role of [99m] Tc-MIBI SPET in predicting and monitoring the chemotherapeutic response in primary lung cancer

The aim of this study was to evaluate the role of technetium-99m methoxyisonitrile [MIBI] which is more available and cheaper than PET agents in monitoring the chemotherapeutic response in primary lung cancer. In this study, 37 patients with primary lung cancer underwent 99mTc-MIBI single photon emission tomography [SPET] before chemotherapy and after the 3rd cycle of chemotherapy. SPET images were recorded at 15 minutes [early] and at 3-4 hours [delayed] post- injection of the tracer. From the SPET images, early and delayed tumor/lung ratios [ER and DR] were obtained before and after chemotherapy. CT scan studies before and after chemotherapy were also performed for all patients. According to the changes in tumor size on CT scan taken two weeks after the 3rd cycle of the chemotherapy, patients were divided into two groups, responders [R[+]] and non- responders [R[-]]. The results suggested that 99mTc-MIBI might be used in routine practice not only to detect and evaluate active lesions, but also to predict and monitor the chemotherapeutic response in patients with primary lung cancer, especially when PET is not available

benefit of postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy

Postoperative radiotherapy has been known to reduce rates of loco regional recurrences in women with breast cancer, but whether it prolongs overall survival is still a controversial subject. This randomized trial was conducted to test the effect of postoperative radiotherapy in high-risk premenopausal women with breast cancer who also received adjuvant systemic chemotherapy. A total of 82 high-risk pre menopausal women with breast cancer were randomly assigned, after modified radical mastectomy to receive either chemotherapy plus radiotherapy or chemotherapy alone. Radiotherapy was given to the chest wall and regional lymph nodes between the third and fourth cycles of FAC chemotherapy [5-Flourouracil. Doxorubicin and Cyclophosphamide], each cycle was administered every 3 weeks for 6 cycles. The end points were loco regional recurrence, distant metastases, disease free survival and overall survival. After 5 years of follow up, the frequency of loco regional recurrence alone or with distant metastases was 9.5% among the women assigned to radiotherapy plus FAC and 35% among those treated only with FAC [P = 0.005]. The disease free survival was 61.9% among the women who received radiotherapy plus FAC and 40% among those treated only with FAC [P = 0.047]. The overall survival was 73.8% among those given radiotherapy and FAC and 52.5% among those who received FAC alone [P = 0.045]. Multivariate analysis demonstrated that post mastectomy radiation therapy significantly improved disease free survival and overall survival irrespective of tumor size, the number of positive nodes, or the histopathological grade [p0.042 and p=0.014 respectively]. The addition of radiotherapy to adjuvant chemotherapy after modified radical mastectomy reduces locoregional recurrences and prolongs survival in high risk premenopausal women with breast cancer