases of breast cancer without metastasis patients as control group. The expression level of Ki67,C-erbB-2 and P53 were evaluated by immunohistochemical method. The expression of P53, Ki67 and C-erbB-2 were calculated by the positive rate and positive regional gray value. The level of CA15-3 and AKP were detected by chemiluminescence immunoassay and biochemical method.Results:The expression quantity of Ki67, P53, C-erbB-2 in breast cancer without bone metastases were 1.07, 1.03, 0.41. While its level in breast cancer with bone metastases were 2.47, 2.47, 1.59. There is significant difference in breast cancer between no bone metastases and bone metastases (Ki67, P<0.01; P53, P<0.001; C-erbB-2, P<0.001). The expression level of CA15-3, AKP in no bone metastases breast cancer were 12.18, 85.59. Compared with the control group with significant difference (CA15-3, P<0.001;AKP, P<0.01), a significant rise in expression levels in bone metastases breast cancer, respectively 25.81, 123.57. Conclusions:The detection level of Ki67, P53, CA153, C-erbB-2 and AKP for prediction and diagnosis of bone metastases in breast cancer have clinical application value. Its expression level has great correlation with bone metastases.%目的:分析乳腺癌发生骨转移时,Ki67、P53、C-erbB-2表达水平及血中CA15-3、AKP水平,并探讨其在乳腺癌发生骨转移时的临床应用价值。方法:选取49例乳腺癌骨转移患者作实验组,29例乳腺癌未转移患者作对照组。采用免疫组化法测定Ki67、P53和C-erbB-2表达水平,采用阳性率和阳性区域灰度值共同积分的方法统计Ki67、P53和C-erbB-2的表达量。

  13. Multiple bone metastases detected on 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography in a breast cancer patient: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Zeki Dostbil

    2012-09-01

    Full Text Available Bone scintigraphy has been widely used to assess skeletal metastasis in patients with breast cancer. 18F-FDGPET/CT is another imaging modality that has gained previously wide use to determine metastasis based on increased glucose metabolism in malignant cells. Generally, these two modalities give similar results in evaluation of bone metastasis of breast cancer. In this breast cancer case, 99mTc-MDP bone scintigraphy showed normal findings in regards to skeletal metastasis while 18FFDG-PET/CT, contrast-enhanced CT and MRI revealed multiple metastatic focuses. J Clin Exp Invest 2012; 3 (3: 426-429Key words: 18F-fluorodeoxyglucose, bone metastasis, bone scintigraphy, positron emission tomography

  14. Metastatic disease of the brain: extra-axial metastases (skull, dura, leptomeningeal) and tumour spread

    Energy Technology Data Exchange (ETDEWEB)

    Maroldi, Roberto; Ambrosi, Claudia; Farina, Davide [University of Brescia, Department of Radiology, Brescia, BS (Italy)

    2005-03-01

    Extra-axial intracranial metastases may arise through several situations. Hematogenous spread to the meninges is the most frequent cause. Direct extension from contiguous extra-cranial neoplasms, secondary invasion of the meninges by calvarium and skull base metastases, and migration along perineural or perivascular structures are less common. Leptomeningeal invasion gives rise to tumour cell dissemination by the cerebrospinal fluid (CSF), eventually leading to neoplastic coating of brain surfaces. Contrast-enhanced magnetic resonance (MR) imaging is complementary to CSF examinations and can be invaluable, detecting up to 50% of false-negative lumbar punctures. MR findings range from diffuse linear leptomeningeal enhancement to multiple enhancing extra-axial nodules, obstructive communicating and non-communicating hydrocephalus. Both calvarial and epidural metastases infrequently transgress the dura, which acts as a barrier against tumour spread. Radionuclide bone studies are still a valuable screening test to detect bone metastases. With computed tomography (CT) and MR, bone metastases extending intracranially and primary dural metastases show the characteristic biconvex shape, usually associated with brain displacement away from the inner table. Although CT is better in detecting skull base erosion, MR is more sensitive and provides more detailed information about dural involvement. Perineural and perivascular spread from head and neck neoplasms require thin-section contrast-enhanced MR. (orig.)

  15. Estrogen potency of oral contraceptive pills.

    Science.gov (United States)

    Chihal, H J; Peppler, R D; Dickey, R P

    1975-01-01

    The estrogen potencies of 9 oral contraceptive pills, Enovid-E, Enovid-5, Ovulen, Demulen, Norinyl+80, Norinyl+50, Ovral, Norlestrin 1 mg. and Norlestrin 2.5 mg., were determined by bioassay. Relative estrogen potency was determined by analysis of variance. Enovid-5, the most estrogenic compound, had a potency of 4.88 compared to ethinyl estradiol, 50 mcg. equal 1.00; Ovral, the least estrogenic compound, had a potency of 0.81, a sixfold difference. Estrogen potencies at a fractional dose of 0.00155 correlate with reports of the incidence of minor side effects and thromboembolic disease. The effect of progestins on estrogen potency was purely additive (norgestrel and norethynodrel), purely antagonistic, or additive at low concentrations and antagonistic at high concentrations (norethindrone, norethindrone acetate, and ethynodiol diacetate). These results suggest that pills with a greater margin of safety might be developed by utilizing greater ratios of progestin to estrogen. In addition, differences in relative estrogen potency of oral contraceptive pills may be used as a basis for better clinical selection.

  16. Authentication of Algorithm to Detect Metastases in Men with Prostate Cancer Using ICD-9 Codes

    Directory of Open Access Journals (Sweden)

    Matthew T. Dolan

    2012-01-01

    Full Text Available Background. Metastasis is a crucial endpoint for patients with prostate cancer (PCa, but currently lacks a validated claims-based algorithm for detection. Objective. To develop an algorithm using ICD-9 codes to facilitate accurate reporting of PCa metastases. Methods. Medical records from 300 men hospitalized at Robert Wood Johnson University Hospital for PCa were reviewed. Using the presence of metastatic PCa on chart review as the gold standard, two algorithms to detect metastases were compared. Algorithm A used ICD-9 codes 198.5 (bone metastases, 197.0 (lung metastases, 197.7 (liver metastases, or 198.3 (brain and spinal cord metastases to detect metastases, while algorithm B used only 198.5. Sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV for the two algorithms were determined. Kappa statistics were used to measure agreement rates between claim data and chart review. Results. Algorithm A demonstrated a sensitivity, specificity, PPV, and NPV of 95%, 100%, 100%, and 98.7%, respectively. Corresponding numbers for algorithm B were 90%, 100%, 100%, and 97.5%, respectively. The agreement rate is 96.8% for algorithm A and 93.5% for algorithm B. Conclusions. Using ICD-9 codes 198.5, 197.0, 197.7, or 198.3 in detecting the presence of PCa metastases offers a high sensitivity, specificity, PPV, and NPV value.

  17. Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Kiminori Uka; Kazuaki Chayama; Hiroshi Aikata; Shintaro Takaki; Hiroo Shirakawa; Soo Cheol Jeong; Keitaro Yamashina; Akira Hiramatsu; Hideaki Kodama; Shoichi Takahashi

    2007-01-01

    AIM: To assess the clinical features and prognosis of 151 patients with extrahepatic metastases from primary hepatocellular carcinoma (HCC), and describe the treatment strategy for such patients.METHODS: After the diagnosis of HCC, all 995consecutive HCC patients were followed up at regular intervals and 151 (15.2%) patients were found to have extrahepatic metastases at the initial diagnosis of primary HCC or developed such tumors during the follow-up period. We assessed their clinical features,prognosis, and treatment strategies.RESULTS: The most frequent site of extrahepatic metastases was the lungs (47%), followed by lymph nodes (45%), bones (37%), and adrenal glands (12%).The cumulative survival rates after the initial diagnosis of extrahepatic metastases at 6, 12, 24, and 36 mo were 44.1%, 21.7%, 14.2%, 7.1%, respectively. The median survival time was 4.9 mo (range, 0-37 mo). Fourteen patients (11%) died of extrahepatic HCC, others died of primary HCC or liver failure.CONCLUSION: The prognosis of HCC patients with extrahepatic metastases is poor. With regard to the cause of death, many patients would die of intrahepatic HCC and few of extrahepatic metastases. Although most of HCC patients with extrahepatic metastases should undergo treatment for the primary HCC mainly,treatment of extrahepatic metastases in selected HCC patients who have good hepatic reserve, intrahepatic tumor stage (T0-T2), and are free of portal venous invasion may improve survival.

  18. Mechanisms of cancer metastasis to the bone

    Institute of Scientific and Technical Information of China (English)

    Juan Juan YIN; Claire B. POLLOCK; Kathleen KELLY

    2005-01-01

    Some of the most common human cancers, including breast cancer, prostate cancer, and lung cancer, metastasize with avidity to bone. What is the basis for their preferential growth within the bone microenvironment? Bidirectional interactions between tumor cells and cells that make up bone result in a selective advantage for tumor growth and can lead to bone destruction or new bone matrix deposition. This review discusses our current understanding of the molecular components and mechanisms that are responsible for those interactions.

  19. Nasopharyngeal carcinoma with metastases to colon

    Directory of Open Access Journals (Sweden)

    Yatiee Swany Lahuri

    2015-07-01

    Full Text Available Squamous cell carcinoma (SCC of the nasopharynx is amongst the most common head and neck cancers. The most common distant metastases are to the bone, liver and lung. Herein, we are reporting a rare case of a 61-year-old man with nasopharyngeal carcinoma (NPC who presented with 3 weeks history of blood streaked sputum, post nasal drip and blocked nose with no history of epistaxis, tinnitus and unilateral hearing loss. Almost 2 years upon completion of his concurrent chemotherapy and radiotherapy, he developed a right hypochondrium mass and underwent colonoscopy which revealed a mass in ascending colon and which was then subsequently resected via right hemicolectomy. Histological analyses from the resected specimen confirmed its nasopharyngeal origin.

  20. Clinical course of breast cancer patients with liver metastases.

    Science.gov (United States)

    Zinser, J W; Hortobagyi, G N; Buzdar, A U; Smith, T L; Fraschini, G

    1987-05-01

    Between June 1973 and November 1980, 1,171 patients with metastatic breast cancer were treated with various doxorubicin-containing regimens at our institution (M.D. Anderson Hospital and Tumor Institute, Houston). Retrospective analysis of all 233 cases (20%) with liver metastases was done to correlate various clinical and biochemical characteristics with response to treatment, survival, and causes of death. A similar analysis was performed for 58 consecutive patients with liver metastases treated at this hospital between December 1955 and December 1957 with hormone therapy or single-agent chemotherapy. Objective responses were observed in 132 of 233 patients (57%) treated with combination chemotherapy. The median survival was 14 months in the 1970s and 5 months in the 1950s. Among patients who had liver metastases at the time of initial diagnosis of breast cancer, survival was longer for the group treated with combination chemotherapy. All cases were classified according to the number of organ sites involved by metastases. Patients with only liver metastases, or liver plus bone lesions had the longest survival. Other clinical and biochemical factors that correlated significantly with longer survival were: no prior chemotherapy, performance status of 1 to 2, absence of ascites, normal bilirubin and lactic dehydrogenase (LDH), SGOT less than or equal to 2 times normal and albumin greater than 4.5 g/dL. The main cause of death was multiorgan failure, with only 20% of patients dying of liver failure. The present study shows that the presence of liver metastases in breast cancer is not by itself an ominous factor. Most patients respond to therapy, and significant palliation with extended survival is possible for several prognostic subgroups. Further improvement in length and quality of survival is expected with earlier diagnosis.

  1. Antibacterial potency screening of Capparis zeylanica Linn

    Institute of Scientific and Technical Information of China (English)

    Rezaul Haque; Wahedul Islam; Selina Parween

    2016-01-01

    Objective: To conduct the antibacterial potency and minimum inhibitory concentration of extracts (n-hexane, acetone, chloroform and methanol) obtained from the root, leaf and stem of Capparis zeylanica. Methods: The powdered leaf, root and stem samples were Soxhlet extracted sequentially in n-hexane, acetone, chloroform and methanol. Antibacterial potency was evaluated by following the agar diffusion method and amoxicillin disc was used as a control. Results: In vitro antibacterial activity against 12 bacteria was performed with crude extracts. Among them, all the bacteria showed the moderate activity but chloroform and methanolic extracts showed promising antibacterial potency against Staphylococcus aureus, Sarcina lutea, Bacillus megaterium, Bacillus subtilis, Salmonella typhi and Shigella dysenteriae (leaf > root > stem). This activity was evaluated using disc diffusion method with a standard antibiotic, 30 µg/disc of amoxicillin. Conclusions: Strong antibacterial potency of chloroform and methanolic extracts provides new antibacterial compounds.

  2. Bone health in cancer patients

    DEFF Research Database (Denmark)

    Coleman, R; Body, J J; Aapro, M

    2014-01-01

    There are three distinct areas of cancer management that make bone health in cancer patients of increasing clinical importance. First, bone metastases are common in many solid tumours, notably those arising from the breast, prostate and lung, as well as multiple myeloma, and may cause major...... morbidity including fractures, severe pain, nerve compression and hypercalcaemia. Through optimum multidisciplinary management of patients with bone metastases, including the use of bone-targeted treatments such as potent bisphosphonates or denosumab, it has been possible to transform the course of advanced...... cancer for many patients resulting in a major reduction in skeletal complications, reduced bone pain and improved quality of life. Secondly, many of the treatments we use to treat cancer patients have effects on reproductive hormones, which are critical for the maintenance of normal bone remodelling...

  3. Chinese expert consensus statement on clinical diagnosis and treatment of malignant tumor bone metastasis and bone related diseases%恶性肿瘤骨转移及骨相关疾病临床诊疗中国专家共识

    Institute of Scientific and Technical Information of China (English)

    Shiying Yu; Zefei Jiang; Li Zhang; Xiaohui Niu; Lvhua Wang; Ning Wu; Jianhui Ma

    2010-01-01

    @@ Clinical diagnosis and treatment of malignant tumor bone metastases Overview Bone is the most common place of metastases in ad vanced malignant diseases. Constant improvement in the treatment of malignant tumors has resulted in prolonged survival time, and so as an increased incidence of osseous metastases and skeletal complications.

  4. 153Sm-EDTMP治療轉移性骨癌骨痛100例療效分析%Efficacy assessment of 153 Sm-EDTMP in treatment of 100 patients with metastatic bone pain

    Institute of Scientific and Technical Information of China (English)

    高曉峰; 王寶東; 陳玉敏; 侯躍君

    2001-01-01

    Objective To evaluate the effect of 153Sm-EDTMP in treating patients with metastatic bone pain.Methods 153 Sm-EDTMP was injected intravenously every 4 weeks to each patient at a dose of 1mCi/kg body weight. 3 to 5 injections made one treating process. Results Complete pain relief was obtained in 34 cases (34%),partial relief in 45 cases (45%) and no relief in21 cases (21%00), respectively. The total effective rate was 79%.60 of the 79 effective cases were those with metastatic lesions from adenocarcinoma (P<0.05). Conclusion 153SmEDTMP is highly selective and effective in treating metastatic bone pain, yet the therapy potency is closely related to histological classification that metastases from adenocarcinoma have better therapy response.

  5. THE CLINICAL COURSE AND TREATMENT RESULTS OF LUNG METASTASES FROM BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    Xu Binghe; Zhou Jichang; Zhou Aiping; Wang Yan; Feng Fengyi; Sun yan

    1998-01-01

    Objective:To analyze the clinical course and treatment result of lung metastases from breast cancer. Method:122 cases with lung metastases from breast cancer were treated with chemotherapy or chemotherapy plus endocrine therapy, response was assessed according to WHO criteria and survival rate estimated using the life Table. Results: The median time from initial treatment of primary tumor to lung metastases was 22 months. Sites of common consecutive metastases were lung, liver and bone. The overall response rate was 48% with a CR rate of 15%. Compared to non- DDP- encompassing regimen, the CR rate was higher in DDP-based chemotherapy (7%versus 21%, P<0.05) with a longer median survival time (MST). The PR rate was higher in regimens containing anthracycline (48%) than in those without anthracycline (20%, P<0.01). The response rate was similar between chemotherapy and chemotherapy plus endocrine therapy (P>0.05). No difference in MST was observed between patients receiving anthracycline-and non-anthracyclineencompassing regimens. The 1-, 3-, 5-, and 10-year survival rate was 77%, 22 %, 11%, and 10%, respectively.Conclusion: Size of primary tumor, the length of diseasefree interval, the number of lung metastases may provide additional information for predicting patients survival after treatment of lung metastases. Combination chemotherapy, especially DDP-based chemotherapy may prolong survival time of patients with lung metastases from breast cancer.

  6. Dosimetry, hematological toxicity and evaluation of chromosomal damage of Sm-153-EDTMP in patients with bone metastases and rheumatoid arthritis; Dosimetria, toxicidade hematologica e avaliacao do dano cromossomico do Sm-153-EDTMP em pacientes portadores de metastases osseas e artrite reumatoide

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Maria Ines Calil Cury; Marinho, Norma V.S.; Ono, Carla R.; Rocha, Euclides T.; Buchpiguel, Carlos Alberto [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Centro de Medicina Nuclear]. E-mail: micguima@br2001.com.br; Silva, Marcia A. da; Okasaki, Kayo [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)]. E-mail: masilva@net.ipen.br

    2001-07-01

    Samarium-153-EDTMP has been successfully used for pain palliation in metastatic bone cancer to a lesser extend in rheumatoid arthritis. Were studied 110 patients, 90 with metastatic bone cancer and 20 with rheumatoid arthritis. Each patient received 37 MBq/kg (1mCi/kg) of Sm-153-EDTMP, intravenously injected. Urine samples were collected during 6 hours. Blood samples were collected before and one hour after the injection. The MIRD formalism was utilized for dosimetric calculations. The absorbed dose for red marrow, cortical and trabecular for patients with rheumatoid arthritis were respectively: 206{+-}66,38 cGy; 544,04{+-}171,31 cGy; 630,80{+-}197,15 cGy. For the patients with metastatic bone cancer, the absorbed dose for red marrow was 319,07{+-}94,06 cGy, cortical 841,58{+-}236,12 cGy; trabecular 978,23{+-} 264,05 cGy. The leukocyte counts decreased 48,5%{+-}19%, the platelets 54,7%{+-}26% and hemoglobin 13,7%{+-}11%, from the baseline values. The principal kind of the structural aberrations observed were: acentric fragments, breaks, chromosomal gaps, centric ring and double minute. The number of the aberrations in blood cells, after the application of Sm-153-EDTMP, was 2,13 times bigger than the baseline. The absorbed dose radiation, the hematological and genetics effects established were in the limits accepted for this kind of treatment. (author)

  7. Potential of activatable FAP-targeting immunoliposomes in intraoperative imaging of spontaneous metastases.

    Science.gov (United States)

    Tansi, Felista L; Rüger, Ronny; Böhm, Claudia; Kontermann, Roland E; Teichgraeber, Ulf K; Fahr, Alfred; Hilger, Ingrid

    2016-05-01

    Despite intensive research and medical advances met, metastatic disease remains the most common cause of death in cancer patients. This results from late diagnosis, poor therapeutic response and undetected micrometastases and tumor margins during surgery. One approach to overcome these challenges involves fluorescence imaging, which exploits the properties of fluorescent probes for diagnostic detection of molecular structures at the onset of transformation and for intraoperative detection of metastases and tumor margins in real time. Considering these benefits, many contrast agents suitable for fluorescence imaging have been reported. However, most reports only demonstrate the detection of primary tumors and not the detection of metastases or their application in models of image-guided surgery. In this work, we demonstrate the influence of fibroblast activation protein (FAP) on the metastatic potential of fibrosarcoma cells and elucidate the efficacy of activatable FAP-targeting immunoliposomes (FAP-IL) for image-guided detection of the spontaneous metastases in mice models. Furthermore, we characterized the biodistribution and cellular localization of the liposomal fluorescent components in mice organs and traced their excretion over time in urine and feces. Taken together, activatable FAP-IL enhances intraoperative imaging of metastases. Their high accumulation in metastases, subsequent localization in the bile canaliculi and liver kupffer cells and suitable excretion in feces substantiates their potency as contrast agents for intraoperative imaging.

