The status of nuclear medicine techniques in the diagnosis of bone metastases in breast cancer.

In this article, the authors present their experience with the diagnosis of bone metastases in patients with breast cancer using bone scintigraphy with 99mTc phosphonate and radioimmunological determination of carcinoembryonic antigen (CEA) and tissue polypeptic antigen (TPA). In a group of 395 patients, there was agreement between tumour markers (CEA, TPA) and the results of bone scintigraphy in 331 cases (84%)--negative in 193 cases (49%) and positive (i.e. in terms of bone scintigraphy results and the presence of at least one tumour marker) in 138 cases (35%). On the basis of this good agreement of the results between bone scintigraphy and CEA and TPA levels, the authors recommend the following algorithm in monitoring patients with breast cancer: follow-up of tumour markers at several-month intervals and, any increase in their levels will refer the patient to further examination using imaging techniques including bone scintigraphy.

Significance of carcinoembryonic and tissue polypeptide antigen determination in the diagnosis of metastases in breast cancer.

A radioimmunological assay of CEA and TPA levels in breast cancer patients revealed a 93.7% concordance of negative and 93.4% of positive values with the clinical activity of the disease. In 26 out of a group of 38 patients (68.4%) with progressive breast carcinoma, an enhanced CEA and TPA level was the first indicator of the presence of metastases. In view of the results obtained, the authors consider this procedure to be a suitable method for monitoring and early detection of metastases in patients with breast cancer.

Our experience with the treatment of nasopharyngeal tumors.

An analysis of a group of 78 patients suffering from nasopharyngeal cancer treated during a period of 15 years is discussed. The ratio of males to females was 1.6 : 1, with a maximum incidence in the 4th and 5th decade. There was a predominance of carcinomas (60 patients) over malignant lymphomas (18 patients). With respect to the stage of the carcinomas, the largest group of patients (36 individuals) could be classified as Stage III. At the beginning of the treatment regional metastases were present in 68% of the carcinomas. Nasopharyngeal tumors were treated only by radiotherapy; in the earlier period by conventional roentgenotherapy, recently by telegammatherapy 60Co only. The 5-year survival rate of patients with carcinomas was 25%, of those with malignant lymphomas was 27.7%. Among carcinomas we found better results in lymphoepitheliomas, among the lymphomas in lymphocytic lymphomas. The present study also discusses the significance of some cofactors that may play a role in respect of prognosis, treatment and final clinical evaluation of patients with nasopharyngeal cancer.

Results of radiotherapy in Hodgkin's disease.

An analysis was made of the results of irradiation therapy applied during the period 1965-1976 to 131 patients with Hodgkin's disease. The results of radiotherapy only of clinically positive lymphogranuloma localizations were compared with those of irradiation of both positive and negative nodes. The evaluation criteria used were the numbers of 3-year long primary remissions, 3-year long survival rates, frequency of onset and localization of relapses. Better therapeutic effects were achieved by radiotherapy as regards duration of primary remission, survival rate and frequency of relapses in originally clinically negative nodes proximate to positive nodes. However, the number of trans-diaphragmatic and extralymphatic relapses did not decline. A 5-year survival rate regardless of the irradiation method and clinical stage in 131 patients (1965-1974) was attained by 70.2%. The discussion bears on problems of an optimum radiotherapy and combined radiochemotherapy, and the significance of diagnostic laparotomy in lymphogranuloma.