Tumour metabolic activity measured by fluorodeoxyglucose positron emission tomography for radiotherapy planning as a prognostic factor for locally advanced non-small cell lung cancer.

OBJECTIVES: To analyse whether the maximum standardized uptake value of the positron emission tomography/computed tomography for radiotherapy planning was useful as a prognostic factor for tumour response and survival of patients with locally advanced non-small cell lung cancer. BACKGROUND: Increased 18F-fluoro-2-deoxyglucose uptake by lung cancer cells, measured as the maximum standardized uptake value, has been reported to predict the biologic aggressiveness of both early and advanced non-small cell lung cancer. METHODS: A prospective study was performed in 61 consecutive patients with unresectable stage IA-IIIB of non-small cell lung cancer. The mean age was 65 years. Seventy five percent of patients in the entire group received an induction chemotherapy. The mean dose of radiotherapy was 61Gy. All patients underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for radiotherapy planning. RESULTS: Thirty six percent of the patients experienced a complete response and 20 % had a partial tumour response. Forty four percent of the patients suffered from a progressive disease. The maximum standardized uptake value of the primary tumour more than 11.4 was correlated with a worse tumour response (p = 0.0001) and a shorter survival of our patients (p = 0.0109). CONCLUSION: We found a correlation between the maximum standardized uptake value and the patient prognosis and lung cancer aggressiveness (Tab. 3, Fig. 5, Ref. 18).

Multiple metachronous malignant fibrous histiocytomas of the upper limbs -  a case report.

BACKGROUND: Soft-tissue sarcomas are rare tumors with the incidence of multiple metachronous or synchronous lesions in the extremities being even more uncommon. In effort to preserve the function of upper extremities, limb-salvage surgery became the treatment of choice for soft-tissue sarcomas. Subsequent adjuvant chemotherapy, as well as radiotherapy, is believed to decrease local recurrence rates, however, their effect on overall survival remains unclear. CASE: We report herein a case of symmetrical bilateral metachronous malignant fibrous histiocytomas of the shoulder. A 19-year-old patient presented with stiffness and pain in the right shoulder. The same symptoms developed 1.5 years later in the other shoulder. The culprit tumors are reported metachronous with regard to the succession in the onset of symptoms. Wide tumor resection was performed in both shoulders, and postoperative radiotherapy was then conducted. Chemotherapy was not indicated after the first surgery; whereas, in the second case it was the patient who refused the recommended adjuvant chemotherapy. CONCLUSION: The phenomenon of either metachronous or synchronous incidence of multiple soft tissue sarcomas is very rare and systematic reporting of every new case in the literature could contribute to further knowledge of tumors unique behavior.Key words: malignant fibrous histiocytoma - radiotherapy - upper extremity - neoplasms - multiple primary.