  8. Soft tissue metastases from differentiated thyroid cancer diagnosed by {sup 18}F FDG PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Califano, Ines; Quildrian, Sergio; Otero, Jose; Coduti, Martin; Califano, Leonardo; Rojas Bilbao, Erica, E-mail: ines.m.califano@gmail.com [Instituto de Oncologia Angel H. Roffo, Universidad de Buenos Aires (Argentina)

    2013-06-15

    Distant metastases of differentiated thyroid cancer are unusual; lung and bones are the most frequently affected sites. Soft tissue metastases (STM) are extremely rare. We describe two cases of patients with differentiated thyroid cancer metastasizing to soft tissues. Both patients had widespread metastatic disease; clinically asymptomatic soft tissue metastases were found by 18-Fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F FDG PET-CT), and confirmed by cytological and/or histopathological studies. These findings underscore the ability of {sup 18}F FDG PET-CT in accurately assessing the extent of the disease, as well as the utility of the method to evaluate regions of the body that are not routinely explored. (author)

  9. Imaging of spinal metastases%脊柱转移瘤影像学研究进展

    Institute of Scientific and Technical Information of China (English)

    蒋伟刚; 刘耀升; 刘蜀彬

    2016-01-01

    The spine is the third most common site for metastatic diseases, following the lung and the liver. Metastases to the spine can involve the bone, epidural space, leptomeninges, and spinal cord. Imaging modalities play complimentary roles in the evaluation of spinal metastatic disease. Imaging examination is the direct evidence to determine the bone metastases, the early detection of bone metastasis and complications caused by bone metastases, tumor invasion, biopsy positioning, etc. It is of great signiifcance. CT can clearly delineate the osseous integrity, while MRI can display the soft tissue involvement. Physiologic properties can be evaluated with other imaging modalities such like FDG-PET and advanced MRI. Imaging plays a fundamental role in not only the diagnosis but also treatment planning of spinal metastatic disease.

  10. 18F-NaF PET-CT与血清肿瘤标志物联合检测对肺癌骨转移早期诊断的价值%Value of 18F-NaF PET-CT and serum tumor markers in the joint detection of bone metastases in recently diagnosed lung cancer patients

    Institute of Scientific and Technical Information of China (English)

    王明霜; 周凡; 甘西伦; 谭蓓蓓

    2015-01-01

    目的:探讨18F-NaF PET-CT与血清肿瘤标志物CEA、CYFRA21-1、NSE联合检测对肺癌骨转移患者早期诊断的临床意义。方法:选取46例来我院就诊,通过临床、CT、MRI等确诊为肺癌骨转移患者,分别于行18F-NaF PET-CT检查同时采取静脉血行血清CEA、CYFRA21-1、NSE检测,得到的最终诊断进行比较,分析两种检查联合检测在肺癌骨转移患者早期诊断中的临床意义。结果:46例患者18F-NaF PET-CT检查的SUVmax平均值为8.81±4.54,CEA平均值为37.45±42.57,CYFRA21-1平均值为32.30±42.66,NSE平均值为50.12±38.45。46例阳性患者,18F-NaF PET-CT检查出44例,灵敏度为93.40%,特异性为91.37%,准确性为93.50%;三种血清肿瘤标志物联合检测诊断肺癌的灵敏度分别为83.49%,特异性为70.52%,准确性为90.99%;两种检查联合诊断的灵敏度为96.85%,特异性为97.43%,准确性为98.33%。结论:18F-NaF PET-CT对肺癌骨转移早期患者诊断的灵敏度和准确性较血清CEA、CYFRA21-1、NSE检测高,但血清CEA、CYFRA21-1、NSE对其诊断也具有一定的价值,对前者检查可以起到协助补充的作用,两者联合应用对于肺癌骨转移早期患者的早期诊断具有重要的临床意义。%ObjectiveTo explore the joint detection value of 18F-NaF PET-CT and serum CEA,CYFRA21-1,and NSE in the diagnosis of bone metastases in recently diagnosed lung cancer patients. Methods46 cases of confirmed bone metastases of recently diagnosed lung cancer were selected, 18F-NaF PET-CT and serum CEA, CYFRA21-1,and NSE detection were performed at the same time, and their value in early detecting the bone metastasis was studied. Results In 46 cases, the SUV max of 18F-NaF PET-CT was 8.81 ± 4.54, serum CEA was 37.45±42.57,serum CYFRA21-1 was 32.30±42.66, seram NSE was 50.12±38.45. The sensitivity of 18F-NaF PET - CT examination was 93.40%, specificity was 91.37%, the diagnostic accuracy was 93

  11. Validation of algorithms to detect distant metastases in men with prostate cancer using routine registry data in Denmark

    Directory of Open Access Journals (Sweden)

    Ehrenstein V

    2015-04-01

    Full Text Available Vera Ehrenstein,1 Rohini K Hernandez,2 Merete Lund Maegbaek,1 Johnny Kahlert,1 Mary Nguyen-Nielsen,1 Mette Nørgaard,1 Alexander Liede2 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Center for Observational Research, Amgen, Thousand Oaks, CA, USA Objective: Among patients with prostate cancer, diagnostic codes for bone metastases in the Danish National Registry of Patients have a sensitivity of 44%. In an attempt to improve the sensitivity of registry-based identification of metastases from prostate cancer, we tested a series of algorithms, combining elevated prostate-specific antigen (PSA levels, use of antiresorptive therapy, and performed bone scintigraphy. Patients and methods: We randomly selected 212 men diagnosed with prostate cancer in 2005–2010 in the Central Denmark Region with prespecified PSA values, antiresorptive therapy, and bone scintigraphy who did not have a registry-based diagnostic code indicating presence of distant metastases. We defined three candidate algorithms for bone metastases: 1 PSA >50 µg/L and bone scintigraphy, 2 PSA >50 µg/L and antiresorptive therapy, and 3 PSA ≤50 µg/L with antiresorptive therapy or bone scintigraphy. An algorithm for distant metastasis site other than bone was defined as PSA >50 µg/L alone. Medical chart review was used as the reference standard to establish the presence or absence of metastases. Validity was expressed as a positive predictive value (PPV or a negative predictive value, based on whether the algorithms correctly classified metastases compared with the reference standard. Results: We identified 113 men with evidence of metastases according to the candidate algorithms, and 99 men without evidence of metastases according to the candidate algorithm. The PPVs of PSA >50 µg/L were 0.10 (95% confidence interval [CI] 0.04–0.19 for bone metastases and 0.14 (95% CI 0.07–0.24 for nonbone metastases, regardless of receipt of antiresorptive

  12. Treatment of colorectal liver metastases

    Directory of Open Access Journals (Sweden)

    Ismaili Nabil

    2011-11-01

    Full Text Available Abstract Colorectal cancer (CRC is the third most common cancer in the word. Liver metastasis is the most common site of colorectal metastases. The prognosis of resectable colorectal liver metastases (CRLM was improved in the recent years with the consideration of chemotherapy and surgical resection as part of the multidisciplinary management of the disease; the current 5-year survival rates after resection of liver metastases are 25% to 40%. Resectable synchronous or metachronous liver metastases should be treated with perioperative chemotherapy based on three months of FOLFOX4 (5-fluorouracil [5FU], folinic acid [LV], and oxaliplatin chemotherapy before surgery and three months after surgery. In the case of primary surgery, pseudo-adjuvant chemotherapy for 6 months, based on 5FU/LV, FOLFOX4, XELOX (capecitabine and oxaliplatin or FOLFIRI (5FU/LV and irinotecan, should be indicated. In potentially resectable disease, primary chemotherapy based on more intensive regimens such as FOLFIRINOX (5FU/LV, irinotecan and oxaliplatin should be considered to enhance the chance of cure. The palliative chemotherapy based on FOLFIRI, or FOLFOX4/XELOX with or without targeted therapies, is the mainstay treatment of unresectable disease. This review would provide additional insight into the problem of optimal integration of chemotherapy and surgery in the management of CRLM.

  13. Leptomeningeal Metastases in Solid Tumors

    Directory of Open Access Journals (Sweden)

    Marija Karakolevska-Ilova

    2014-12-01

    CONCLUSION: The prognostic factors associated with survival in patients with LM metastasis are not certain as well as right treatment for these patients which is still a big challenge. Due to the lack of randomized studies and especially of studies referring to one specific primary tumor, there is currently no generally accepted standard of care in the treatment of LM metastases.

  14. Thyroid Carcinoma with Pituitary Metastases: 2 Case Reports and Literature Review

    Directory of Open Access Journals (Sweden)

    Weiying Lim

    2015-01-01

    Full Text Available We present 2 patients with pituitary metastases from thyroid carcinoma—the first from anaplastic thyroid carcinoma and the second from follicular thyroid carcinoma. The first patient, a 50-year-old lady, presented with 2-week history of hoarseness of voice, dysphagia, dyspnoea, and neck swelling. Imaging revealed metastatic thyroid cancer to lymph nodes and bone. Histology from surgery confirmed anaplastic thyroid cancer. She was found to have pituitary metastases postoperatively when she presented with nonvertiginous dizziness. She subsequently underwent radiotherapy and radioiodine treatment but passed away from complications. The second patient, a 65-year-old lady, presented with loss of appetite and weight with increased goitre size and dyspnoea. Surgery was performed in view of compressive symptoms and histology confirmed follicular thyroid carcinoma. Imaging revealed metastases to bone, lung, and pituitary. She also had panhypopituitarism with hyperprolactinemia and diabetes insipidus. She received radioiodine therapy but eventually passed away from complications.

  15. Development in the study of radium-223 chloride for treating castration-resistant prostate carcinoma with bone metastases%镭-223氯化物治疗去势抵抗性前列腺癌骨转移的研究进展

    Institute of Scientific and Technical Information of China (English)

    桂继琮; 刘兴党

    2015-01-01

    近年来,全世界前列腺癌的发病率和病死率不断增长,各种治疗方法的研究也进展迅速。镭-223发射的重α粒子(具有<100μm的超短波)靶向作用于骨转移部位和周围新骨生长区域。镭-223氯化物在药物临床试验中以稳定的安全性显著降低了患者的病死率,成为近来被寄予厚望的转移性去势抵抗性前列腺癌(CRPC)治疗领域的“主角”。2013年美国食品药品管理局已批准镭-223氯化物用于治疗有症状的骨转移、未发现内脏转移的CRPC患者。未来其联合治疗方案将会是研究的重点。%Prostate carcinoma rates and mortalities are increasing worldwide. The therapeutic landscape of castration-resistant prostate carcinoma (CRPC) has changed rapidly. Radium-223 chloride, which is a radiopharmaceutical agent, targets bone metastasis by emitting high-energy alpha-particles with extremely short range (<100 μm ) . This chemical is effective in reducing mortality without increasing toxicity. Thus, this agent has the potential to become a new alternative for treating patients with CRPC. The Food and Drug Administration approved radium-223 dichloride for treating patients with CRPC, symptomatic bone metastases, and unknown visceral metastatic disease in 2013. Therefore, combination and sequencing strategies will be future research directions.

  16. Preoperative scintigraphic detection of lung metastases of a follicular thyroid carcinoma associated with hyperthyroidism; Detection scintigraphique preoperatoire de metastases pulmonaires d'un carcinome vesiculaire de la thyroide associe a une hyperthyroidie

    Energy Technology Data Exchange (ETDEWEB)

    Biyi, A.; Oufroukhi, Y.; Doudouh, A. [Hopital Militaire d' Instruction Mohammed V, Rabat Instituts, Service de Medecine Nucleaire, Rabat (Morocco); Baizri, H.; El Quatni, M. [Hopital Militaire d' Instruction Mohammed V, Service d' Endocrinologie, Rabat (Morocco); Al Bouzidi, A. [Hopital Militaire d' Instruction Mohammed V, Service d' Anatomie Pathologique, Rabat (Morocco)

    2009-10-15

    Preoperative accumulation of radioiodine in metastases of thyroid carcinoma and its association with hyperthyroidism are uncommon. We report a case of 58-year-old woman with follicular thyroid carcinoma revealed by thyrotoxicosis caused by a hot nodule, and bilateral pulmonary uptake of I-131 before total thyroidectomy. Despite four ablative doses of I-131, bone metastases were identified and the patient died 42 month after the initial diagnosis. (authors)

  17. Intracranial metastases: spectrum of MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Kyoung; Lee, Eun Ja; Lee, Yong Seok [Department of Radiology, Dongguk University Ilsan Hospital, Goyang-shi (Korea, Republic of)], E-mail: ejl1048@hanmail.net; Kim, Mi Sung; Park, No Hyuck [Department of Radiology, Kwandong University, College of Medicine, Myongji Hospital, Goyang-shi (Korea, Republic of); Park, Hee-Jin [Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); II, Sung Park [Department of Diagnostic Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2012-12-15

    Intracranial metastatic lesions arise through a number of routes. Therefore, they can involve any part of the central nervous system and their imaging appearances vary. Magnetic resonance imaging (MRI) plays a key role in lesion detection, lesion delineation, and differentiation of metastases from other intracranial disease processes. This article is a reasoned pictorial review illustrating the many faces of intracranial metastatic lesions based on the location - intra-axial metastases, calvarial metastases, dural metastases, leptomeningeal metastases, secondary invasion of the meninges by metastatic disease involving the calvarium and skull base, direct or perineural intracranial extension of head and neck neoplasm, and other unusual manifestations of intracranial metastases. We also review the role of advanced MRI to distinguish metastases from high-grade gliomas, tumor-mimicking lesions such as brain abscesses, and delayed post-radiation changes in radiosurgically treated patients.

  18. DATA MINING POTENCY ESTIMATORS FROM TOXICOLOGICAL DATABASES

    OpenAIRE

    Piegorsch, Walter W.; Simmons, Susan J.; Zeiger, Errol

    2004-01-01

    We discuss use of data mining techniques to study estimators of toxic potency (activity) in toxicological databases. The methods are slight variations on the standard data mining motif, but fit fully within the larger context of knowledge discovery in databases. An example illustrates the general theme of the approach, using results from a U.S. National Toxicology Program Salmonella mutagenicity database.

  19. Bone metastasis treatment using magnetic resonance-guided high intensity focused ultrasound

    NARCIS (Netherlands)

    Yeo, Sin Yuin; Elevelt, Aaldert; Donato, Katia; van Rietbergen, Bert; ter Hoeve, Natalie D.; van Diest, Paul J.; Grüll, Holger

    2015-01-01

    Objectives: Bone pain resulting from cancer metastases reduces a patient's quality of life. Magnetic Resonance-guided High Intensity Focused Ultrasound (MR-HIFU) is a promising alternative palliative thermal treatment technique for bone metastases that has been tested in a few clinical studies. Here

  20. Histological Regression of Giant Cell Tumor of Bone Following RANK Ligand Inhibition

    Directory of Open Access Journals (Sweden)

    Martin F. Dietrich MD, PhD

    2014-11-01

    Full Text Available Lung metastases are a rare complication of giant cell tumors of bone. We herein describe an interesting case of histological regression and size reduction of lung metastases originating from a primary giant cell tumor of bone in response to the RANK ligand inhibitor denosumab.

  1. Nasal metastases from renal cell carcinoma are associated with Memorial Sloan-Kettering Cancer Center poor-prognosis classification

    Institute of Scientific and Technical Information of China (English)

    Caroline Victoria Choong; Tiffany Tang; Wen Yee Chay; Christopher Goh; Miah Hiang Tay; Nor Azhari Mohd Zam; Puay Hoon Tan; Min-Han Tan

    2011-01-01

    Unusual sites of metastases are recognized in patients with renai cell carcinoma (RCC). However, the prognostic implications of these sites are not well understood. We used the Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification for metastatic RCC to evaluate 912 consecutive patients with RCC managed at the Singapore General Hospital between 1990 and 2009. Among these patients, 301 had metastases either at diagnosis or during the course of illness. Nasal metastases, all arising from clear cell RCC, were identified histologically in 4 patients (1.3% of those with metastasis). All 4 patients were classified as MSKCC poor prognosis by current risk criteria. Nasal metastases were significantly associated with lung and bone metastases. The frequency of nasal metastases in patients with metastatic RCC is about 1%, occurring predominantly in patients with clear cell RCC. Nasal metastases are associated with poor prognosis as estimated by the MSKCC risk classification, with attendant implications for selection of targeted therapy, and are usually associated with multi-organ dissemination, including concurrent lung and bone involvement.

  2. Widespread hematogenous metastases and Trousseau's syndrome in gastric adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Santos Vitorino Modesto dos

    2001-01-01

    Full Text Available A case of widespread hematogenous metastases and Trousseau's syndrome is reported in a 40 year-old white housewife with gastric cancer, presenting subdural hematoma, ecchymoses, epistaxis, stomach and uterine bleeding. After undergoing hematoma drainage, she was unsuccessfully treated with platelets, red blood cells, plasma cryoprecipitate transfusions, and antibiotics. Necropsy disclosed gastric ring-signet adenocarcinoma invading the serous layer, with massive disseminated intravascular coagulation and systemic neoplastic embolism. Multiple old and recent hyaline (rich in fibrin and platelets microthrombi, and tumor emboli were observed in the bone marrow, meninges, liver, lungs, kidneys, lymph nodes, adrenals, thyroid, heart, pancreas, and ovaries (Krukenberg tumor.

  3. Metastasizing Esthesioneuroblastoma in a Dog.

    Science.gov (United States)

    Siudak, K; Klingler, M; Schmidt, M J; Herden, C

    2015-07-01

    A 7-year-old Afghan hound presented with a history of disorientation, loss of vision, and seizures. Magnetic resonance imaging helped identify a mass at the level of the main olfactory bulb that compressed and displaced adjacent tissues in the cribriform plate into the nasal cavity and nasopharynx. Bony structures were osteolytic. After removing almost 80% of the mass, the tumor recurred a few months later. Due to severe respiratory distress and subsequent to an ultrasound diagnosis of a liver tumor, the dog was euthanized. In addition to the nasal mass, a single nodule in the liver and multiple nodules in the lung were present. All masses had similar cell morphology and were diagnosed as metastasizing esthesioneuroblastoma. The neoplastic cells expressed neuron-specific enolase and chromogranin A, and a few cells within the nasal mass were positive for cytokeratin. This is the first description of a canine esthesioneuroblastoma with distant metastases.

  4. Extraneural metastases in anaplastic ependymoma

    Directory of Open Access Journals (Sweden)

    Kumar Pavan

    2007-01-01

    Full Text Available Ependymoma are rare glial neoplasm, it rarely metastasize outside the central nervous system. We present a case of anaplastic ependymoma with extraneural metastases with review of literature. A ten-year-old male child presented with anaplastic ependymoma of choroid plexus and treated with craniospinal radiotherapy in 1998. He had intracranial recurrence in 2004, confirmed by biopsy. He was given adjuvant chemotherapy in form of PCV. At 10 months after completion of chemotherapy, he developed extracranial scalp metastasis and so was treated with palliative local radiation therapy to the scalp metastasis and systemic chemotherapy with oral Etoposide. Scalp metastasis completely disappeared and ataxia improved. After five cycles of chemotherapy, the patient had progression of disease in form of scalp and cervical lymph node metastasis confirmed by fine needle aspiration cytology, biopsy and immunohistochemistry. He was given salvage chemotherapy (carboplatin + ifosfamide + etoposide at 3-weekly. He had partial response and was still on chemotherapy till May 2007.

