Dermo Beta Brachytherapy with 188Re in extramammary Paget's disease.

AIM: Extramammary Paget's disease (EMPD) is a rare neoplastic pathology involving the vulva, scrotum, and perianal areas, and it is characterized by a slow and insidious course. EMPD may also be associated with internal malignancy, and its clinical presentation features long-standing pruritic lesions, eczema-like, refractory to any therapy. The pathogenesis is unclear, and univocal standardization of treatment is yet to be determined. As regard to the patients who suffer from it, women are more often affected than men. The therapeutic approach depends on the extent of involvement; wide surgical excision is the first choice among treatments, but other forms of therapy, alone or in combination, include imiquimod 5%, photodynamic therapy, Mohs surgery as well as external beam radiotherapy and Brachytherapy. In the present paper a new therapeutic alternative is proposed: Dermo-Beta-Brachytherapy (DBBT) with 188Re. METHODS: Five patients with EMPD, one secondary and four primary cases, have been treated by Brachytherapy with DBBT. This therapy has been successfully used for non-melanocytic skin tumors and basically consists in the topical application of a specially designed, tailor-made mould containing a radioactive beta-emitting isotope, rhenium-188. RESULTS: The patients healed completely, after one session in one case and after two sessions in four cases, with 34 months mean follow-up. CONCLUSION: Brachyterapy could represent a new alternative therapy, instead than invasive treatments as surgery and conventional radiotherapy, capable to treat EMPD independently of its extension, with aesthetic and functional satisfactory results.

Dermatological high-dose-rate brachytherapy for the treatment of basal and squamous cell carcinoma.

BACKGROUND: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are among the most common cancers in humans. Various therapies are currently being used to treat these tumours including surgery, topical treatments and radiotherapy. We describe a new treatment for BCC and SCC. This consists of superficial radiotherapy, using synthetic resin containing a radioactive beta-emitting isotope. The resin is applied to the lesion to perform a selective beta-irradiation brachytherapy treatment. METHODS: In total, 53 patients with histologically confirmed diagnosis of BCC and of SCC were enrolled for the treatment. RESULTS: In all treated cases, an apparent clinical remission occurred in approximately 3 months, and complete healing was obtained in 100% of the treated patients; in 82% of the cases, this occurred after a single application. No disfiguring scars or any side-effects were seen. After a follow-up of 20-72 months (mean 51 months), no clinical relapses were observed in the treated patients. Histological examination confirmed complete tumour regression. CONCLUSION: The results indicated that brachytherapy is an effective treatment for BCC and SCC.

A process for the recovery of strontium from the urine of patients injected with 89Sr.

89Sr is a beta emitter used for palliation of pain in patients with metastatic bone cancer. After each intravenous administration, up to 80% of the isotope is eliminated in the urine. A simple chemical process is described, which permits the recovery and purification of the 89Sr from the urine.

Gamma camera imaging of osseous metastatic lesions by strontium-89 bremsstrahlung.

The aim of this study was to optimise the parameters affecting the Bremsstrahlung scintigraphy of patients injected with strontium-89 chloride. The parameters considered were : (1) instrumental detection efficiency, and (2) tissue attenuation factor for 89Sr calibrated sources, which permit quantitative evaluation of the activity in a given bone lesion. Some typical examples of in vivo 89Sr imaging are presented to illustrate the clinical utility of the imaging procedure developed by us, which is implemented in our department for all patients treated with 89Sr chloride.

Determination of firing distance and firing angle by neutron activation analysis in a case involving gunshot wounds.

This paper reports the determination of the firing distance and a method for the evaluation of the firing angle in a fatal incident caused by two gunshots. Neutron Activation Analysis (NAA) was used to determine the Sb pattern around the bullet entrance holes on a garment of the victim, and around bullet holes produced by different shots on test targets from the gun and ammunition under investigation. The calibration curves obtained at various distances and firing angles enabled the determination of the firing distances and angles of the crime shots with a standard deviation of +/- 2 cm and +/- 5 degrees, respectively.

Bullet identification: a case of a fatal hunting accident resolved by comparison of lead shot using instrumental neutron activation analysis.

Bullet identification by chemical analysis often provides a powerful clue in forensic science. A case is reported in which a hunting accident was resolved by using instrumental neutron activation analysis (INAA) for direct comparison of the trace element content in lead shot. Different preparation batches of lead shot appear to have a high within-group composition homogeneity, and good differentiation is achieved between different batches. Determination of the nickel and antimony content on a bush branch demonstrated that the branch had been perforated by one of the shot pellets, and this helped the detectives in reconstruction of the crime scene.