ABSTRACT
CONTEXT: Scanty reports have focused on FDG-PET after radiofrequency ablation (RFA), for recurrence of hepatic metastases. OBJECTIVE: To assess FDG-PET diagnostic accuracy on detection of recurrent hepatic lesions. METHODS: After a comprehensive search of PubMed and EMBASE, we performed a patient-based diagnostic meta-analysis of post-RFA FDG-PET. RESULTS: Across nine included articles, independent, random-effects sensitivity and specificity were 0.73(0.50-0.88) and 0.85(0.72-0.93), respectively. A symmetrical SROC curve was produced with no significant heterogeneity. Specificity was optimal for surgical RFA and colorectal origin of metastases. CONCLUSION: Synthesis of published evidence suggests PET/CT as an appropriate tool for optimizing post-ablation follow-up.
Subject(s)
Colorectal Neoplasms/surgery , Fluorodeoxyglucose F18 , Liver Neoplasms/surgery , Multimodal Imaging , Neoplasm Recurrence, Local/diagnostic imaging , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed , Area Under Curve , Catheter Ablation , Colorectal Neoplasms/diagnostic imaging , Colorectal Neoplasms/pathology , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/secondary , Neoplasm Recurrence, Local/prevention & control , ROC Curve , RadiosurgeryABSTRACT
Carboplatin is a chemotherapeutic agent approved in the first-line setting of numerous malignancies. Hypersensitivity to carboplatin has been reported in up to 44% of patients receiving this antineoplastic agent, usually occurring after several courses of treatment. The aim of this study was to determine the usefulness of skin tests in ruling out cross-reaction to cisplatin to continue platinum-based chemotherapy in patients who are responsive to these agents. Prick tests and intradermal tests with a series of dilutions of carboplatin and cisplatin were performed on three patients who had exhibited medium and severe hypersensitivity reactions to carboplatin. Prick tests were negative in both the antineoplastic agents. Intradermal tests with carboplatin were positive in all three patients and negative with cisplatin. In all patients, the administration of cisplatin instead of carboplatin was well tolerated without the need of premedication. In conclusion, intradermal skin tests can be a useful tool for detecting a potential cross-reaction between platinum salts. It allows safe administration of a different platinum agent in patients who seem to benefit from platinum-based therapy. Discontinuation of chemotherapy, desensitization protocols and steroid premedication can be avoided.
Subject(s)
Antineoplastic Agents/adverse effects , Carboplatin/adverse effects , Cisplatin/adverse effects , Drug Hypersensitivity/diagnosis , Adenocarcinoma, Bronchiolo-Alveolar/drug therapy , Aged , Antineoplastic Agents/administration & dosage , Carboplatin/administration & dosage , Cisplatin/administration & dosage , Female , Humans , Immunoglobulin E , Intradermal Tests , Lung Neoplasms/drug therapy , Male , Mesothelioma/drug therapy , Middle Aged , Ovarian Neoplasms/drug therapy , Skin TestsABSTRACT
A case of a 69-year-old woman with myelofibrosis presenting with non-small cell lung cancer was reported at Sotiria General Hospital in Athens. She was administered bevacizumab infusions biweekly and a great decrease in the number of her white blood cells was observed. Such low levels of white blood cells had never been reached in the past, when she was receiving hydroxyurea.
Subject(s)
Angiogenesis Inhibitors/administration & dosage , Antibodies, Monoclonal/administration & dosage , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Primary Myelofibrosis/drug therapy , Aged , Antibodies, Monoclonal, Humanized , Bevacizumab , Carcinoma, Non-Small-Cell Lung/blood , Carcinoma, Non-Small-Cell Lung/blood supply , Drug Administration Schedule , Female , Humans , Hydroxyurea/therapeutic use , Infusions, Parenteral , Leukocyte Count , Lung Neoplasms/blood , Lung Neoplasms/blood supply , Primary Myelofibrosis/blood , Treatment OutcomeABSTRACT
Angiogenesis is the physiological process of the formation of new blood vessels from pre-existing ones. Multiple molecules regulate angiogenesis, such as the vascular endothelial growth factor, angiopoietins, the fibroblast growth factor, the platelet-derived growth factor and the transforming growth factor-beta. Angiogenesis plays an important role in the growth, progression and metastasis of a tumour. Inhibiting the angiogenic process or targeting existing tumour vessels can be used for treatment of tumours as an alternative or in parallel with conventional chemotherapy. Many anti-angiogenic factors are under investigation and some are already being used in clinical practice with various results.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Neoplasms , Neovascularization, Pathologic/drug therapy , Neovascularization, Pathologic/physiopathology , Humans , Neoplasms/blood supply , Neoplasms/drug therapy , Neoplasms/physiopathologyABSTRACT
Gemcitabine-associated thrombotic thrombocytopenic purpura is a rare complication of gemcitabine treatment with an incidence ranging from 0.015 to 1.4%. Clinically, this disease manifests as haemolytic anaemia, thrombocytopenia and renal insufficiency; hypertension and neurological and pulmonary symptoms are also known complications. The risk of thrombotic thrombocytopenic purpura increases as the cumulative dose of gemcitabine approaches 20,000 mg/m(2). The pathophysiology of this disease entity is unknown although several theories, involving both immune and non-immune mechanisms, have been proposed. The most effective treatment is discontinuation of gemcitabine, the provision of antihypertensive medications as needed, and consideration of plasmapheresis or use of immunoadsorption column in severe cases.