  5. Brain metastases from colorectal cancer

    DEFF Research Database (Denmark)

    Vagn-Hansen, Chris Aksel; Rafaelsen, Søren Rafael

    2001-01-01

    Brain metastases from colorectal cancer are rare. The prognosis for patients with even a single resectable brain metastasis is poor. A case of surgically treated cerebral metastasis from a rectal carcinoma is reported. The brain tumour was radically resected. However, cerebral, as well...... as extracerebral, disease recurred 12 months after diagnosis. Surgical removal of colorectal metastatic brain lesions in selected cases results in a longer survival time....

  6. 儿童颅面骨转移性神经母细胞瘤的CT和MRI诊断%CT and MRI Diagnosis of Craniofacial Bone Metastases of Neuroblastoma in Children

    Institute of Scientific and Technical Information of China (English)

    陈利军; 陈士新; 赵志友; 李维华

    2013-01-01

    Objective To investigate the CT and MRI characteristics of metastatic neuroblastoma in the craniofacial bones in children. Methods CT and MRI features of 7 children with pathologically proved metastatic neuroblastoma in the craniofacial bones were retrospectively evaluated. Seven patients underwent orbital plain CT, MRI and enhanced orbital MRI scan. The 5 cases underwent abdominal plain CT scan,and 3 of which underwent abdominal enhanced CT scan. Results Six of seven children had multiple lesions and one had single lesion. Multiple lesions mainly located at bilateral cephalic orbital bone junction. CT scan showed vermiform destruction, irregular cortex and subperiosteal vertical spiculated high density in the affected bone. There were some flat and spindle high density mass surrounding the destructive area of the bone,including the spots, patches and irregular shadow. MRI showed normal bone marrow signal replaced by soft tissue mass, which expressed isointensity signal on T1 weighted image and inhomogenous slightly hyperintensity signal on T2 weighted image. MRI enhanced scan showed heterogeneous enhancement of focal area, and 4 cases of them expressed thickening of dura mater of brain with abnormal enhancement and destructively interruption. Upper abdominal CT scan of 5 cases showed abnormal soft tissue mass with uneven density in unilateral adrenal gland area and retroperitoneal space and multiple swollen ret-roperitoneal lymphnodes, heterogeneous enhancement was seen in three case. Conclusion CT and MRI manifestations of metastatic neuroblastoma of the craniofacial bones in children have some characteristics. CT is superior to MRI in depicting spiculated periosteal reaction and calcification patch in soft tissue masses,while MRI is superior to CT in showing lesion extent and the metastasis to dura mater of brain.%目的 探讨儿童颅面骨转移性神经母细胞瘤的CT和MRI特征.方法 分析7例经病理证实的颅面骨转移性神经

  7. Cutaneous Metastases From Esophageal Adenocarcinoma

    Science.gov (United States)

    Triantafyllou, Stamatina; Georgia, Doulami; Gavriella-Zoi, Vrakopoulou; Dimitrios, Mpistarakis; Stulianos, Katsaragakis; Theodoros, Liakakos; Georgios, Zografos; Dimitrios, Theodorou

    2015-01-01

    The aim of this study is to present 2 rare cases of cutaneous metastases originated from adenocarcinoma of the gastro-esophageal junction, thus, underline the need for early diagnosis and possible treatment of suspicious skin lesions among patients with esophageal malignancy. Metastatic cancer to the skin originated from internal malignancies, mostly lung cancer, breast cancer, and colorectal cancer, constitute 0.5 to 9% of all metastatic cancers.5,8,15 Skin metastases, mainly from squamous cell carcinomas of the esophagus, are rarely reported. Cutaneous metastasis is a finding indicating progressiveness of the disease.17 More precisely, median survival is estimated approximately 4.7 months.2,14 This study is a retrospective review of 2 cases of patients with adenocarcinoma of the esophagus and a review of the literature. Two patients aged 60 and 32 years old, respectively, underwent esophagectomy. Both pathologic reports disclosed adenocarcinoma of the gastro-esophageal junction staged T3 N2 M0 (stage IIIB). During follow-up time, the 2 patients were diagnosed with cutaneous metastases originated from the primary esophageal tumor 11 and 4 months after surgery, respectively. The first patient is alive 37 months after diagnosis, while the second one died 16 months after surgery. Cutaneous metastasis caused by esophageal adenocarcinoma is possible. Therefore, follow-up of patients who were diagnosed with esophageal malignancy and underwent esophagectomy is mandatory in order to reveal early surgical stages. PMID:25785344

  8. Rare clinical experiences for surgical treatment of melanoma with osseous metastases in Taiwan

    Directory of Open Access Journals (Sweden)

    Yang Rong-Sen

    2007-07-01

    Full Text Available Abstract Background Malignant melanoma occurs infrequently in Taiwan. Once it has progressed into osseous metastases, the prognosis is poor. There are no reported clinical experiences of surgical management in this area. Methods To improve our understanding of the rare clinical experiences, we retrospectively investigated clinical characteristics, radiological findings, treatment modalities, survival outcomes and prognoses of 11 Taiwanese patients with osseous metastasis of melanoma treated surgically at two national medical centers, National Taiwan University Hospital and National Cheng Kung University Hospital from January 1983 to December 2006. Results Six patients suffered from acral-lentiginous melanoma. Nine patients sustained multiple osseous metastases and most lesions were osteolytic. Nine patients also had sustained metastases to other organs including liver, lungs, lymph nodes, brain and spleen. Second malignancies including lung cancer, thyroid papillary carcinoma, renal cell carcinoma and cervical cancer co-existed in four patients. The interval from the initial diagnosis of melanoma to the clinical detection of osseous metastases varied from 0–37.8 months (mean 9.75 months. Metastatic melanoma was invariably fatal; the mean survival time from bone metastases to death was 5.67 months. Conclusion Due to the high morbidity and poor survival of Taiwanese patients with osseous metastases of melanoma, surgical treatment should be directed towards pain relief and the prevention of skeletal debilitation in order to maintain their quality of life.

  9. Cerebellar, Pancreatic, and Paraspinal Metastases in Soft Tissue Sarcomas: Unusual Sites or Changing Patterns?

    Directory of Open Access Journals (Sweden)

    Girish Bedre

    2007-07-01

    Full Text Available Context Soft tissue sarcomas generally first metastasize to the lungs followed by the involvement of other sites such as lymph nodes and bones as part of the disseminated disease. Cerebellar and pancreatic metastases from tumors of mesenchymal origin such as soft tissue sarcomas are exceptional, more so in the absence of pulmonary metastases. Case report A previously treated case of chest wall sarcoma presented with the sudden onset of neurological symptoms. An MRI brain scan was suggestive of a solitary cerebellar metastasis. A CT scan of the thorax and abdomen showed no evidence of disease. A metastasectomy of the solitary brain lesion confirmed a deposit from a previously treated sarcoma. Within two months he presented with central abdominal pain and low backache radiating down both lower limbs. FDG-PET and CT scans revealed a large pancreatic and left paraspinal mass with intense tracer uptake suggestive of metastatic involvement. There was no evidence of pulmonary metastases. A CT-guided biopsy was suggestive of high-grade sarcoma. He was treated with palliative radiotherapy with good symptomatic relief. Conclusion Cerebellar, pancreatic, and paraspinal metastases from soft tissue sarcomas are rare, especially in the absence of pulmonary metastases. A high index of suspicion is necessary, and appropriate imaging should be considered for symptomatic patients.

  10. Leptomeningeal disease following stereotactic radiosurgery for brain metastases from breast cancer.

    Science.gov (United States)

    Trifiletti, Daniel M; Romano, Kara D; Xu, Zhiyuan; Reardon, Kelli A; Sheehan, Jason

    2015-09-01

    Leptomeningeal disease (LMD) is a highly aggressive and usually rapidly fatal condition. The purpose of this study is to identify clinical factors that can serve to predict for LMD at the time of stereotactic radiosurgery (SRS) for brain metastases from breast carcinoma. We conducted a retrospective review of patients with brain metastases from breast cancer treated with SRS from 1995 to 2014 at our institution. Clinical, radiographic, and dosimetric data were collected. LMD was diagnosed by cerebrospinal fluid (CSF) cytology or MRI demonstrating CSF seeding. Comparative statistical analyses were conducted using Cox proportional hazards regression, binary logistic regression, and/or log-rank test. 126 patients met inclusion criteria. Eighteen patients (14 %) developed LMD following SRS. From the time of SRS, the actuarial rate of LMD at 12 months from diagnosis of brain metastasis was 9 % (11 patients). Active disease in the chest at the time of SRS was associated with development of LMD (p = 0.038). Factors including receptor status, tumor size, number of intra-axial tumors, cystic tumor morphology, prior WBRT, active bone metastases, and active liver metastases were not significantly associated with the development of LMD. In patients with brain metastasis from breast cancer that undergo SRS, there is a relatively low rate of LMD. We found that while tumor hormonal status, bone metastases, and hepatic metastases were not associated with the development of LMD, active lung metastases at SRS was associated with LMD. Further research may help to delineate a causative relationship between metastatic lung disease and LMD.

  11. 21 CFR 640.56 - Quality control test for potency.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Quality control test for potency. 640.56 Section...) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Cryoprecipitate § 640.56 Quality control test for potency. (a) Quality control tests for potency of antihemophilic factor shall be...

  12. Bone marrow oedema associated with benign and malignant bone tumours

    Energy Technology Data Exchange (ETDEWEB)

    James, S.L.J. [Department of Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP (United Kingdom)], E-mail: steven.james@roh.nhs.uk; Panicek, D.M. [Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021 (United States); Davies, A.M. [Department of Radiology, Royal Orthopaedic Hospital, Birmingham, B31 2AP (United Kingdom)

    2008-07-15

    Bone marrow oedema is associated with a wide variety of pathological processes including both benign and malignant bone tumours. This imaging finding in relation to intraosseous tumours can aid in providing a more focused differential diagnosis. In this review, we will discuss the MR imaging of bone marrow oedema surrounding intraosseous neoplasms. The different pulse sequences used in differentiating underlying tumour from surrounding oedema are discussed along with the role of dynamic contrast enhanced MRI. Benign lesions commonly associated with bone marrow oedema include osteoid osteoma, osteoblastoma, chondroblastoma and Langerhan's cell histiocytosis. Metastases and malignant primary bone tumours such as osteosarcoma, Ewing's sarcoma and chondrosarcoma may also be surrounded by bone marrow oedema. The imaging findings of these conditions are reviewed and illustrated. Finally, the importance of bone marrow oedema in assessment of post chemotherapeutic response is addressed.

  13. Percutaneous cementoplasty for painful osteolytic distal femur metastases: a case report.

    Science.gov (United States)

    Lei, Mingxing; Liu, Yaosheng; Yang, Shaoxing; Jiang, Weigang; Cao, Yuncen; Liu, Shubin

    2016-01-01

    Percutaneous cementoplasty has been shown to immediately restore the mechanical stability of affected bones, prevent further risk of bone fractures, and allow immediate weight bearing. It is emerging as one of the most promising procedures for patients with painful bone metastasis who are unsuitable for surgery or who show resistance to radiotherapy and/or analgesic therapies. This study aimed at describing the procedure, indications, and benefits of percutaneous cementoplasty for painful osteolytic distal femur metastases. We report the case of a painful metastatic lesion in the left distal femur secondary to non-small-cell lung cancer in a 58-year-old woman. The patient underwent percutaneous cementoplasty and experienced effective pain relief and recovery of knee function postoperatively. In addition, no perioperative complication was observed. Percutaneous cementoplasty for osteolytic distal femur metastases offers effective pain relief and restores impaired knee function. Although this method may be a safe option, larger samples of retrospective or prospective confirmation are warranted.

  14. Bony metastases from breast cancer - a study of foetal antigen 2 as a blood tumour marker

    Directory of Open Access Journals (Sweden)

    Iles Ray K

    2010-05-01

    Full Text Available Abstract Background Foetal antigen 2 (FA-2, first isolated in the amniotic fluid, was shown to be the circulating form of the aminopropeptide of the alpha 1 chain of procollagen type I. Serum concentrations of FA-2 appeared to be elevated in a number of disorders of bone metabolism. This paper is the first report of its role as a marker of bone metabolism in metastatic breast cancer. Methods Serum FA-2 concentrations were measured by radioimmunoassay in 153 women with different stages of breast cancer and in 34 normal controls. Results Serum FA-2 was significantly elevated in women with bony metastases (p Conclusions FA-2 is a promising blood marker of bone metabolism. Further studies to delineate its role in the diagnosis and management of bony metastases from breast cancer are required.

  15. Bony Calvarium as the Sole Site ofMetastases in Squamous Cell Carcinomaof the Uterine Cervix

    Directory of Open Access Journals (Sweden)

    Mohammad Mohammadianpanah

    2010-10-01

    Full Text Available Isolated skeletal metastasis to the bony calvarium is extremely rare in patients with squamous cell carcinoma of the uterine cervix. We describe the clinical and imaging findings in a case of squamous cell carcinoma of the uterine cervix with metastases tothe bony calvarium as the sole site of metastasis. The patient was a 65-year-old woman with squamous cell carcinoma of the uterine cervix, FIGO stage IIIb, whose initial treatement was chemoradiation therapy. After 22 sessions of external-beam radiation,she developed headaches. On physical examination she had skull bone tenderness. On plain skull X-ray, there were osteolytic bony lesions. Brain MRI showed multiple enhancing skull bone metatstses. Eventually, a whole body bone scintigraphy revealed isolated diffuse increased activity in the bony calvarium. In the literature review, wefound only three similar cases of cervical cancer with scalp metastases and involvement of the bony calvarium.

  16. Extrarenal multiorgan metastases of collecting duct carcinoma of the kidney: A case series

    Directory of Open Access Journals (Sweden)

    Nakamura Hisao

    2008-09-01

    Full Text Available Abstract Introduction Collecting duct carcinoma is a rare type of renal cell carcinoma. The primary is difficult to diagnose on imaging, and metastases are often present on initial presentation. Extensive multiorgan metastases can result in complex presentations that can be difficult to diagnose. Case presentation We present two case reports of multiorgan metastases of collecting duct carcinoma that were autopsy confirmed. The first case was a 55-year-old man who presented with fever and abdominal pain. Abdominal computed tomography showed enlargement of the right kidney. Pyelonephritis was considered on the basis of laboratory test results and imaging findings. However, multiple cavitary lesions were found on routine chest radiography. These lesions were biopsied, resulting in a histological diagnosis of metastatic adenocarcinoma. A renal tumor was considered. Transitional cell carcinoma was suspected, which proved to be misdiagnosed and chemotherapy was given accordingly. However, this was not effective and the patient died after 2 months. Autopsy demonstrated the primary tumor to be collecting duct carcinoma, with metastases to lung, liver, spleen, bone marrow, right adrenal gland, and para-aortic lymph node. Computed tomography done while the patient was alive detected lung, liver, and para-aortic lymph node metastases. The second case was a 77-year-old man who presented with fever. Pyelonephritis was considered on the basis of the laboratory test results and imaging findings. Antibiotic therapy improved his symptoms and laboratory indicators of inflammation. One year later, he developed backache. Computed tomography revealed a progressively enlarging right renal lesion, multiple liver masses, enlargement of the para-aortic lymph nodes, and multiple osteoblastic and osteoclastic lesions. A renal tumor with multiple metastases was diagnosed. Chemotherapy was given without effect, and the patient died of cardiac failure 1 year later. Autopsy

  17. Cerebellar metastases of recurrent phyllodes tumor breast; a rare phenomenon reflecting the unpredictable outcome.

    Science.gov (United States)

    Singh, Jyotsna; Majumdar, Kaushik; Gupta, Rahul; Batra, Vineeta Vijay

    2015-01-01

    Carcinomas of lung, breast, colon, kidney, and malignant melanomas are the most common malignancies that metastasize to the central nervous system (CNS). Phyllodes tumor is a rare fibroepithelial tumor of the breast, often having unpredictable recurrences, with increasing histological grade and distant metastasis. Malignant forms exist, which may develop distant metastases usually to the lung, pleura, bone, and liver. CNS metastasis of phyllodes tumor is rare and associated with a poor prognosis, with resistance to chemotherapy and radiation. We present a rare case of cerebellar metastasis in recurrent phyllodes tumor breast with subsequent rapid downhill course.

  18. Does increased local bone resorption secondary to breast and prostate cancer result in increased cartilage degradation?

    DEFF Research Database (Denmark)

    Leeming, Diana J; Byrjalsen, Inger; Qvist, Per

    2008-01-01

    BACKGROUND: Breast and prostate cancer patients often develop lesions of locally high bone turnover, when the primary tumor metastasizes to the bone causing an abnormal high bone resorption at this site. The objective of the present study was to determine whether local increased bone turnover...... in breast and prostate cancer patients is associated with an increase in cartilage degradation and to test in vitro whether osteoclasts or cathepsin K alone generate CTXII from human bone. METHODS: The study included 132 breast and prostate cancer patient, where presence of bone metastases was graded...... according to the Soloway score. Total bone resorption (CTXItotal) and cartilage degradation (CTXII) were determined. RESULTS: Breast and prostate cancer patients with bone metastases revealed significant increased levels of CTXItotal at Soloway scores 1 and higher compared to patients without bone...

  19. Metastatic tumours in upper maxillary bone of esophageal adenocarcinoma. A case report.

    Science.gov (United States)

    Sánchez-Jiménez, Juan; Acebal-Blanco, Faustino; Arévalo-Arévalo, Rafael E; Molina-Martínez, Manuel

    2005-01-01

    Metastases in the oral cavity are rare lesions which represent approximately 1% of all malignant neoplasms in the oral cavity. Oral metastases are located in the mandible 80-90% on average, the maxilla location being rarer. Metastases in mouth soft tissue are also rare, and within these it is on the gums where they more frequently occur. Primary tumours which metastasize to mouth are most commonly: lung, breast and kidney. Oral cavity metastases appear as a result of distant disease spreading and show wrong prognosis, with short survival. Here we present a clinical case of a patient diagnosed with esophagus adenocarcinoma which presented metastasis in upper-left maxillary bone.

  20. Effect of Salmon calcitonin on metabolism of Blood 89 Sr and combined treatment with 89 SrCl2 in Cancer Patients with Bone Metastases%鲑鱼降钙素联合氯化锶对恶性肿瘤骨转移性骨痛及对血锶代谢影响的临床观察

    Institute of Scientific and Technical Information of China (English)

    张云平; 李仰康; 刘阳晨

    2016-01-01

    目的:观察降钙素联合氯化89锶治疗恶性肿瘤骨转移痛的疗效,判断降钙素在治疗中的作用。方法73名恶性肿瘤骨转移病例分为,联合组29例患者,用氯化89锶(3-4 mci iv)+降钙素(100IU 喷鼻1次/天);氯化89锶治疗组25例患者,用氯化89锶(3-4mci iv)和对照组19例患者,不同意锶治疗的肿瘤骨转移病人(其它方法治疗骨痛),观察镇痛总有效率并以火焰原子吸收法测定全血锶含量,随诊12个月,2例死亡退出观察。结果联合治疗组疗效高峰出现在第一个月,总有效率96.4%(27/28);绿化锶组疗效高峰出现在第一个月,总有效率83.33%(20/24),两治疗组比较差异显著(P <0.01);联合治疗组血锶水35.5μg/L,明显低于氯化89锶组和对照组(P <0.05)。氯化锶组血锶水平39.8μg/L,与对照组血锶含量无显著性差异(P >0.05)。结论降钙素联合氯化89锶镇痛效果显著好于氯化锶组(P <0.01);降钙素促进骨转移灶对89锶吸收,降钙素可以作为氯化89锶的增效剂。%Objective To observe the effect of salmon calcitonin on concentration of blood 89 Sr and efficacy of treat-ment combined with 89 SrCl2 in blood of cancer patients with bone metastases.Methods There were 73 cases cancer pa-tients with bone metastases selected from October 2013 to October 2014.29 cases were treated with 89 SrCl2 (4mci iv) combined with salmon calcitonin;25 cases were treated with 89 SrCl2 and the 19 with other therapy.The total response rate and the pain level was estimated,the 89 Sr concentrations in blood were measured by Flame atomic absorption spec-trophotometer.Two patients withdrawn due to death and all patients were followed up one year.Results The 28 pa-tients were treated with 89 SrCl2 (4mci iv)combined with salmon calcitonin,the pain levels were relieved in all patients except one (96.4%),89 SrCl2 group

  1. Cytokeratin - positive rib osteosarcoma metastasizing to the small intestine

    Directory of Open Access Journals (Sweden)

    Hiroko Kuwabara

    2014-01-01

    Full Text Available Osteosarcoma (OS is a malignant tumor in which osteoid or bone is produced directly by tumor cells. Some OS cells are positive for cytokeratin (CK and epithelial membrane antigen by immunohistochemistry (IHC and this may lead to a misdiagnosis of metastatic carcinoma, particularly when the tumor location is unusual. On the other hand, gastrointestinal metastasis of OS is rare. We present the case of a 67-year-old Japanese man with a small intestinal intussusception due to metastasis of a CK-positive rib OS. The tumor cells were positive for CK, osteopontin and osteonectin by IHC and a diagnosis of a CK-positive chest wall OS metastasizing to the small intestine was considered. Osteoid or bone formation was histologically absent and therefore chest wall OS had to be differentially diagnosed from metastatic carcinoma of unknown origin. A postmortem histological analysis confirmed a rib OS. Awareness of CK-positive OS is important for making a correct diagnosis and for disease management and an immunohistochemical analysis of the tumor for expression of osteopontin and osteonectin may be used to support the diagnosis. In addition, this case shows that rib OS can metastasize to the gastrointestinal tract, albeit rarely, which may induce an intestinal intussusception.

