RESUMO
Ten patients with intracranial malignancies were studied by radioimmunoscintigraphy with I-131 BC-2 MoAb. Sensitivity and specificity of radioimmunoimaging were determined and compared with the results obtained with computed X-ray tomography and magnetic resonance imaging. BC-2 MoAb is a murine IgG1 anti-tenascin, which is not expressed by adult normal brain and has been found in large amount in gliomas and/or cerebral metastases, as well as other human tumors. Gamma-camera images obtained at 1 to 4 days exhibited increasing uptake of BC-2 in eight tumors, with varying degrees of contrast with the surrounding normal brain. Two lesions resulted negative to RIS: a meningioma and an oligodendroglioma. Specific tumor uptake of I-131 BC-2 was determined, by external gamma imaging, and ranged from 0.002 up to 0.007 percent of injected dose. Nonspecific uptake in the tumor was determined injecting 99m-Tc-FO23C5 (an isotype-matched control IgG1) in four patients and it was lower than 0.0001% ID. I-131 BC-2 tumor/nontumor ratios, measured using the geometric mean on digital images, ranged from 3 to 7.5:1. This study demonstrates that the tumor uptake of BC-2 in patients with glioma was due to specific processes.
Assuntos
Anticorpos Monoclonais , Neoplasias Encefálicas/diagnóstico por imagem , Glioma/diagnóstico por imagem , Animais , Humanos , Imunoglobulina G , Radioisótopos do Iodo/farmacocinética , Camundongos , CintilografiaRESUMO
A 59 year old man suffering from intractable chronic pain from sacral coccygeal relapsing neoplasia with pelvic invasion, operated and irradiated more than once, after a first partial success with subarachnoid intermittent morphine infusion by means of a subcutaneous reservoir, refilled transcutaneously, has been treated with continuous intrathecal low-dose morphine infusion with a totally implantable pump. This device not only greatly resolves many of the problems connected to spinal administration of morphine, but it also allows to obtain constant concentrations of the drug, so that an efficacious therapeutic action is already present at low doses, reducing the risks of overdose and supraspinal redistribution as well as the development of tolerance. This case represents the first example in Italy of the use of a completely implantable pump for this purpose.