RESUMO
Somatostatin receptors have been identified on the cellular surface of a subset of patients with small cell lung cancer (SCLC) and may be associated with a less aggressive evolution of the tumor. Moreover, medical therapy with somatostatin analogues holds promise for neoplastic growth control. We performed planar imaging in 22 patients with histologically proven SCLC at 2-4 and 24 hours after the injection of 111-185 MBq of 111In-DTPA-octreotide (Octreoscan, Byk-Gulden). Tumor uptake was observed in 19 patients in both early and late scans, while 2 patients previously treated with chemotherapy showed negative early and late scans. One patient had a positive early scan and a negative late scan. All the scintigraphic studies showed more extensive disease than expected by CT. No significant modification in tumor uptake of radiooctreotide was observed in three patients studied before and after chemotherapy. In conclusion, 111In-octreotide is a suitable radiopharmaceutical for the in vivo evaluation of the somatostatin receptors of small lung cancer. The prognostic and therapeutical implications of this nuclear technique must be further investigated, however.
Assuntos
Carcinoma de Células Pequenas/diagnóstico por imagem , Radioisótopos de Índio , Neoplasias Pulmonares/diagnóstico por imagem , Octreotida/análogos & derivados , Ácido Pentético/análogos & derivados , Compostos Radiofarmacêuticos , Idoso , Carcinoma de Células Pequenas/tratamento farmacológico , Carcinoma de Células Pequenas/metabolismo , Carcinoma de Células Pequenas/patologia , Feminino , Seguimentos , Humanos , Radioisótopos de Índio/administração & dosagem , Radioisótopos de Índio/farmacocinética , Injeções Intravenosas , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Octreotida/administração & dosagem , Octreotida/farmacocinética , Ácido Pentético/administração & dosagem , Ácido Pentético/farmacocinética , Prognóstico , Cintilografia , Compostos Radiofarmacêuticos/administração & dosagem , Compostos Radiofarmacêuticos/farmacocinética , Receptores de Somatostatina/análise , Somatostatina/análogos & derivados , Somatostatina/uso terapêutico , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
In a group of 33 patients affected by diabetes mellitus transcutaneous oxygen tension (PtcO2) was measured by means of a Clark polarographic electrode. Patients were divided into 3 groups according to the symptoms and/or to the clinical findings: group A: paresthesia (22 limbs); group B: claudication (6 limbs); group C: rest pain and/or necrosis (13 limbs). Moreover, group C was divided into: C1 trophic neuropathy lesion (7 limbs) and C2 trophic ischemic lesion (6 limbs). Our data point out that there is a statistically significant difference between mean PtcO2 values in limbs with trophic ischemic lesions versus the other 3 groups. Therefore, PtcO2 is particularly indicated and useful in the study of diabetic patients with peripheral vascular disease where integrates the other instrumental noninvasive techniques.