  2. Bone scintigraphy (B S) in testicle tumours

    Energy Technology Data Exchange (ETDEWEB)

    Braga, F.J.H.N.; Arbex, M.A.; Souza, J.F.; Haddad, J. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    1997-12-31

    Full text. Testicle tumours are not very frequent and radiotherapy has an important role in the cure of many patients. The detection of metastases is not an easy task and we do not know any study concerning B S in the search for bone metastases in such cases. We studied 28 patients (8-52 years old) with proven testicle tumours by means of 99 m Tc-M D P (750 MBq intravenously). Images were obtained 2 h after. B S was normal in 21 studies. In 7 evaluations the only abnormality we found was variable but diffuse involvement of the iliac bone on the same side as the affected testicle. Five out of these patients showed important uptake of M D P (4 seminoma and 1 epididymoma) and the 2 others showed moderate uptake of the radio pharmaceutical (2 seminoma). Metastases were confirmed by biopsy. Testicle tumour metastases are known to occur through the lymphatic drainage which goes to the iliac lymph node chain and this makes our findings very logical. The scintigraphic aspect of the affected iliac bone is characteristic and makes it possible to imagine an `iliac sign` for such cases. Early detection of metastases is very important because of radiotherapy efficacy and B S may play an important role in such cases. Testicle tumour metastases should be thought of when this scintigraphic aspect is seen. Differential diagnosis is Paget`s Disease

  3. Is there a role of whole-body bone scan in patients with esophageal squamous cell carcinoma

    OpenAIRE

    Li Shau-Hsuan; Huang Yung-Cheng; Huang Wan-Ting; Lin Wei-Che; Liu Chien-Ting; Tien Wan-Yu; Lu Hung-I

    2012-01-01

    Abstract Background Correct detection of bone metastases in patients with esophageal squamous cell carcinoma is pivotal for prognosis and selection of an appropriate treatment regimen. Whole-body bone scan for staging is not routinely recommended in patients with esophageal squamous cell carcinoma. The aim of this study was to investigate the role of bone scan in detecting bone metastases in patients with esophageal squamous cell carcinoma. Methods We retrospectively evaluated the radiographi...

  4. Hyperaldosteronism associated with liver metastases.

    Science.gov (United States)

    Pandya, K J; Whitehead, R; Crowley, J; Citrin, D L

    1980-07-11

    Plasma aldosterone levels were measured in 50 patients with confirmed liver metastases from various histologically proved primary tumors. None of these patients had electrolyte abnormalities or history of benign liver disease, congestive heart failure, hypertension, or renal disease. Patients with edema, ascites, or both had significantly greater elevation of plasma aldosterone levels compared to nonedematous patients; these patients also demonstrated a substantial degree of hepatic dysfunction as evidenced by lower serum albumin levels and higher bilirubin and alkaline phosphatase levels. This study provides a rational basis for the use of the specific aldosterone inhibitor spironolactone in the treatment of patients with advanced metastatic liver disease and edematous states.

  5. Bone marrow micrometastasis detected by flow cytometry is associated bone, bone marrow, lung macrometastasis in breast cancer

    Directory of Open Access Journals (Sweden)

    Mustafa Salih Akin

    2014-04-01

    Material and Methods: Bone marrow samples were obtained from 52 breast cancer patients and 16 control patients via aspiration from the iliac spine at the time of first diagnosis after the surgery. Epithelial cells were identified with anti-cytokeratin monoclonal antibody, and double-staining with propidium iodide and CD45using flow cytometry. Results: In all, 2 (12.5% of the 16 control patients and 11 (21% of the 52 breast cancer patients had cytokeratin-18 positive cells in their bone marrow. A relationship between the presence of occult metastatic cells in bone marrow, and the presence/absence of lymph node metastases, tumor size, stage, menopausal status, hormone receptor status, histological grade, c-erb-B2 expression, tumor subtype, lymphovascular invasion, Ductal carcinoma in situ (DCIS component, and gender was not observed. Significant positive relationships were observed between bone marrow micrometastasis, and age, and bone, bone marrow, lung, and liver metastases. Conclusion: Bone marrow micrometastasis was associated with age, bone, bone marrow, lung, and liver metastases at the time of diagnosis.. [Cukurova Med J 2014; 39(2.000: 305-314

  6. Potency of Animal Models in KANSEI Engineering

    Science.gov (United States)

    Ozaki, Shigeru; Hisano, Setsuji; Iwamoto, Yoshiki

    Various species of animals have been used as animal models for neuroscience and provided critical information about the brain functions. Although it seems difficult to elucidate a highly advanced function of the human brain, animal models have potency to clarify the fundamental mechanisms of emotion, decision-making and social behavior. In this review, we will pick up common animal models and point to both the merits and demerits caused by the characteristics. We will also mention that wide-ranging approaches from animal models are advantageous to understand KANSEI as well as mind in humans.

  7. The Role of Osteoblast-Derived Cytokines in Bone Metastatic Breast Cancer

    Science.gov (United States)

    2009-01-01

    metastasize to bone include prostate, lung, thyroid, and kidney [47]. In contrast, cancers of the gastrointestinal tract seldom do [47]. There are many...or prostate cancer have bone metastases [1]. The incidences from thyroid, kidney , and lung cancer also are high (about 40%). In contrast, it has been...factor- alpha (TNF-α), IL-6, and leptin , which stimulate bone resorption and inhibit osteoblast proliferation [18, 19]. Factors secreted by adipocytes

  8. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  9. The diagnostic and prognostic value of serum bone Gla protein (osteocalcin) in patients with recurrent breast cancer

    DEFF Research Database (Denmark)

    Kamby, C; Egsmose, C; Söletormos, G

    1993-01-01

    bone survey. The sites of recurrence were bone (61%), bone marrow (46%), soft tissue (52%), lung (13%), pleura (11%), liver (4%), and brain (2%). Radiology and bone biopsy served as key diagnoses as to the presence or absence of bone metastases. The diagnostic efficiency of B-scan and S-AP was greater...... than that of S-BGP, and the result of BGP measurement was associated with neither extent nor number of bone metastases. However, the BGP values were significantly lower in patients who had visceral metastases, and the median duration of survival after recurrence was 13 months for patients with low S......Serum bone Gla protein (S-BGP), a marker of bone metabolism, was measured in 60 patients included in a staging programme for recurrent breast cancer. Other diagnostic procedures comprised S-alkaline phosphatase (S-AP), bone scan (B-scan), bilateral iliac crest bone marrow biopsies, and radiological...

  10. DIAGNOSTICS OF BONE METABOLISM DISORDERS IN ONCOLOGICAL DISEASES

    Directory of Open Access Journals (Sweden)

    O. I. Apolikhin

    2015-01-01

    Full Text Available Osteoporosis is one of the most significant bone complications of cancer. About 1.5 million cancer patients worldwide have bone metastases. Patients with myeloma, breast cancer, prostate, thyroid, bladder and lung have very high risk of development of bone lesions and related complications. Currently, osteodensitometry is the gold standard for the diagnosis of osteoporosis. In recent years we frequently use the innovative imaging techniques for bone metastases, such as CT, MRI, PET/CT. Unfortunately, the diagnostic value of these methods is that it is not always possible to identify abnormalities of bone metabolism in cancer, especially in the early stages. This review shows the world experience of usage of biochemical markers of bone resorption (calcium, hydroxyproline, NTX, CTX, PYD, DPD, TRAP-5b, bone sialoprotein - BSP and markers of bone synthesis (osteocalcin, CSF, ACF, Karlovy vary IFF, their advantages and disadvantages. The level of these markers is increased in most patients with osteoporosis and bone metastases, it is suggesting a potential role in early diagnosis of bone metastases.

  11. Multiplex Assay for Protein Profiling and Potency Measurement of German Cockroach Allergen Extracts.

    Directory of Open Access Journals (Sweden)

    Taruna Khurana

    Full Text Available German cockroach (GCr allergens induce IgE responses and may cause asthma. Commercial GCr allergen extracts are variable and existing assays may not be appropriate for determining extract composition and potency.Our aim was to develop a multiplex antibody/bead-based assay for assessment of GCr allergen extracts.Single chain fragment variable (scFv antibodies against GCr were obtained by screening libraries derived from naïve human lymphocytes and hyperimmunized chicken splenocytes and bone marrow. Selected clones were sequenced and characterized by immunoblotting. Eighteen scFv antibodies (17 chicken, 1 human coupled to polystyrene beads were used in this suspension assay; binding of targeted GCr allergens to antibody-coated beads was detected using rabbit antisera against GCr, and against specific allergens rBla g 1, rBla g 2, and rBla g 4. The assay was tested for specificity, accuracy, and precision. Extracts were also compared by IgE competition ELISA.Chicken scFv's generated eight different binding patterns to GCr proteins from 14 to 150 kDa molecular weight. Human scFv's recognized a 100 kDa GCr protein. The multiplex assay was found to be specific and reproducible with intra-assay coefficient of variation (CV of 2.64% and inter-assay CV of 10.0%. Overall potencies of various GCr extracts were calculated using mean logEC50s for eight selected scFvs. Overall potency measures were also analyzed by assessing the contributions to potency of each target.An scFv antibody-based multiplex assay has been developed capable of simultaneously measuring different proteins in a complex mixture, and to determine the potencies and compositions of allergen extracts.

  12. Incremental Diagnostic Value of SPECT-CT Fusion Imaging for Bone Metastases from Breast Cancer%SPECT-CT融合图像评价乳腺癌骨转移的增益价值

    Institute of Scientific and Technical Information of China (English)

    顾涛颖; 石洪成; 陈曙光; 修雁; 蔡良; 顾宇参

    2013-01-01

    目的:探讨SPECT-CT融合图像评价乳腺癌骨转移的增益价值.方法:回顾分析经病理证实为乳腺癌、排除其他恶性肿瘤病史且行全身骨显像(whole-body bone scintigraphy,WBBS)及局部SPECT-CT(single photon emission computed tomograpby-computed tomography)融合图像检查的53例女性患者的临床资料,根据患者综合表现诊断为肿瘤骨转移、无肿瘤骨转移和不能确定,以手术病理或随访结果为最终诊断标准.分别计算并比较WBBS、SPECT-CT融合图像对病例及病灶诊断的灵敏度、特异度、阳性预测值、阴性预测值、正确诊断百分率、肿瘤骨转移诊断符合率和无肿瘤骨转移诊断符合率.结果:53例患者中确诊为肿瘤骨转移者27例,无肿瘤骨转移者26例;在共计177个病灶中,95个病灶确诊为肿瘤骨转移,82个病灶确诊为无肿瘤骨转移.WBBS对病例和病灶诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为92.6%和93.7%、61.5%和73.2%、71.4%和80.2%、88.9%和90.9%;正确诊断百分率、肿瘤骨转移诊断符合率、无肿瘤骨转移诊断符合率分别为56.6%(30/53)和72.1%(111/177)、51.9%(14/27)和61.1%(58/95)、61.5%(16/26)和73.2%(60/82).SPECT-CT融合图像对病例和病灶诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为96.3%和98.9%、84.0%和95.1%、86.7%和95.9%、95.7%和98.7%;正确诊断百分率、肿瘤骨转移诊断符合率、无肿瘤骨转移诊断符合率分别为90.6%(48/53)和97.2%(172/177)、96.3%(26/27)和98.9%(94/95)、88.5%(23/26)和95.1%(78/82),均高于WBBS(病例分析:x2分别为15.725、13.886和5.026,P值分别为0.000、0.000和0.025;病灶分析:x2分别为55.618、42.632和14.809,P值均为0.000).结论:评价乳腺癌骨转移时,SPECT-CT融合图像较WBBS更具有增益价值.

  13. Efficacy of surgical resection in management of isolated extrahepatic metastases of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Kun-Ming Chan; Ming-Chin Yu; Ting-Jung Wu; Chen-Fang Lee; Tse-Ching Chen; Wei-Chen Lee; Miin-Fu Chen

    2009-01-01

    AIM: To clarify the benefit of surgical excision for patients with extrahepatic metastases of hepatocellular carcinoma (HCC).METHODS: We retrospectively reviewed the medical records of 140 patients with pathologically proven extrahepatic metastases of HCC and evaluated the outcomes of those who had undergone surgical resection (SR) for extrahepatic metastatic lesions.Prognoses made on the basis of extrahepatic metastatic sites were also examined.RESULTS: The survival rates of patients who underwent SR of extrahepatic metastases were significantly better than those of patients who did not receive SR.For the SR group, 1- and 3-year survival rates were 24% and 7%, respectively, while for the non-resection group, the survival rates were 8% and 0%, respectively ( P < 0.0001).Survival rates related to metastatic sites were also significantly superior after SR of extrahepatic metastases: median survivals were 32 mo with lung metastasis, 10 mo with bone metastasis, 6.1 mo with brain metastasis.CONCLUSION: SR can provide survival benefits for patients with 1 or 2 isolated extrahepatic metastases and who concurrently exhibit good hepatic functional reserve and general performance status as well as successful treatment of intrahepatic HCC.

  14. Rotator cuff metastases: A report of two cases with literature review

    Directory of Open Access Journals (Sweden)

    Gokhan Soker

    2014-01-01

    Full Text Available Context: Distant metastases of primary malignancies to the skeletal muscle tissue are a very rare event. Distant metastases that affect the rotator cuff are even rarer, and only a few of cases have been reported so far. Case Report: The present article reports two cases that presented to our hospital with the complaint of shoulder pain and had a soft tissue mass affecting the muscles of the rotator cuff and invading the neighboring bone compartments. One of the patients developed mucoepidermoid cancer metastasis of the submandibular gland, and the other was found to have a malignant epithelial tumor metastasized from the lower lobe of the right lung, whose primary origin could not be diagnosed until the imaging examinations were employed. Ultrasound and magnetic resonance imaging findings are presented in this paper. Conclusion: Metastases to the muscle tissues could be misdiagnosed as primary sarcomas. Because the therapy regiments and prognoses are fairly different for these two entities, the possibility of a metastasis to the muscle tissue must be considered as a differential diagnosis for case of painful soft tissue mass. Ultrasound is very useful in detection of the lesion and acts as a very important tool during guidance for biopsy. Magnetic resonance imaging, however, is a very valuable asset in the evaluation of the borders of the soft tissue mass and its invasive effect on the bony tissues. Particularly when the features such as lobulated contours, peripheral edema, and intratumoral necrosis exist, the possibility of metastases must be considered.

  15. Bone-seeking therapeutic radiopharmaceuticals

    Directory of Open Access Journals (Sweden)

    Srivastava Suresh C.

    2002-01-01

    Full Text Available Bone-seeking therapeutic radiopharmaceuticals are utilized on the basis of the radionuclide?s particulate emissions (primarily low to intermediate beta emission. The requirements therefore are different from those of bone imaging agents that consist mainly of short-lived single photon emitters. Lately, the therapeutic bone seeking radiopharmaceuticals have attained increasing importance due to their potential role in alleviating pain from osseous metastases in cancer patients, for the treatment of joint pain resulting from inflamed synovium (radiosynoviorthesis, or radiosynovectomy, or from various other forms of arthritic disease. There is, however, a paucity of published data on the bio-pharmacokinetics of these agents when used following intravenous administration for bone pain palliation. This paper will briefly review and summarize the presently available chemical and biopharmacokinetic information on the various clinically approved as well as experimental bone-localizing therapeutic radiopharmaceuticals, and make projections on their clinical application for the treatment of primary/metastatic cancer in bone.

  16. Prostatic carcinosarcoma with lung metastases.

    Science.gov (United States)

    Furlan, Stefanie R; Kang, David J; Armas, Armando

    2013-01-01

    Carcinosarcoma of the prostate is an uncommon malignancy with poor long-term prognosis. The cancer is typically discovered at an advanced stage, and with less than 100 reported cases, there is limited literature concerning treatment options. Our patient presented with a history of benign prostatic hypertrophy, erectile dysfunction, and nocturia. Biopsy of his prostate indicated that the patient had prostatic adenocarcinoma, but histopathology after prostatectomy revealed carcinosarcoma. It has been over six years since this patient's diagnosis of carcinosarcoma. Over this span of time, he has received a radical prostatectomy, radiotherapy, and androgen ablative therapy. The patient also developed multiple lung metastases that have been treated with video-assisted thoracic surgery and stereotactic body radiosurgery. Overall, he has remained unimpaired and in good condition despite his aggressive form of cancer.

  17. Prostatic Carcinosarcoma with Lung Metastases

    Directory of Open Access Journals (Sweden)

    Stefanie R. Furlan

    2013-01-01

    Full Text Available Carcinosarcoma of the prostate is an uncommon malignancy with poor long-term prognosis. The cancer is typically discovered at an advanced stage, and with less than 100 reported cases, there is limited literature concerning treatment options. Our patient presented with a history of benign prostatic hypertrophy, erectile dysfunction, and nocturia. Biopsy of his prostate indicated that the patient had prostatic adenocarcinoma, but histopathology after prostatectomy revealed carcinosarcoma. It has been over six years since this patient’s diagnosis of carcinosarcoma. Over this span of time, he has received a radical prostatectomy, radiotherapy, and androgen ablative therapy. The patient also developed multiple lung metastases that have been treated with video-assisted thoracic surgery and stereotactic body radiosurgery. Overall, he has remained unimpaired and in good condition despite his aggressive form of cancer.

  18. Endobronchial metastases from extrathoracic malignancies.

    Science.gov (United States)

    Akoglu, Sebahat; Uçan, Eyüp S; Celik, Gülperi; Sener, Gülper; Sevinç, Can; Kilinç, Oğuz; Itil, Oya

    2005-01-01

    Endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated with EBM are breast, renal and colorectal carcinomas. In this study, we aimed to evaluate the clinical, radiographic and bronchoscopic aspects of patients with EBM who were diagnosed between 1992 and 2002. Data about patients' clinical conditions, symptoms, radiographic and endoscopic findings, and histopathological examination results were investigated. EBM was defined as bronchoscopically visible lesions histopathologically identical to the primary tumor in patients with extrapulmonary malignancies. We found 15 cases with EBM. Primary tumors included breast (3), colorectal (3), and renal (2) carcinomas; Malignant Melanoma (2); synovial sarcoma (1), ampulla of Vater adenocarcinoma (1), pheochromocytoma (1), hypernephroma (1), and Hodgkin's Disease (1). The most common symptoms were dyspnea (80%), cough (66.6%) and hemoptysis (33.3%). Multiple (40%) or single (13.3%) pulmonary nodules, mediastinal or hilar lymphadenopathy (40%), and effusion (40%) were the most common radiographic findings. The mean interval from initial diagnosis to diagnosis of EBM was 32.8 months (range, 0-96 months) and median survival time was 18 months (range, 4-84). As a conclusion, various extrapulmonary tumors can metastasize to the bronchus. Symptoms and radiographic findings are similar with those in primary lung cancer. Therefore, EBM should be discriminated from primary lung cancer histopathologically. Although mean survival time is usually short, long-term survivors were reported. Consequently, treatment must be planned according to the histology of the primary tumor, evidence of metastasis to other sites and medical status of the patient.

  19. Cytogenetic findings in metastases from colorectal cancer

    DEFF Research Database (Denmark)

    Bardi, G; Parada, L A; Bomme, L;

    1997-01-01

    Eighteen tumor samples from 11 patients with metastatic colorectal cancer were cytogenetically analyzed after short-term culturing. Of the 13 metastases examined, 11 were from lymph nodes, 1 from the peritoneum and 1 from the lung. In 5 of the 11 patients, matched samples from the primary tumor...... and lymph node metastases were analyzed. Cytogenetic similarities between the primary and secondary lesions were found in all 5 cases, indicating that many of the chromosomal aberrations presumably occurred before disease spreading took place. Compared with the primaries, the metastases appeared to exhibit...

  20. Targeting Brain Metastases in Patients with Melanoma

    Directory of Open Access Journals (Sweden)

    Dionysis Papadatos-Pastos

    2013-01-01

    Full Text Available Patients with brain metastases from malignant melanoma historically have a very poor outcome. Surgery and radiotherapy can be used, but for the majority of patients the disease will progress quickly. In the recent past, patients with brain metastases derived only minimal benefit from cytotoxic chemotherapy. Novel therapies that have been shown to be superior to chemotherapy in metastatic melanoma have made their way in clinic and data regarding their use in patients with treated or untreated brain metastases are encouraging. In this paper we describe the use of vemurafenib, dabrafenib, and ipilimumab in patients with melanoma disseminated to the brain in addition to other treatments currently in development.

  1. Bone metastasis in hepatocellular carcinoma. A report of five cases and a review of the literature.

    Science.gov (United States)

    Maccauro, G; Muratori, E; Sgambato, A; Liuzza, F; Esposito, M; Grieco, A; Gosheger, G

    2005-01-01

    Hepatocarcinoma occurs frequently throughout the world. Bone metastases are rare although incidence has increased because of progress in diagnosis and treatment. The authors report 5 cases of bone metastases and review the literature. The spine is the most frequent localization of bone metastases. Radiotherapy is the treatment of choice for this lesion. Surgery should be used to prevent and treat complications such as nerve compression and pathologic fracture, only if the coagulative pattern and the conditions of the patient allow it. The authors recommend the use of long intramedullary nailing when localization of the disease is in the femur, with prophylactic stabilization of the neck in diaphyseal metastasis.

  2. Oncological outcome of unresectable lung metastases without extrapulmonary metastases in colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To explore the oncological outcomes of unresectable lung metastases without extrapulmonary metastases in colorectal cancer. METHODS: Patients with unresectable isolated lung metastases from colorectal cancer were prospectively collected in a single institution during a 5-year period. All patients received either the fluorouracil/leucovorin plus oxaliplatin, fluorouracil/leucovorin plus irinotecan or capecitabine plus oxaliplatin regimen as first-line treatment. The resectability after preoperative chem...

  3. I BRAZILIAN CONSENSUS ON MULTIMODAL TREATMENT OF COLORECTAL LIVER METASTASES. MODULE 2: APPROACH TO RESECTABLE METASTASES

    Science.gov (United States)

    RIBEIRO, Héber Salvador de Castro; TORRES, Orlando Jorge Martins; MARQUES, Márcio Carmona; HERMAN, Paulo; KALIL, Antonio Nocchi; FERNANDES, Eduardo de Souza Martins; de OLIVEIRA, Fábio Ferreira; CASTRO, Leonaldson dos Santos; HANRIOT, Rodrigo; OLIVEIRA, Suilane Coelho Ribeiro; BOFF, Marcio Fernando; da COSTA, Wilson Luiz; GIL, Roberto de Almeida; PFIFFER, Tulio Eduardo Flesch; MAKDISSI, Fabio Ferrari; ROCHA, Manoel de Souza; do AMARAL, Paulo Cezar Galvão; COSTA, Leonardo Atem Gonçalves de Araújo; ALOIA, Tomas A.; D'ALBUQUERQUE, Luiz Augusto Carneiro; COIMBRA, Felipe José Fernandez

    2016-01-01

    Background: Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution of patients. Aim: In the second module of this consensus, management of resectable liver metastases was discussed. Method: Concept of synchronous and metachronous metastases was determined, and both scenarius were discussed separately according its prognostic and therapeutic peculiarities. Results: Special attention was given to the missing metastases due to systemic preoperative treatment response, with emphasis in strategies to avoid its reccurrence and how to manage disappeared lesions. Conclusion: Were presented validated ressectional strategies, to be taken into account in clinical practice. PMID:27120731

  4. Comparing Postoperative Radiation Therapies for Brain Metastases

    Science.gov (United States)

    In this clinical trial, patients with one to four brain metastases who have had at least one of the metastatic tumors removed surgically will be randomly assigned to undergo whole-brain radiation therapy or stereotactic radiosurgery.

  5. Pulmonary nodules and metastases in colorectal cancer

    DEFF Research Database (Denmark)

    Nordholm-Carstensen, Andreas

    2016-01-01

    Patients with newly diagnosed colorectal cancer (CRC) are subjected to a preoperative thoraco-abdominal CT scan to determine the cancer stage. This staging is of relevance with regard to treatment and prognosis. About 20% of the patients have distant metastatic spread at the time of diagnosis, i.......e. synchronous metastases. Most common are hepatic metastases followed by pulmonary involvement. The optimal staging modality for detecting synchronous pulmonary metastases is debated. It has been argued, that synchronous pulmonary metastases (SPCM) are rare in CRC and that the consequence of detecting SPCM...... is minimal. Furthermore, the current staging practice is complicated by a high number of incidental findings on the thoracic CT, so-called indeterminate pulmonary nodules (IPN). IPN can potentially represent SPCM. The purpose of this thesis was to estimate the prevalence, characteristics and clinical...

  6. Clinical value of SPECT radionuclide bone imaging in efficacy evaluation of radiotherapy and chemotherapy in bone metastases%SPECT放射性核素骨显像在转移性骨肿瘤放化疗疗效评价中的临床价值

    Institute of Scientific and Technical Information of China (English)

    杨宁; 左书耀; 王怀全; 刘冬

    2011-01-01

    目的:探讨SPECT放射性核素骨显像在转移性骨肿瘤放化疗疗效评价中的应用价值.方法:60例转移性骨肿瘤患者分为:A组,放疗联合化疗;B组,单纯放疗.在治疗后第1、3、6个月分别行骨显像检查,观察疗效差异.结果:①A组治疗后第1、3、6个月的疗效分别为63.9%、72.7%、54.3%;B组分别为52.0%、61.9%、42.2%.2组均为第3个月疗效最高.②2组间治疗后3月的疗效比较,A组均比B组高,差异均有统计学意义.治疗后第3个月2组间不同部位的疗效A组均比B组高,胸部病灶疗效差异有统计学意义(P<0.01).③治疗后第3个月2组间不同类型骨转移疗效A组均比B组高,乳腺癌骨转移的疗效差异有统计学意义 (P<0.05).结论:转移性骨肿瘤患者放化疗后定期的一系列骨显像检查对于其临床治疗决策的制订和调整具有较高的临床价值.%Objective:To explore the value of SPECT radionuclide bone in aging in the efficacy evaluation of radiotherapy and chem otherapy in bone m etastasis.M ethods: Sixty patients with bone m etastases,group A accep ted radiotherapy com bined with chem otherapy,group B accep ted radio therapy alone.After treatm ent com pletion 1,3,6 threem on ths, bone in aging inspection was rechecked separately,observing the differences of the efficay.Results:①The efficacy of the group A after treatm ent completion 1,3,6 three m on ths were:63 .9%,72 .7 %and 54 .3 %;group B:52 .0%61 .9% and 42 .2%,respectively.The efficacv of the third m on thafter treatm entw as better than the other two months in both group A and B.②The efficacy after treatment 1,3,6three m on ths in the group A were better than that in the group B,the dfferences were statistically significant.The efficacy of the differen tparts of the thid month after treatm entin the group A were better than that in the group B,the dfference was statistically significant in the chest part( P< 0.01).③The efficacy of the

  7. Treatment and prevention of bone complications from prostate cancer.

    Science.gov (United States)

    Lee, Richard J; Saylor, Philip J; Smith, Matthew R

    2011-01-01

    Bone metastases and skeletal complications are major causes of morbidity in prostate cancer patients. Despite the osteoblastic appearance of bone metastases on imaging studies, patients have elevated serum and urinary markers of bone resorption, indicative of high osteoclast activity. Increased osteoclast activity is independently associated with higher risk of subsequent skeletal complications, disease progression, and death. Osteoclast-targeted therapies are therefore a rational approach to reduction of risk for disease-related skeletal complications, bone metastases, and treatment-related fractures. This review focuses on recent advances in osteoclast-targeted therapy in prostate cancer. Bisphosphonates have been extensively studied in men with prostate cancer. Zoledronic acid significantly decreased the risk of skeletal complications in men with castration-resistant prostate cancer and bone metastases, and it is FDA-approved for this indication. Denosumab is a human monoclonal antibody that binds and inactivates RANKL, a critical mediator of osteoclast differentiation, activation, and survival. Recent global phase 3 clinic trials demonstrated an emerging role for denosumab in the treatment of prostate cancer bone metastases and prevention of fractures associated with androgen deprivation therapy.

  8. Viral Immunotherapy to Eradicate Subclinical Brain Metastases

    Science.gov (United States)

    2014-05-01

    metastases is highlighted in the case of breast cancer. Since the introduction of Herceptin , several groups have reported a high incidence of brain...brain4,5 but is probably also due to the disparity of effectiveness of Herceptin in the brain versus 40 systemically. Herceptin is effective...systemically and may prolong survival to such an extent that brain metastases, which manifest late in the clinical course, become apparent.2 Herceptin

  9. Interventional Management of Vertebral Body Metastases

    OpenAIRE

    Prince, Ethan A.; Ahn, Sun Ho

    2013-01-01

    Metastases to the vertebral column are often due to hypervascular primary tumors, the most common of which is renal cell carcinoma. Clinical symptoms attributed to vertebral body metastases include localized pain, mechanical instability of the vertebral column, and neurologic deficits resulting from mass effect. Treatment options include targeted radiotherapy, percutaneous vertebral augmentation with or without thermal ablation, and surgical resection with subsequent fusion. Overall, surgical...

  10. Isolated pleural metastases from renal cell carcionoma

    DEFF Research Database (Denmark)

    Eckardt, Jens; Ladegaard, Lars; Licht, Peter Bjorn

    2011-01-01

    A 71-year-old female was referred with three right-sided intrathoracic tumours. In 2003, she underwent radical left nephrectomy for renal cell cancer (RCC) clinical stage 1. She was since followed at her local hospital with annual computed tomography (CT)-scans during the first five years and did....... Histology demonstrated metastases from RCC which apparently can reach the parietal pleura without lung metastases. Keywords: Pleural metastasis; Renal cell cancer....

  11. The regensburg protocol for spinal metastases

    Directory of Open Access Journals (Sweden)

    José Manuel Pérez Atanasio

    2013-12-01

    Full Text Available Metastases to the vertebrae are a common problem in the practice of a spine surgeon. Therapeutic intervention can alleviate pain, preserve or improve neurologic function, achieve mechanical stability, optimize local tumor control, and improve quality of life. Treatment options available for metastatic spine tumors include radiation therapy, chemotherapy and surgery. This article is focused on the decision making for spine surgeons and shows the protocol to treat spinal metastases at the University Hospital of Regensburg, Germany.

  12. Ca2+ Receptor, Prostate Cancer, and Bone Metastases

    Science.gov (United States)

    2005-03-01

    and antibodies against the EGFR and HB-EGF (heparin-bound EGF) also reduced ERK phosphorylation, consistent with the model of transactivation shown on...even following serum starvation. These results are consistent with model shown below 6 in which activation of the CaSR stimulates transactivation of...and PC-2 cells (R), whinh wan s iminated byo crtineu, the lAR firned by the marked reductions in their intensities nntis-rum with the poptite FF7

  13. Leiomyosarcoma of the uterus with sphenoid bone and orbital metastases.

    Science.gov (United States)

    Su, Grant W; Hong, Sang H

    2007-01-01

    A 55-year-old woman presented with a 1-week history of vision loss in the right eye associated with proptosis and diplopia. Past medical history was significant for high-grade leiomyosarcoma of the uterus status post total abdominal hysterectomy and bilateral salpingo-oophorectomy and postoperative pelvic radiation 18 months prior to presentation. Staging studies at the time of initial diagnosis of uterine leiomyosarcoma showed no evidence for metastatic disease. At presentation, CT and MRI showed a well-circumscribed 3.0 cm x 3.6 cm x 2.4 cm mass centered in the right greater sphenoid wing, extending into the middle cranial fossa and the superior and lateral orbital wall. Biopsy of the orbital mass revealed a poorly differentiated high-grade leiomyosarcoma, consistent with recurrent metastatic disease from the uterus. The patient subsequently underwent radiation treatment followed by a left orbital exenteration 6 months after the orbital biopsy. A left thoracostomy was performed 8 months after the orbital biopsy for a metastatic nodule in the left lower lobe of the lung. The clinicopathologic findings of this rare metastatic orbital lesion are presented.

  14. Brain metastases: A single institute experience

    Directory of Open Access Journals (Sweden)

    Asifa Andleeb

    2016-01-01

    Full Text Available Background: Brain metastases represent an important cause of morbidity for cancer patients. Its incidence has increased overall overtime as a consequence of improved detection by magnetic resonance imaging (MRI. However, in Indian literature, scant data are available. At this moment, we have analyzed our data from a single tertiary care center in North India. The purpose of the study was to analyze the clinical profile of patients with brain metastases. A retrospective study from a single tertiary care center. Patients and Methods: A retrospective review of records of all patients who were registered in hospital-based cancer registry and developed brain metastases from June 2011 to June 2013 yielded 95 patients for analyses. Results: Majority of cases were seen in the 6th decade of life. Lung cancer was the most common primary followed by breast. On imaging (computed tomography or MRI, multiple lesions were more common than single. Most of the patients presented with a headache (37.9%. Supratentorial involvement was seen in 87.3% against 12.6% infratentorial involvement. Median time interval from diagnosis of primary and development of brain metastases was 13.8 months. A median survival of only 3 months was seen after development of brain metastases. Conclusion: The present study highlights that brain metastases occur mainly in elderly people with lung being the most common primary malignancy. It is a deadly event with a median survival of only 3 months.

  15. A partial differential equation model of metastasized prostatic cancer.

    Science.gov (United States)

    Friedman, Avner; Jain, Harsh Vardhan

    2013-06-01

    Biochemically failing metastatic prostate cancer is typically treated with androgen ablation. However, due to the emergence of castration-resistant cells that can survive in low androgen concentrations, such therapy eventually fails. Here, we develop a partial differential equation model of the growth and response to treatment of prostate cancer that has metastasized to the bone. Existence and uniqueness results are derived for the resulting free boundary problem. In particular, existence and uniqueness of solutions for all time are proven for the radially symmetric case. Finally, numerical simulations of a tumor growing in 2-dimensions with radial symmetry are carried in order to evaluate the therapeutic potential of different treatment strategies. These simulations are able to reproduce a variety of clinically observed responses to treatment, and suggest treatment strategies that may result in tumor remission, underscoring our model's potential to make a significant contribution in the field of prostate cancer therapeutics.

  16. Bone scintigraphy in costo-iliac impingement syndrome

    DEFF Research Database (Denmark)

    Madsen, Jan L

    2008-01-01

    fractures of several thoracic and lumbar vertebrae. She presented with progressive lower back pain and weight loss. Bone scintigraphy revealed increased uptake in the lower ribs on both sides compatible with the costo-iliac impingement syndrome. There were no signs of bone metastases....

  17. MATHEMATICAL MODELING FOR ERYTHROMYCIN POTENCY DETERMINATION OF MASTIKER

    Directory of Open Access Journals (Sweden)

    Victorita Burghelea

    2016-12-01

    Full Text Available Mastiker E is an antibacterial suspension for intramammary infusion in cattle mastitis. The active drug is erythromycin, a macrolide antibiotic. The main characteristic of commercial product is erythromycin potency. The potency of erythromycin is estimated by comparing the inhibition of growth of sensitive micro-organisms produced by known concentrations of the antibiotic to be examined and a reference substance. The validation study aims to demonstrate the determination of the potency of erythromycin, it is an appropriate analytical method, reproducible and meets the quality requirements of Mastiker product. The paper establishes the performance characteristics of the method considered and identify the factors that influence these characteristics. The diameters of inhibition zones, directly proportional to the logarithm of the concentration of the antibiotic used for the assay, measured and calculated using statistical methods (Combistats Soft. The assay is designed in such a way that the mathematical model on which the potency equation is based can be proved to be valid. A parallel-line model is chosen. The two log dose response lines of the preparation under examination and the standard preparation are parallel; they are rectilinear over the range of doses used in the calculation. These conditions are verified by validity tests for a given probability (P = 0.05. The test is not valid unless the confidence limits (P = 0.95 are not less than 50% and not more than 200% of the estimated potency. The estimated potency is not less than 95% and not more than 105% of the stated potency. The stated potency is not less than 50.000 IU/g. The validation procedure includes details on protocol working to determine the potency of erythromycin, validation criteria, experimental results, mathematical modeling for determining the potency, inter laboratory comparisons.

  18. Primary bone tumors of the spine.

    Science.gov (United States)

    Cañete, A Navas; Bloem, H L; Kroon, H M

    2016-04-01

    Primary bone tumors of the spine are less common than metastases or multiple myeloma. Based on the patient's age and the radiologic pattern and topography of the tumor, a very approximate differential diagnosis can be established for an osseous vertebral lesion. This article shows the radiologic manifestations of the principal primary bone tumors of the spine from a practical point of view, based on our personal experience and a review of the literature. If bone metastases, multiple myeloma, lymphomas, hemangiomas, and enostoses are excluded, only eight types of tumors account for 80% of all vertebral tumors. These are chordomas, osteoblastomas, chondrosarcomas, giant-cell tumors, osteoid osteomas, Ewing's sarcomas, osteosarcomas, and aneurysmal bone cysts.

  19. Prion potency in stem cells biology.

    Science.gov (United States)

    Lopes, Marilene H; Santos, Tiago G

    2012-01-01

    Prion protein (PrP) can be considered a pivotal molecule because it interacts with several partners to perform a diverse range of critical biological functions that might differ in embryonic and adult cells. In recent years, there have been major advances in elucidating the putative role of PrP in the basic biology of stem cells in many different systems. Here, we review the evidence indicating that PrP is a key molecule involved in driving different aspects of the potency of embryonic and tissue-specific stem cells in self-perpetuation and differentiation in many cell types. It has been shown that PrP is involved in stem cell self-renewal, controlling pluripotency gene expression, proliferation, and neural and cardiomyocyte differentiation. PrP also has essential roles in distinct processes that regulate tissue-specific stem cell biology in nervous and hematopoietic systems and during muscle regeneration. Results from our own investigations have shown that PrP is able to modulate self-renewal and proliferation in neural stem cells, processes that are enhanced by PrP interactions with stress inducible protein 1 (STI1). Thus, the available data reveal the influence of PrP in acting upon the maintenance of pluripotent status or the differentiation of stem cells from the early embryogenesis through adulthood.

  20. Hip fracture after radiofrequency ablation therapy for bone tumors : two case reports

    NARCIS (Netherlands)

    Dierselhuis, Edwin F.; Jutte, Paul C.; van der Eerden, Pepijn J. M.; Suurmeijer, Albert J. H.; Bulstra, Sjoerd K.

    2010-01-01

    Radiofrequency ablation (RFA) has become a valuable therapeutic modality in cancer treatment over the last decade. In orthopedic surgery, RFA is used for the treatment of benign bone tumors and bone metastases. Complications are rare and, to our knowledge, bone fracture as a complication due solely

  1. Routine bone scintigraphy in primary staging of soft tissue sarcoma - Is it worthwhile?

    NARCIS (Netherlands)

    Jager, PL; Hoekstra, HJ; Leeuw, JA; van der Graaf, WTA; de Vries, EGE; Piers, DA

    2000-01-01

    BACKGROUND. The incidence of bone metastases in soft tissue sarcoma (STS) patients seems to be low but has not been studied separately. In this study, the authors aimed to determine the value of routine radionuclide bone scanning in preoperative staging of STS patients. METHODS. Preoperative bone sc

  2. [Results of a combined therapy of patients with metastatic bone diseases].

    Science.gov (United States)

    Protsenko, V V; Konovalenko, V F; Boĭchuk, S I; Volkov, I B

    2007-01-01

    In the department of bone and soft tissue tumors of Institute of oncology the authors performed a combined treatment (surgery + combined chemotherapy + bisphosphonates + radiation) in 20 patients with bone metastases. Results showed that postoperative complications were observed in 2 patients, new bone lesions in 4 patients. Those satisfactory results prove the efficacy of these treatment options.

  3. Bone Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging ... the limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided ...

  4. Results of Treating Vertebral Metastases by Percutaneous Vertebroplasty Combined with Interventional Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Hongyi Cai; Xiaohu Wang; Huiping Cao; Xiaoqi Wang; Xiaodong Liu; Zhiyong Zhang; Xinchun Dong

    2005-01-01

    OBJECTIVE Vertebral metastases are a common manifestation in patients with advanced cancer and treatment is often ineffective. This study was conducted to explore the efficacy of treating vertebral metastases by percutaneous vertebroplasty (PVP) combined with interventional chemotherapy.METHODS Seventy-five patients with vertebral metastases (42 men, 33women; ages 31~76 years) were divided into 2 groups: 39 cases were treated by PVP combined with chemotherapy (VPCC group), and 36 cases were treated by PVP alone (VP group). All procedures were guided by computed tomography (CT) scanning. The results and complications were evaluated by a questionnaire regarding pain and routine follow-up.RESULTS The response rate was significantly higher in the VPCC group than in the VP group (93.0% vs 74.4%, P<0.05); total response rates for the VPCC and VP groups were 25.6% and 10.3% respectively. A common complication related to VPCC was transient aggravating pain.CONCLUSION PVP may ameliorate pain, and consolidate the vertebrae of patients with vertebral metastases. Its short-term effect may be enhanced by adding drugs into the bone cement.

  5. Stereotactic radiosurgery for multiple brain metastases

    Science.gov (United States)

    Lee, Anna; (Josh Yamada, Yoshiya

    2017-01-01

    Whole brain radiation therapy has been the traditional treatment of choice for patients with multiple brain metastases. Although stereotactic radiosurgery is widely accepted for the management to up to 4 brain metastases, its use is still controversial in cases of 5 or more brain metastases. Randomized trials have suggested that stereotactic radiosurgery alone is appropriate in up to 4 metastases without concomitant whole brain radiation. Level 1 evidence also suggests that withholding whole brain radiation may also reduce the impact of radiation on neurocognitive function and also may even offer a survival advantage. A recent analysis of a large multicentre prospective database has suggested that there are no differences in outcomes such as the likelihood of new metastasis or leptomeningeal disease in cases of 2-10 brain metastases, nor in overall survival. Hence in the era of prolonged survival with stage IV cancer, stereotactic radiosurgery is a reasonable alternative to whole brain radiation in order to minimize the impact of treatment upon quality of life without sacrificing overall survival.

  6. Bone marrow invasion in multiple myeloma and metastatic disease.

    Science.gov (United States)

    Vilanova, J C; Luna, A

    2016-04-01

    Magnetic resonance imaging (MRI) of the spine is the imaging study of choice for the management of bone marrow disease. MRI sequences enable us to integrate structural and functional information for detecting, staging, and monitoring the response the treatment of multiple myeloma and bone metastases in the spine. Whole-body MRI has been incorporated into different guidelines as the technique of choice for managing multiple myeloma and metastatic bone disease. Normal physiological changes in the yellow and red bone marrow represent a challenge in analyses to differentiate clinically significant findings from those that are not clinically significant. This article describes the findings for normal bone marrow, variants, and invasive processes in multiple myeloma and bone metastases.

  7. [Encounter of cancer cells with bone. Therapy for bone metastasis from lung cancer].

    Science.gov (United States)

    Sugiura, Hideshi

    2011-03-01

    Bone metastasis from lung cancer requires a thorough examination of bones, including axial bones (e.g., spine, pelvis, and proximal femur) . Most patients have multiple bone metastases by the time they are initially diagnosed. In such patients, radiation therapy is often the first choice of treatment. Surgical treatment is indicated for pathological fracture and impending fracture associated with cortical bone invasion in long bone metastasis. Spinal metastasis requires accurate imaging to evaluate the extent of bone metastasis ; surgical treatment is indicated when the spinal cord is compressed. Given reports that bisphosphonates decrease the incidence of pathological fractures, prescribing bisphosphonates at an early stage is likely to be an effective therapeutic strategy for bone metastasis.

  8. Bone Densitometry (Bone Density Scan)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Densitometry (DEXA) Bone densitometry, also called dual-energy ... limitations of DEXA Bone Densitometry? What is a Bone Density Scan (DEXA)? Bone density scanning, also called ...

  9. Strategies for Management of Synchronous Colorectal Metastases.

    Science.gov (United States)

    Castellanos, Jason A; Merchant, Nipun B

    2014-06-01

    The management of synchronous presentation of colorectal cancer and liver metastases has long been a topic of debate and discussion for surgeons due to the unique dilemma of balancing operative timing along with treatment strategy. Operative strategies for resection include staged resection with colon first approach, "reverse" staged resection with liver metastases resected first, and one-stage, or simultaneous, resection of both the primary tumor and liver metastases approach. These operative strategies can be further augmented with perioperative chemotherapy and other novel approaches that may improve resectability and patient survival. The decision on operative timing and approach, however, remains largely dependent on the surgeon's determination of disease resectability, patient fitness, and the need for neoadjuvant chemotherapy.

  10. Treatment of breast cancer brain metastases.

    Science.gov (United States)

    Hofer, Silvia; Pestalozzi, Bernhard C

    2013-10-05

    Breast cancer represents the second most frequent cause of brain metastases. Treatment planning should consider several tumor and patient factors to estimate prognosis based on the Karnofsky Performance Status (KPS), age, extent of extra-cerebral disease as well as genetic subtype. When systemic disease is under control patients with up to three metastases qualify for local therapy, such as surgical excision or stereotactic radiotherapy. After the local treatment the addition of whole brain radiation therapy may be postponed until disease progression in the brain is observed and overall survival will not be compromised. Asymptomatic brain metastases may be first approached with a systemic treatment to which the primary tumor is considered to be sensitive.

  11. [Systemic treatment of melanoma brain metastases].

    Science.gov (United States)

    Le Rhun, É; Mateus, C; Mortier, L; Dhermain, F; Guillot, B; Grob, J-J; Lebbe, C; Thomas, M; Jouary, T; Leccia, M-T; Robert, C

    2015-02-01

    Melanomas have a high rate of brain metastases. Both the functional prognosis and the overall survival are poor in these patients. Until now, surgery and radiotherapy represented the two main modalities of treatment. Nevertheless, due to the improvement in the management of the extracerebral melanoma, the systemic treatment may be an option in patients with brain metastases. Immunotherapy with anti-CTLA4 (cytotoxic T-lymphocyte-associated protein 4) - ipilimumab - or BRAF (serine/threonine-protein kinase B-raf) inhibitors - vemurafenib, dabrafenib - has shown efficacy in the management of brain metastases in a- or pauci-symptomatic patients. Studies are ongoing with anti-PD1 (programmed cell death 1) and combinations of targeted therapies associating anti-RAF (raf proto-oncogene, serine/threonine kinase) and anti-MEK (mitogen-activated protein kinase kinase).

  12. Intestinal perforation secondary to metastasic lung carcinoma

    Directory of Open Access Journals (Sweden)

    M. C. Álvarez Sánchez

    2014-11-01

    Full Text Available Secondary symptomatic gastrointestinal metastases from lung primary tumor are rare. They can cause a variety of clinical conditions such as perforation, obstruction and bleeding. Intestinal perforations of intestinal metastases have a very poor prognosis. We present a case of a patient with metastatic lung cancer who presents with intestinal perforation and pneumoperitoneum. A 67 year old male, immunosuppressed and smoker is diagnosed with acute abdomen secondary to perforation of a tumor of the terminal ileum, as well as three other similar injuries. Resection and anastomosis. The patient died two months after surgery. The final pathological diagnosis supports epidermoidide poorly differentiated lung carcinoma. It was concluded that given an intestinal perforation in a patient diagnosed with lung carcinoma, it shouldn´t be excluded the metastases origen . Surgery is a purely palliative procedure.

  13. Carcinoma cervix with fat attenuating skull metastases

    Institute of Scientific and Technical Information of China (English)

    Anuradha Kapali; Atmakuri Sateesh Kumar; Mukunda Malathi; S D Shamsundar

    2016-01-01

    Skeletal metastasis in carcinoma cervix occurs in about 0.8-23% of cases. These lesions are usually radiographically lytic. Very few cases of metastases to the skull have been identiifed, about 5 cases to the best of our knowledge. We present a case of adenosquamous cell carcinoma of cervix with fat attenuating skull metastases in a 38-year-old lady that is not reported till date. The lesion was lytic, expansile and with negative attenuation of -15 to -30 Hounsifeld units corresponding to fat.Metastases must be included in the differentials of scalp lesions. A history of recent onset of swelling and associated lytic areas in calvarium on contrast enhanced computed tomography with multiplicity can give a clue to metastatic nature of disease.

  14. Bone sialoprotein and osteopontin in bone metastasis of osteotropic cancers.

    Science.gov (United States)

    Kruger, Thomas E; Miller, Andrew H; Godwin, Andrew K; Wang, Jinxi

    2014-02-01

    The mechanisms underlying malignant cell metastasis to secondary sites such as bone are complex and no doubt multifactorial. Members of the small integrin-binding ligand N-linked glycoproteins (SIBLINGs) family, particularly bone sialoprotein (BSP) and osteopontin (OPN), exhibit multiple activities known to promote malignant cell proliferation, detachment, invasion, and metastasis of several osteotropic cancers. The expression level of BSP and OPN is elevated in a variety of human cancers, particularly those that metastasize preferentially to the skeleton. Recent studies suggest that the "osteomimicry" of malignant cells is not only conferred by transmembrane receptors bound by BSP and OPN, but includes the "switch" in gene expression repertoire typically expressed in cells of skeletal lineage. Understanding the role of BSP and OPN in tumor progression, altered pathophysiology of bone microenvironment, and tumor metastasis to bone will likely result in development of better diagnostic approaches and therapeutic regimens for osteotropic malignant diseases.

  15. Cancer Cell Colonisation in the Bone Microenvironment

    Directory of Open Access Journals (Sweden)

    Casina Kan

    2016-10-01

    Full Text Available Bone metastases are a common complication of epithelial cancers, of which breast, prostate and lung carcinomas are the most common. The establishment of cancer cells to distant sites such as the bone microenvironment requires multiple steps. Tumour cells can acquire properties to allow epithelial-to-mesenchymal transition, extravasation and migration. Within the bone metastatic niche, disseminated tumour cells may enter a dormancy stage or proliferate to adapt and survive, interacting with bone cells such as hematopoietic stem cells, osteoblasts and osteoclasts. Cross-talk with the bone may alter tumour cell properties and, conversely, tumour cells may also acquire characteristics of the surrounding microenvironment, in a process known as osteomimicry. Alternatively, these cells may also express osteomimetic genes that allow cell survival or favour seeding to the bone marrow. The seeding of tumour cells in the bone disrupts bone-forming and bone-resorbing activities, which can lead to macrometastasis in bone. At present, bone macrometastases are incurable with only palliative treatment available. A better understanding of how these processes influence the early onset of bone metastasis may give insight into potential therapies. This review will focus on the early steps of bone colonisation, once disseminated tumour cells enter the bone marrow.

  16. Cancer Cell Colonisation in the Bone Microenvironment

    Science.gov (United States)

    Kan, Casina; Vargas, Geoffrey; Le Pape, François; Clézardin, Philippe

    2016-01-01

    Bone metastases are a common complication of epithelial cancers, of which breast, prostate and lung carcinomas are the most common. The establishment of cancer cells to distant sites such as the bone microenvironment requires multiple steps. Tumour cells can acquire properties to allow epithelial-to-mesenchymal transition, extravasation and migration. Within the bone metastatic niche, disseminated tumour cells may enter a dormancy stage or proliferate to adapt and survive, interacting with bone cells such as hematopoietic stem cells, osteoblasts and osteoclasts. Cross-talk with the bone may alter tumour cell properties and, conversely, tumour cells may also acquire characteristics of the surrounding microenvironment, in a process known as osteomimicry. Alternatively, these cells may also express osteomimetic genes that allow cell survival or favour seeding to the bone marrow. The seeding of tumour cells in the bone disrupts bone-forming and bone-resorbing activities, which can lead to macrometastasis in bone. At present, bone macrometastases are incurable with only palliative treatment available. A better understanding of how these processes influence the early onset of bone metastasis may give insight into potential therapies. This review will focus on the early steps of bone colonisation, once disseminated tumour cells enter the bone marrow. PMID:27782035

  17. Percutaneous cementoplasty for painful osteolytic distal femur metastases: a case report

    Directory of Open Access Journals (Sweden)

    Lei M

    2016-10-01

    Full Text Available Mingxing Lei,1 Yaosheng Liu,1 Shaoxing Yang,2 Weigang Jiang,1 Yuncen Cao,1 Shubin Liu1 1Department of Orthopedic Surgery, 2Department of Pulmonary Neoplasms Internal Medicine, The Affiliated Hospital of Academy of Military Medical Sciences, Beijing, People’s Republic of China Abstract: Percutaneous cementoplasty has been shown to immediately restore the mechanical stability of affected bones, prevent further risk of bone fractures, and allow immediate weight bearing. It is emerging as one of the most promising procedures for patients with painful bone metastasis who are unsuitable for surgery or who show resistance to radiotherapy and/or analgesic therapies. This study aimed at describing the procedure, indications, and benefits of percutaneous cementoplasty for painful osteolytic distal femur metastases. We report the case of a painful metastatic lesion in the left distal femur secondary to non-small-cell lung cancer in a 58-year-old woman. The patient underwent percutaneous cementoplasty and experienced effective pain relief and recovery of knee function postoperatively. In addition, no perioperative complication was observed. Percutaneous cementoplasty for osteolytic distal femur metastases offers effective pain relief and restores impaired knee function. Although this method may be a safe option, larger samples of retrospective or prospective confirmation are warranted. Keywords: minimally invasive procedure, percutaneous cementoplasty, bone metastasis, distal femur

  18. Establishment of a Novel Chinese Human Lung Adenocarcinoma Cell Line CPA-Yang1 which Produces Highly Bone Metastases in Immunodeficient Mice%中国人肺腺癌细胞系CPA-Yang1的建立及其生物学特性

    Institute of Scientific and Technical Information of China (English)

    杨顺芳; 苏建中; 曹杰; 张佩玲; 陆建英; 谢文晖

    2009-01-01

    背景与目的 肺癌是我国肿瘤疾病中的头号杀手.建立国人肺腺癌高转移细胞株CPA-Yang1,为肺癌的发生、发展的研究提供实验模型.方法 本细胞取自50岁男性肺腺癌患者的心包积液作细胞原代培养成功.免疫缺陷小鼠致瘤率实验;绘制细胞生长曲线;细胞染色体核型分析;肿瘤标志物检测;荧光定量PCR检测部分癌基因表达.结果 第一代细胞经BNX小鼠和裸鼠皮下种植的动物实验证实,瘤体生长迅速,致瘤率达100%且以后各代均表现稳定的强致瘤率(100%);体外培养细胞在显微镜下显示为半悬浮生长且细胞面积较大;经裸鼠左心室和尾静脉种植(75-80万细胞/只)2-3周后陆续出现小鼠下肢瘫痪和脊柱骨肿胀变形且体重下降,经核素骨显像检测和病理确定为骨转移达90%,且仅10%同时伴有肺转移.该细胞的染色体核型分析为亚三倍体;肿瘤标志物放射免疫检测CEA为高分泌(10.1 ng/mL).RT-PCR检测VEGF-C、IL-6、IL-8癌基因过表达.结论 新建的CPA-Yang1是株亲代细胞就具有骨转移特性的国人肺腺癌细胞株,细胞代谢旺盛,性状稳定,细胞形态特殊,该细胞将成为肺癌研究的一个良好细胞实验模型.%Background and objective Lung cancer is a common malignancy and is the major determinant of overall cancer mortality worldwidely. Approximately 70% of lung cancer patients will die from metastatic diseases. The aim of this study is to establish a Chinese lung adenocarcinoma cell line with high metastasis potency for exploring the mechanism of occurrence and development in lung cancer. Methods The cell came from the pericardial effusion of a fifty-year old male patient with lung adenocarcinoma and the cells in primary culture were obtained successfully. Immunodeficient mice tumorigenidty was assayed. The cell growth curve was mappinged Analysis of chromosome karyotype was tested. Tumor marker was detected by radioim-munoassay.The gene

  19. Turbo STIR magnetic resonance imaging as a whole-body screening tool for metastases in patients with breast carcinoma: preliminary clinical experience.

    Science.gov (United States)

    Walker, R; Kessar, P; Blanchard, R; Dimasi, M; Harper, K; DeCarvalho, V; Yucel, E K; Patriquin, L; Eustace, S

    2000-04-01

    This study was undertaken to assess the utility of whole-body turbo short tau inversion recovery (STIR) magnetic resonance imaging (MRI) to detect metastases to liver, brain, and bone as a single examination in women with breast cancer. Seventeen patients with biopsy-proven breast cancer and suspected metastatic disease attending over a 12-month period referred for both conventional imaging and whole-body MRI were included in the study. Three patients were found to be free of metastases at both conventional and MR imaging. Appendicular or axial skeletal metastases were identified in 11 of 17 patients, with correlation between findings at whole-body MRI and scintigraphy in 15 of the 17 patients. Five patients had evidence of hepatic metastases on whole-body MRI, of which metastases were identified in only three patients at CT despite contrast enhancement. Four patients had brain abnormalities (metastases in three patients, meningioma in one patient) detected on both whole-body and dedicated brain MRI. Preliminary clinical experience suggests that turbo STIR whole-body MRI may represent a convenient and cost-effective method of total body screening for metastases in patients with breast carcinoma.

  20. Elektrokemoterapi til behandling af kutane metastaser

    DEFF Research Database (Denmark)

    Falk, Hanne; Matthiessen, Louise Wichmann; Dahlstrøm, Karin;

    2015-01-01

    effect by at least 300-fold. Electrochemotherapy is an efficient, once only treatment for cutaneous metastases with an objective response of 62-99%. Electrochemotherapy can reduce discomfort such as ulceration, oozing, bleeding and pain. Adverse events depend on the size of treatment area, but are very......Cutaneous metastases occur in up to 9% of all patients with cancer and may cause discomfort and stigmatization. Electrochemotherapy is a local treatment using electric pulses to permeabilize cell membranes, enabling chemotherapy, such as bleomycin, to enter the cells and increase the cytotoxic...

  1. The usefulness of early whole body bone scintigraphy in the detection of bone metastasis from prostatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Otsuka, Nobuaki; Fukunaga, Masao; Furukawa, Yohji; Tanaka, Hiroyoshi (Kawasaki Medical School, Kurashiki, Okayama (Japan))

    1994-06-01

    Early whole body bone scintigraphy was performed on 25 patients with prostatic cancer (15 cases with bone metastases and 10 cases without bone metastasis) to obtain anterior and posterior whole body images five minutes after administration of [sup 99m]Tc-hydroxymethylene diphosphonate(HMDP). The results were compared with the findings of routine bone scintigraphy after three hours, and the usefulness of the above method for the diagnosis of bone metastasis from prostatic cancer was evaluated. In cases in which increased activity was found in the upper and lower lumbar vertebrae by routine bone scintigraphy but no abnormality was seen by early whole body bone scintigraphy, senile degenerative bone changes such as spondylosis deformance were observed by bone radiography. In cases with multiple bone metastases, abnormal multiple accumulations were found by both early whole body bone scintigraphy and routine bone scintigraphy. In addition, in cases showing super bone scan, high accumulation in the skeletal system had already been detected by early whole body bone scintigraphy. When the courses before and after treatment in nine cases of multiple bone metastases were passaged from the results of early whole body bone scintigraphy and from changes in tumor markers (prostatic specific antigen, [gamma]-semino protein and prostatic acid phosphatase), increased activity and the appearance of new hot spots as well as an increase in tumor markers were detected by early whole body scintigraphy in three of the four advanced cases, whereas decreased accumulations and a decrease in and normalization of tumor markers were observed in five improved cases. (author).

  2. Classification of contact allergens according to potency: proposals.

    Science.gov (United States)

    Kimber, I; Basketter, D A; Butler, M; Gamer, A; Garrigue, J-L; Gerberick, G F; Newsome, C; Steiling, W; Vohr, H-W

    2003-12-01

    It is clear that contact allergens vary substantially with regard to the relative potency with which they are able to induce skin sensitisation. Considerations of potency will in the future become a significant factor in the classification of skin sensitising chemicals. It is therefore appropriate to establish what is known of potency and thresholds in the induction of skin sensitisation and the elicitation of allergic contact dermatitis, and to identify approaches that might be available for assessment of relative potency for the purposes of categorising chemical allergens. This paper was prepared by an ECETOC (European Centre for Ecotoxicology and Toxicology) Task Force that had the objective of recommending approaches for the measurement of potency and definition of thresholds for both the induction and elicitation of contact sensitisation. The deliberations recorded here build upon recommendations made previously by an ECETOC Task Force that considered the conduct of standard skin sensitisation test methods for the purposes of hazard identification and risk assessment (ECETOC, Monograph No. 29, Brussels, 2000). The emphasis in this present paper is also on standard and accepted methods for the assessment of skin sensitisation, and for which OECD guidelines are available: the local lymph node assay (LLNA), the guinea pig maximisation test and the occluded patch test of Buehler. For various reasons, discussed in detail herein, attention focused primarily upon consideration of categorisation of chemical allergens and the identification of thresholds with respect to the induction of skin sensitisation, rather than the elicitation of allergic contact dermatitis. It is concluded that although the LLNA is the method of choice for the determination of skin sensitisation potency for the purposes of categorisation, if data are already available from appropriate guinea pig tests then their judicious interpretation may provide information of value in determinations of

  3. Subtrochanteric Femoral Insufficiency Fracture Following Bisphosphonate Therapy for Osseous Metastases.

    Science.gov (United States)

    Bush, Lisabeth A; Chew, Felix S

    2008-01-01

    We present the case of an insufficiency fracture of the femoral shaft in a 61-year-old man who had received bisphosphonate therapy to reduce the fracture risk from lytic renal cell carcinoma metastases to the spine. Approximately 1.5 years after beginning monthly intravenous infusions of zoledronic acid (Zometa), the patient complained of persistent thigh pain. Radionuclide bone scan showed mildly increased activity in the lateral subtrochanteric cortex of the right femur, where there was focally increased T2 signal on MRI and a small, triangular ridge or cortical beak on radiographs. The lesion was initially thought to represent a metastasis, but after the patient returned with a transverse femoral shaft fracture through the ridge following minimal trauma, MRI and biopsy of the lesion failed to show any evidence of tumor. We suggest that this fracture is similar to the low-energy proximal femoral shaft fractures recently reported in postmenopausal women who have received oral bisphosphonates for osteoporosis. Suppression of bone turnover may play a role in the development of these fractures.

  4. Percutaneous kyphoplasty for the treatment of spinal metastases

    Science.gov (United States)

    CHEN, FENG; XIA, YONG-HUI; CAO, WEN-ZHEN; SHAN, WEI; GAO, YANG; FENG, BO; WANG, DIFEI

    2016-01-01

    The bones are the most common location for metastases, which may cause severe pain and damage, including osteolytic destruction and fractures. Pathological fractures of the spine are extremely painful and cause significant disability and morbidity in patients. Traditional open surgery has numerous complications, and radiation therapy may take weeks to become effective. To avoid the trauma and complication of open surgery, percutaneous kyphoplasty (PKP) is a minimally invasive procedure that has played a great role in the treatment of spinal metastases over the past several years. To evaluate the efficacy and safety of the treatment of spinal metastasis using PKP, the present study evaluated 282 patients who had received PKP between April 2009 and June 2014. The efficacy of PKP was evaluated using the visual analog scale for pain (VAS), Karnofsky performance score (KPS) and quality of life (QOL) score (short form with 36 questions). The KPS and QOL were measured pre-operatively and 3 months post-operatively. In addition, radiographical data, including the degree of restoration of the kyphotic angle and the anterior vertebral height, and leakage of bone cement, were measured. The safety of the surgery was assessed by complications and side effects reported during or subsequent to surgery. The present study measured the parameters prior to the surgery and at 24 h, 3 months, 6 months and 1 year post-surgery, as well as at the last follow-up date. The range of the follow-up time was between 105 days and 15 months (mean, 401 days). The 282 patients underwent successful operations and the pain felt by the patients prior to the surgery was significantly alleviated. In addition, the analgesic intake of patients greatly decreased following PKP. KPS improved prior to and 3 months after the surgery. QOL also improved prior to and 3 months after the surgery. Radiographical data demonstrated that the kyphotic angle decreased following PKP, and the anterior vertebral height

  5. Skeletal metastases - the role of the orthopaedic and spinal surgeon.

    Science.gov (United States)

    Eastley, Nicholas; Newey, Martyn; Ashford, Robert U

    2012-09-01

    Developments in oncological and medical therapies mean that life expectancy of patients with metastatic bone disease (MBD) is often measured in years. Complications of MBD may dramatically and irreversibly affect patient quality of life, making the careful assessment and appropriate management of these patients essential. The roles of orthopaedic and spinal surgeons in MBD generally fall into one of four categories: diagnostic, the prophylactic fixation of metastatic deposits at risk of impending fracture (preventative surgery), the stabilisation or reconstruction of bones affected by pathological fractures (reactive surgery), or the decompression and stabilisation of the vertebral column, spinal cord, and nerve roots. Several key principals should be adhered to whenever operating on skeletal metastases. Discussions should be held early with an appropriate multi-disciplinary team prior to intervention. Detailed pre-assessment is essential to gauge a patient's suitability for surgery - recovery from elective surgery must be shorter than the anticipated survival. Staging and biopsies provide prognostic information. Primary bone tumours must be ruled out in the case of a solitary bone lesion to avoid inappropriate intervention. Prophylactic surgical fixation of a lesion prior to a pathological fracture reduces morbidity and length of hospital stay. Regardless of a lesion or pathological fracture's location, all regions of the affected bone must be addressed, to reduce the risk of subsequent fracture. Surgical implants should allow full weight bearing or return to function immediately. Post-operative radiotherapy should be utilised in all cases to minimise disease progression. Spinal surgery should be considered for those with spinal pain due to potentially reversible spinal instability or neurological compromise. The opinion of a spinal surgeon should be sought early, as delays in referral directly correlate to worse functional recovery following intervention

  6. Two breast metastases from thyroid carcinoma presented 6 years later after total thyroidectomy: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Gene Hyuk; Kang, Bong Joo; Kim, Sung Hun; Lee, Ah Won [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Jung, Na Young [Dept. of Radiology, Bucheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Bucheon (Korea, Republic of)

    2016-04-15

    Thyroid carcinoma is usually indolent with good prognosis, as compared to other malignancy. Distant metastases from thyroid cancer are rare and usually manifest as multiple lesions especially in lungs, bones and lymph nodes, in advanced stages of the disease. Metastasis to the breast from thyroid carcinoma is extremely rare, with about 16 cases reported in the English literature. Herein, we reported a case of metastatic poorly differentiated thyroid carcinoma, which presented as 2 breast masses in a 72-year-old woman, 6 years after total thyroidectomy for papillary thyroid carcinoma. Although the computed tomography (CT) and ultrasonography (USG) image findings are nonspecific oval mass with circumscribed or partially indistinct margin, metastases from thyroid cancer should be included in the differential diagnosis when recurrence of thyroid carcinoma is suspected. Also, fusion images of CT and USG are helpful to the radiologists in localizing the targeted lesion and conducting accurate USG-guided biopsy.

  7. Prediction of survival after surgery due to skeletal metastases in the extremities

    DEFF Research Database (Denmark)

    Sørensen, M S; Gerds, T A; Hindsø, K

    2016-01-01

    AIMS: The purpose of this study was to develop a prognostic model for predicting survival of patients undergoing surgery owing to metastatic bone disease (MBD) in the appendicular skeleton. METHODS: We included a historical cohort of 130 consecutive patients (mean age 64 years, 30 to 85; 76 females....../54 males) who underwent joint arthroplasty surgery (140 procedures) owing to MBD in the appendicular skeleton during the period between January 2003 and December 2008. Primary cancer, pre-operative haemoglobin, fracture versus impending fracture, Karnofsky score, visceral metastases, multiple bony...... metastases and American Society of Anaesthesiologist's score were included into a series of logistic regression models. The outcome was the survival status at three, six and 12 months respectively. Results were internally validated based on 1000 cross-validations and reported as time-dependent area under...

  8. A Case of Brain Metastases from Breast Cancer Treated with Whole-Brain Radiotherapy and Eribulin Mesylate

    Directory of Open Access Journals (Sweden)

    Carsten Nieder

    2012-01-01

    Full Text Available Patients with triple receptor-negative breast cancer often develop aggressive metastatic disease, which also might involve the brain. In many cases, systemic and local treatment is needed. It is important to consider the toxicity of chemo- and radiotherapy, especially when newly approved drugs become available. Randomised studies leading to drug approval often exclude patients with newly diagnosed brain metastases. Here we report our initial experience with eribulin mesylate and whole-brain radiotherapy (WBRT in a heavily pretreated patient with multiple brain, lung, and bone metastases from triple receptor-negative breast cancer. Eribulin mesylate was given after 4 previous lines for metastatic disease. Two weeks after the initial dose, that is, during the first cycle, the patient was diagnosed with 5 brain metastases with a maximum size of approximately 4.5 cm. She continued chemotherapy and received concomitant WBRT with 10 fractions of 3 Gy. After 3 cycles of eribulin mesylate, treatment was discontinued because of newly diagnosed liver metastases and progression in the lungs. No unexpected acute toxicity was observed. The only relevant adverse reactions were haematological events after the third cycle (haemoglobin 9.5 g/dL, leukocytes 3.1×109/L. The patient died from respiratory failure 18.5 months from diagnosis of metastatic disease, and 2.7 months from diagnosis of brain metastases. To the best of our knowledge, this is the first report on combined WBRT and eribulin mesylate.

  9. Catching metastasizing cells in the act

    NARCIS (Netherlands)

    Coumans, F.A.W.

    2012-01-01

    Distant metastases are formed by tumor cells that shed from the primary tumor into the bloodstream. These circulating tumor cells (CTC) may be enumerated in a patients¿ blood. The number of CTC provides a prognosis, predicts a response to therapy and the expression of certain molecules in the CTC al

  10. [Muscular metastases. A case report (author's transl)].

    Science.gov (United States)

    Trèves, R; Barruche, D; Desproges-Gotteron, R

    Muscular metastases are exceptionally reported. The authors present a case of crural neuralgia in relation with a localisation in the psoas iliacus of a gastric carcinoma. A review of literature defines the rarity of this facts (156 cases) the etiology (carcinome more often) and the explication who is still obscur.

  11. [Malignant schwannoma metastasizing to the heart].

    Science.gov (United States)

    Menezes Júnior, A da S; Greco, O T; Fiorini, M; Pavarino, P; Corbucci, H; Caixeta, A M

    1992-01-01

    We introduce the case of a 34-year-old male with a malignant metastasizing tumor in the heart associated with skin manifestations. The patient was submitted to heart surgery to resect the tumor. The correct diagnosis was done by pathological findings and immunohistochemical methods and showed, malignant schwannoma.

  12. Assessment of intracranial metastases from neuroendocrine tumors/carcinoma

    Directory of Open Access Journals (Sweden)

    Ahmed M Ragab Shalaby

    2016-01-01

    Full Text Available Background: The most common sites of origin for neuroendocrine carcinoma are gastrointestinal tract and its accessory glands, and lungs. Materials and Methods: One-hundred fifty cases diagnosed with metastatic brain lesions were retrieved from hospital records within 5 years. For these cases, the primary neoplasm, histopathological classification, metastasis, treatment, and fate all were studied. Results: Intracranial deposits were detected in 10%. The primary lesion was in the lungs in 87% of patients, and 1 patient in the breast and 1 in esophagus. Pathological classification of the primary lesion was Grade 2 (MIB-1: 3–20% in 1 patient and neuroendocrine carcinoma (MIB-1: ≥21% in 14 patients. The median period from onset of the primary lesion up to diagnosis of brain metastasis was 12.8 months. About 33% of patients had a single metastasis whereas 67% patients had multiple metastases. Brain metastasis was extirpated in 33% of patients. Stereotactic radiotherapy alone was administered in 20% of patients, and brain metastasis was favorably controlled in most of the patients with coadministration of cranial irradiation as appropriate. The median survival period from diagnosis of brain metastasis was 8.1 months. Conclusion: Most of patients with brain metastasis from neuroendocrine carcinoma showed the primary lesion in the lungs, and they had multiple metastases to the liver, lymph nodes, bones, and so forth at the time of diagnosis of brain metastasis. The guidelines for accurate diagnosis and treatment of neuroendocrine carcinoma should be immediately established based on further analyses of those patients with brain metastasis.

  13. Radioiodine therapy in skeletal metastases from well-differentiated thyroid cancer: a Johannesburg experience

    Directory of Open Access Journals (Sweden)

    Nalini Sindy Perumal

    2010-03-01

    Full Text Available Aim.The purpose of this study was to examine the outcome of patients with skeletal metastases from well-differentiated thyroid carcinoma and analyse the effect of variables that influence the prognosis of this disease. Method. We retrospectively reviewed 352 patients treated and followed-up at the Charlotte Maxeke Johannesburg Academic Hospital’s thyroid cancer clinic from 1982 - 1999. Findings. Skeletal metastases were diagnosed in 24 (6.8%, 17 at presentation to the thyroid clinic, and 7 at follow-up. Patients’ ages ranged from 30 - 77 years (mean 53.9 years and the female:male ratio was 3.8:1. Based on the original pathology reports from resected tumours, 9 were papillary and 15 were follicular cancers. Twenty-three of the 24 patients underwent thyroid surgery as the initial management – total thyroidectomy in 18, subtotal thyroidectomy in 3, and lobectomy plus neck dissection in one. The diagnosis of thyroid cancer was based on lobectomy in a single subject. Radioactive iodine (RAI was used as part of the original treatment; external radiation therapy (XRT was mainly used to alleviate severe symptoms. Twenty-one patients (87.5% were treated with RAI; 11 (45.8% received radiotherapy. Seven patients died – 4 from neurological disease directly associated with bone metastases. Of the 17 surviving patients, 2 appeared to be disease-free, 8 were asymptomatic despite overt bony disease, and 7 had persistent symptoms which much improved in 5. Bone metastases were uncommon, and follicular cancer predominated in this survey. Conclusion. RAI therapy improves quality of life in most patients. There is a place for XRT.

  14. Development of a Novel Method for Intraoperative Radiotherapy During Kyphoplasty for Spinal Metastases (Kypho-IORT)

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Frank, E-mail: frank.schneider@umm.de [Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg (Germany); Greineck, Fabian; Clausen, Sven; Mai, Sabine [Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg (Germany); Obertacke, Udo [Department of Orthopaedics and Trauma Surgery, University Medical Center Mannheim, University of Heidelberg (Germany); Reis, Tina; Wenz, Frederik [Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg (Germany)

    2011-11-15

    Purpose: Approximately 30% of patients with cancer receive bone metastases, of which 50% are in the spine. Approximately 20% present with unstable lesions requiring surgical intervention, followed by fractionated radiotherapy over 2-4 weeks to prevent early regrowth. Because of the limited survival time of patients with metastatic cancer, novel treatment concepts shortening the overall treatment time or hospitalization are desirable. In this study, we established a novel approach for intraoperative radiotherapy during kyphoplasty (Kypho-IORT), a method that combines stabilizing surgery and radiotherapy within one visit, after estimating the percentage of eligible patients for this treatment. Methods and Materials: To estimate the percentage of eligible patients, 53 planning CTs (897 vertebrae) of patients with spinal metastases were evaluated. The number of infiltrated vertebrae were counted and classified in groups eligible or not eligible for Kypho-IORT. The Kypho-IORT was performed in a donated body during a standard balloon kyphoplasty using the INTRABEAM system and specially designed applicators. A single dose of 10 Gy (in 10 mm) was delivered over 4 min to the vertebra. This was verified using two ionization chambers and a Monte Carlo simulation. Results: The estimation of eligible patients resulted in 34% of the evaluated patients, and thus 34% of patients with instable spinal metastases are suitable for Kypho-IORT. This study shows also that, using the approach presented here, it is possible to perform an IORT during kyphoplasty with an additional 15 min operation time. The measurement in the donated body resulted in a maximum dose of 3.8 Gy in the spinal cord. However, the Monte Carlo depth dose simulation in bone tissue showed 68% less dose to the prescription depth. Conclusion: We present for the first time a system using an x-ray source that can be used for single-dose IORT during kyphoplasty. The described Kypho-IORT can decrease the overall treatment

  15. Targeting Bone Metabolism in Patients with Advanced Prostate Cancer: Current Options and Controversies

    Directory of Open Access Journals (Sweden)

    Tilman Todenhöfer

    2015-01-01

    Full Text Available Maintaining bone health remains a clinical challenge in patients with prostate cancer (PC who are at risk of developing metastatic bone disease and increased bone loss due to hormone ablation therapy. In patients with cancer-treatment induced bone loss (CTIBL, antiresorptive agents have been shown to improve bone mineral density (BMD and to reduce the risk of fractures. For patients with bone metastases, both zoledronic acid and denosumab delay skeletal related events (SREs in the castration resistant stage of disease. Novel agents targeting the Wnt inhibitors dickkopf-1 and sclerostin are currently under investigation for the treatment of osteoporosis and malignant bone disease. New antineoplastic drugs such as abiraterone, enzalutamide, and Radium-223 are capable of further delaying SREs in patients with advanced PC. The benefit of antiresorptive treatment for patients with castration sensitive PC appears to be limited. Recent trials on the use of zoledronic acid for the prevention of bone metastases failed to be successful, whereas denosumab delayed the occurrence of bone metastases by a median of 4.1 months. Currently, the use of antiresorptive drugs to prevent bone metastases still remains a field of controversies and further trials are needed to identify patient subgroups that may profit from early therapy.

  16. Comparison of survival of patients with metastases from known versus unknown primaries: survival in metastatic cancer

    Directory of Open Access Journals (Sweden)

    Riihimäki Matias

    2013-01-01

    Full Text Available Abstract Background Cancer of unknown primary site (CUP is considered an aggressive metastatic disease but whether the prognosis differs from metastatic cancers of known primary site is not known. Such data may give insight into the biology of CUP and the metastatic process in general. Methods 6,745 cancer patients, with primary metastatic cancer at diagnosis, were identified from the Swedish Cancer Registry, and were compared with 2,881 patients with CUP. Patients were diagnosed and died between 2002 and 2008. The influence of the primary site, known or unknown, on survival in patients with metastases at specific locations was investigated. Hazard ratios (HRs of death were estimated for several sites of metastasis, where patients with known primary sites were compared with CUP patients. Results Overall, patients with metastatic cancers with known primary sites had decreased hazards of death compared to CUP patients (HR = 0.69 [95% CI = 0.66–0.72]. The exceptions were cancer of the pancreas (1.71 [1.54–1.90], liver (1.58 [1.36–1.85], and stomach (1.16 [1.02–1.31]. For individual metastatic sites, patients with liver or bone metastases of known origin had better survival than those with CUP of the liver and bone. Patients with liver metastases of pancreatic origin had an increased risk of death compared with patients with CUP of the liver (1.25 [1.06–1.46]. The median survival time of CUP patients was three months. Conclusions Patients with CUP have poorer survival than patients with known primaries, except those with brain and respiratory system metastases. Of CUP sites, liver metastases had the worst prognosis. Survival in CUP was comparable to that in metastatic lung cancer. The aggressive behavior of CUP may be due to initial immunosuppression and immunoediting which may allow accumulation of mutations. Upon escape from the suppressed state an unstoppable tumor spread ensues. These novel data on the epidemiology of the

  17. Radiosurgery for brain metastases and cerebral edema.

    Science.gov (United States)

    Gazit, Inbal; Har-Nof, Sagi; Cohen, Zvi R; Zibly, Zion; Nissim, Uzi; Spiegelmann, Roberto

    2015-03-01

    The objective of this study was to assess reduction in cerebral edema following linear accelerator radiosurgery (LINAC) as first line therapy for brain metastasis. We reviewed the medical records of all patients who underwent LINAC radiosurgery for brain metastasis at our institution during 2010-2012, and who had not previously undergone either surgery or whole brain radiotherapy. Data were analyzed for 55 brain metastases from 46 patients (24 males), mean age 59.9 years. During the 2 months following LINAC radiosurgery, the mean steroid dose decreased from 4.8 to 2.6 mg/day, the mean metastasis volume decreased from 3.79±4.12 cc to 2.8±4.48 cc (p=0.001), and the mean edema volume decreased from 16.91±30.15 cc to 12.85±24.47 cc (p=0.23). The 17 patients with reductions of more than 50% in brain edema volume had single metastases. Edema volume in the nine patients with two brain metastases remained stable in five patients (volume change 10%, 2-14 cc). In a subanalysis of eight metastases with baseline edema volume greater than 40 cc, edema volume decreased from 77.27±37.21 cc to 24.84±35.6 cc (p=0.034). Reductions in brain edema were greater in metastases for which non-small-cell lung carcinoma and breast cancers were the primary diseases. Overall, symptoms improved in most patients. No patients who were without symptoms or who had no signs of increased intracranial pressure at baseline developed signs of intracranial pressure following LINAC radiosurgery. In this series, LINAC stereotactic radiosurgery for metastatic brain lesions resulted in early reduction in brain edema volume in single metastasis patients and those with large edema volumes, and reduced the need for steroids.

  18. Role of palliative radiotherapy in brain metastases

    Directory of Open Access Journals (Sweden)

    Ramesh S Bilimagga

    2009-01-01

    Full Text Available Background: Brain metastases are a common manifestation of systemic cancer and exceed primary brain tumors in number and are a significant cause of neurologic problems. They affect 20-40% of all cancer patients. Aggressive management of brain metastases is effective in both symptom palliation and prolonging the life. Radiotherapy has a major role to play in the management of brain metastases. AIM: The aim of the study was to know the outcome of palliative radiotherapy in symptomatic brain metastases in terms of improvement in their performance status. Materials and Methods: This is a retrospective study of 63 patients diagnosed to have brain metastases and treated with palliative whole brain radiotherapy to a dose of 30 Gy in 10 fractions over two weeks between June 1998 and June 2007. Diagnosis was done in most of the cases with computed tomography scan and in a few with magnetic resonance imaging. Improvement in presenting symptoms has been assessed in terms of improvement in their performance status by using the ECOG scale. Results: Fifty-four patients completed the planned treatment. Eight patients received concurrent Temozolamide; 88% of patients had symptom relief at one month follow-up; 39/54 patients had a follow-up of just one to three months. Hence survival could not be assessed in this study. Conclusion: External beam radiotherapy in the dose of 30 Gy over two weeks achieved good palliation in terms improvement in their performance status in 88% of patients. Addition of concurrent and adjuvant Timozolamide may improve the results.

  19. Esophageal Cancer with Bone Marrow Hyperplasia Mimicking Bone Metastasis: Report of a Case

    Directory of Open Access Journals (Sweden)

    Hiromi Yasuda

    2016-11-01

    Full Text Available A 63-year-old man visited the clinic with numbness in the right hand. Magnetic resonance imaging demonstrated multiple low-intensity lesions in the cervical vertebrae and sacrum, which was suspicious of cervical bone metastasis. Fluorodeoxyglucose positron emission tomography/computed tomography revealed areas of increased fluorodeoxyglucose uptake in the thoracic esophagus, sternum and sacrum. A flat, elevated esophageal cancer was identified by upper gastrointestinal endoscopy, and the macroscopic appearance indicated early-stage disease. From the cervical, thoracic and abdominal computed tomography images, there were no metastatic lesions except for the bone lesions. To confirm whether the bone lesions were metastatic, we performed bone biopsy. The histopathological diagnosis was bone marrow hyperplasia. It was crucial for treatment planning to establish whether the lesions were distant metastases. Here, we report a case of esophageal cancer with bone marrow hyperplasia mimicking bone metastasis.

  20. Multiple Metastasis-Like Bone Lesions in Scintigraphic Imaging

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    Ying Zhang

    2012-01-01

    Full Text Available Multiple benign osteolytic lesions are very hard to differentiate from disseminated bone metastasis. Whole-body bone scintigraphy (WBBS with technetium-99m methylene diphosphonate (Tc-99m MDP demonstrates multiple lesions with increased uptake in any bone involved. Even combined with medical history and multiple imaging results, such as MRI and CT, the clinical diagnosis of metastasis lesion remains as a challenge. These clinical characteristics are similar to multiple malignant bone metastases and therefore affect the following treatment procedures. In this paper, we analyzed multiple benign osteolytic lesions, like eosinophilic granuloma (EG, multiple myeloma (MM, disseminated tuberculosis, fibrous dysplasia, or enchondroma, occurring in our daily clinical work and concluded that additional attention should be paid before giving the diagnosis of multiple bone metastases.

  1. Identification of mouse cathepsin K structural elements that regulate the potency of odanacatib.

    Science.gov (United States)

    Law, Simon; Andrault, Pierre-Marie; Aguda, Adeleke H; Nguyen, Nham T; Kruglyak, Natasha; Brayer, Gary D; Brömme, Dieter

    2017-02-20

    Cathepsin K (CatK) is the predominant mammalian bone-degrading protease and thus an ideal target for antiosteoporotic drug development. Rodent models of osteoporosis are preferred due to their close reflection of the human disease and their ease of handling, genetic manipulation and economic affordability. However, large differences in the potency of CatK inhibitors for the mouse/rat vs. the human protease orthologs have made it impossible to use rodent models. This is even more of a problem considering that the most advanced CatK inhibitors, including odanacatib (ODN) and balicatib, failed in human clinical trials due to side effects and rodent models are not available to investigate the mechanism of these failures. Here, we elucidated the structural elements of the potency differences between mouse and human CatK (hCatK) using ODN. We determined and compared the structures of inhibitor-free mouse CatK (mCatK), hCatK and ODN bound to hCatK. Two structural differences were identified and investigated by mutational analysis. Humanizing subsite 2 in mCatK led to a 5-fold improvement of ODN binding, whereas the replacement of Tyr61 in mCatK with Asp resulted in an hCatK with comparable ODN potency. Combining both sites further improved the inhibition of the mCatK variant. Similar results were obtained for balicatib. These findings will allow the generation of transgenic CatK mice that will facilitate the evaluation of CatK inhibitor adverse effects and to explore routes to avoid them.

  2. [Radiation therapy in simultaneous choroidal and brain metastases].

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    Conill, C; Jorcano, S; Planas, I; Marruecos, J; Casas, F; Fontenla, J R

    2005-09-01

    Choroidal metastases from lung cancer can be the initial clinical manifestation of metastasic disease, although they generally coexist with at least two more metastasic sites. The most common symptom is decreased vision, however 20% of brain metastases can present with visual alterations. A differential diagnosis within brain metastases and/or choroidal is necessary. We present the case of a patient with lung cancer and decreased vision who was diagnosed as simultaneous choroidal and brain metastases. Radiation therapy (20Gy/5fractions) significantly improves decreased vision. This case shows that, although life expectancy of patients with metastasic lung cancer is short, an adequate diagnosis and treatment, can improve the quality of life of those patients.

  3. Bone within a bone

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    Williams, H.J.; Davies, A.M. E-mail: wendy.turner@roh.nhs.uk; Chapman, S

    2004-02-01

    The 'bone within a bone' appearance is a well-recognized radiological term with a variety of causes. It is important to recognize this appearance and also to be aware of the differential diagnosis. A number of common conditions infrequently cause this appearance. Other causes are rare and some remain primarily of historical interest, as they are no longer encountered in clinical practice. In this review we illustrate some of the conditions that can give the bone within a bone appearance and discuss the physiological and pathological aetiology of each where known.

  4. Bone resorption facilitates osteoblastic bone metastatic colonization by cooperation of insulin-like growth factor and hypoxia.

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    Kuchimaru, Takahiro; Hoshino, Takuya; Aikawa, Tomoya; Yasuda, Hisataka; Kobayashi, Tatsuya; Kadonosono, Tetsuya; Kizaka-Kondoh, Shinae

    2014-05-01

    Bone metastasis is a multistep process that includes cancer cell dissemination, colonization, and metastatic growth. Furthermore, this process involves complex, reciprocal interactions between cancer cells and the bone microenvironment. Bone resorption is known to be involved in both osteolytic and osteoblastic bone metastasis. However, the precise roles of the bone resorption in the multistep process of osteoblastic bone metastasis remain unidentified. In this study, we show that bone resorption plays important roles in cancer cell colonization during the initial stage of osteoblastic bone metastasis. We applied bioluminescence/X-ray computed tomography multimodal imaging that allows us to spatiotemporally analyze metastasized cancer cells and bone status in osteoblastic bone metastasis models. We found that treatment with receptor activator of factor-κB ligand (RANKL) increased osteoblastic bone metastasis when given at the same time as intracardiac injection of cancer cells, but failed to increase metastasis when given 4 days after cancer cell injection, suggesting that RANKL-induced bone resorption facilitates growth of cancer cells colonized in the bone. We show that insulin-like growth factor-1 released from the bone during bone resorption and hypoxia-inducible factor activity in cancer cells cooperatively promoted survival and proliferation of cancer cells in bone marrow. These results suggest a mechanism that bone resorption and hypoxic stress in the bone microenvironment cooperatively play an important role in establishing osteoblastic metastasis.

  5. SURGICAL TACTICS REGARDING CEREBRAL METASTASES WITH HEMORRHAGES

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    E. V. Prozorenko

    2015-01-01

    Full Text Available Cerebral metastases occur with 10 to 30 % of all oncological patients. Hemorrhages into cerebral metastases are one of the most dangerous complications of the metastatic process. With that, cerebral metastases of such widespread solid malignant tumors as melanoma, kidney cancer, germ cell tumors, less frequently, lung cancer and breast cancer are prone to hemorrhages. The purpose of the work is to improve the results of surgical treatment of patients with brain metastases complicated with hemorrhages.Materials  and  methods. Surgical  treatment  of  69  patients  with  brain  metastases complicated  with  hemorrhages was  performed in N.N. Blokhin Russian Cancer Research Center. Hemorrhage on the macroscopic level was confirmed intraoperatively and in accordance with the results of the morphological study of surgical drugs. Total microsurgical resection of one or several cerebral metastases with hemor rhages was performed regarding all patients studied. The time interval of observation of patients after the surgical treatment comprises 1 to 72 months. There were 27 women and 42 men. The age range was from 18 to 74 y.o. Besides, the state of veins of lower extremities and the state of the coagulation blood system in accordance with the data of coagulograms was studies. The analysis of the macrostructure and the microstructure of metastases with hemorrhages as well as the morphological study of the brain tissue adjacent to hematomas was performed with a morphological study and histological techniques. The patients were distributed in accordance with the RPA (recursive partitioning analysis classes: I class (n = 7, II class (n = 39, III class (n = 23; in accordance with the hemorrhage type: intratumoral type (26 metastases, perifocal type (20, mixed type (32; in accordance with the histological principle: melanoma (n = 25, lung cancer (n = 13, kidney cancer (n = 17, breast cancer (n = 4, colorectal cancer (n = 1, soft tissue sarcoma (n

  6. Potency determination of antidandruff shampoos in nystatin international unit equivalents

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    Anusha Hewage D.B.G

    2008-01-01

    Full Text Available A convenient standard microbiological potency determination test for the antidandruff shampoos was developed by adopting the pharmacopoeial microbiological assay procedure of the drug nystatin. A standard curve was drawn consisting of the inhibition zone diameters vs. logarithm of nystatin concentrations in international units using the fungus Saccharomyces cerevisiae (yeast strain National Collection of Type Culture (NCTC 1071606 as the test organism. From the standard curve the yeast inhibitory potencies of the shampoos in nystatin international unit equivalents were determined from the respective inhibition zones of the test samples of the shampoos. Under test conditions four shampoo samples showed remarkable fungal inhibitory potencies of 10227, 10731, 12396 and 18211 nystatin international unit equivalents/ml while two shampoo samples had extremely feeble inhibitory potencies 4.07 and 4.37 nystatin international unit equivalents/ml although the latter two products claimed antifungal activity. The potency determination method could be applied to any antidandruff shampoo with any one or a combination of active ingredients.

  7. How I do it: managing bone health in patients with prostate cancer.

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    Barkin, Jack

    2014-08-01

    Urologists have two scenarios where they have to address bone loss or increased risk of fractures in men with prostate cancer. In the first setting, a patient who has been started on androgen deprivation therapy may develop cancer-treatment-induced bone loss. In the second setting, a patient's prostate cancer may have metastasized to the bone. This article describes six steps to manage bone health in patients diagnosed with prostate cancer in a community practice.

  8. A review of bone metastasis and its treatments, with a special emphasis on local and systemic radiotherapy

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    Peiman Haddad

    2014-01-01

    Treatment of bone metastases consist of analgesics, radiotherapy, surgery and bisphosphonates. Control of bone metastases is a challenging process, necessitating a multi-disciplinary approach and teamwork between the treating physicians. Radiotherapy is the most useful modality for this purpose in oncology, given both as a local and systemic therapy. We hope that this review would be able to help in choosing the best treatment option for this common palliative situation in Iranian cancer patients.

  9. [Radiotherapy of choroid metastases in breast carcinoma].

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    Dobrowsky, W; Schmid, A P; Dobrowsky, E

    1987-06-01

    From 1975 to 1984, thirteen patients were submitted to radiotherapy for choroid metastases of mammary carcinoma. Bilateral manifestation was found in three cases, thus sixteen eyes have been treated. All irradiations were performed with high voltage equipment. The posterior section of the eye was irradiated with 25 to 50 Gy over 2.5 to 5 weeks. Complete regression was achieved in nine out of sixteen cases, five patients showed an improvement of at least 50%, no considerable effect was found in two cases. The survival is 4 to 48 months (median survival 20 months) from the beginning of radiotherapy. Radiotherapy is a quick, efficient, and sparing treatment in choroid metastases. If applied in due time, it can prevent a visual disorder or amaurosis, thus improving the patients' quality of life.

  10. Laparoscopic radiofrequency ablation of neuroendocrine liver metastases.

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    Berber, Eren; Flesher, Nora; Siperstein, Allan E

    2002-08-01

    We previously reported on the safety and efficacy of laparoscopic radiofrequency thermal ablation (RFA) for treating hepatic neuroendocrine metastases. The aim of this study is to report our 5-year RFA experience in the treatment of these challenging group of patients. Of the 222 patients with 803 liver primary and secondary tumors undergoing laparoscopic RFA between January 1996 and August 2001, a total of 34 patients with 234 tumors had neuroendocrine liver metastases. There were 25 men and 9 women with a mean +/- SEM age of 52 +/- 2 years who underwent 42 ablations. Primary tumor types included carcinoid tumor in 18 patients, medullary thyroid cancer in 7, secreting islet cell tumor in 5, and nonsecreting islet cell tumor in 4. There was no mortality, and the morbidity was 5%. The mean hospital stay was 1.1 days. Symptoms were ameliorated in 95%, with significant or complete symptom control in 80% of the patients for a mean of 10+ months (range 6-24 months). All patients were followed for a mean +/- SEM of 1.6 +/- 0.2 years (range 1.0-5.4 years). During this period new liver lesions developed in 28% of patients, new extrahepatic disease in 25%, and local liver recurrence in 13%; existing liver lesions progressed in 13%. Overall 41% of patients showed no progression of their cancer. Nine patients (27%) died. Mean +/- SEM survivals after diagnosis of primary disease, detection of liver metastases, and performance of RFA were 5.5 +/- 0.8 years, 3.0 +/- 0.3 years, and 1.6 +/- 0.2 years, respectively. Sixty-five percent of the patients demonstrated a partial or significant decrease in their tumor markers during follow-up. In conclusion, RFA provides excellent local tumor control with overnight hospitalization and low morbidity in the treatment of liver metastases from neuroendocrine tumors. It is a useful modality in the management of these challenging group of patients.

  11. Management of unknown origin cerebral metastases

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    F.M. Gramada

    2011-03-01

    Full Text Available Aim: The present study attempts todetermine the steps for obtaining theetiological diagnosis of brain metastaseswith unknown origin.Material and methods: A total of 190patients with brain metastases diagnosed inthe Department of Neurosurgery inEmergency Hospital ”N. Oblu” Iasibetween 2007-2010 were included in thisstudy. The clinical characteristics andpathological features were analyzed.Results: There were 102 males and 88females with a M:F ratio of 1.15:1. Themedian age of patients was 47.07 years(range 31-77 years. Females patients wereolder (mean age 57.21 years than malespatients (49.15 years. 154 patients (81.05%had single brain metastasis, and 36 patients(18.95% had more than two. The lesionswere supratentorial in 142 patients(74.73%, infratentorial in 18 (9.47%, andboth infratentorial and supratentorial in 30patients (15.78%. Surgical treatmentinvolved complete resection in 47.9% ofcases, subtotal resection in 26.8%, andbiopsy alone in the remainder (25.3%.Brain metastases originating in lung cancerrepresented the most common type(47.39%, followed by thos