phosphorus-radioisotopes and Head-and-Neck-Neoplasms

In this early Phase II study, the authors investigated the efficacy of intratumoral injection of P-32 chromic phosphate in 17 patients with refractory solid tumors or solitary metastases in terms of response rates and overall survival.. Seventeen patients (median age, 60 years) with either cytostatic drug-resistant tumors or tumors known to be primarily chemotherapy-resistant were entered into the study. After sonographic determination of the tumor volume, P-32 chromic phosphate (74-555 MBq) was injected into the central part of the tumor under sonographic guidance. Follow-up investigations included serial scintigraphy, sonographic examinations, and hematologic studies.. Injection of P-32 chromic phosphate into refractory tumors resulted in remarkable regression. The median survival of all patients was 13 months (range, 8-25 months). The response rate was 71% (12 patients). A complete remission was seen in 7 patients (41%), and the rate of partial remissions was 29% (5 patients). However, 5 patients (30%) did not respond to the treatment. In one patient thrombocytopenia was observed, but no other side effects were apparent. Important pathologic and anatomic changes within the tumor tissue were demonstrated in solitary liver metastases of gastrointestinal malignancies excised in second-look operations. In all cases examined, formation of a cyst within the area of central activity, surrounded by a centrifugal necrotic ring and a marginal fibrotic structure, was found.. Lack of persistent systemic or local side effects, as well as noteworthy efficacy, are properties of this optimal regional treatment modality with P-32 chromic phosphate. This modality deserves consideration for further clinical trials.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Breast Neoplasms; Carcinoma; Carcinoma, Hepatocellular; Chromium Compounds; Digestive System Neoplasms; Drug Resistance, Neoplasm; Female; Head and Neck Neoplasms; Humans; Injections, Intralesional; Lung Neoplasms; Male; Middle Aged; Neoplasms; Phosphates; Phosphorus Radioisotopes; Survival Rate

The purpose of this study was to validate a previously reported body contour measurement using Compton backscatter sources with bremsstrahlung SPECT imaging.. Bremsstrahlung SPECT imaging was performed with 32P using a dual-headed camera system fitted with medium-energy, parallel-hole collimators. Two sources of 99mTc were placed directly on each collimator. Energy windows of 100 keV +/- 25% were used to image the 32P and also to record the Compton scatter from the 99mTc sources. Eleven patients enrolled in clinical Phase I therapeutic protocols were injected with 32P-chromic phosphate and SPECT images were acquired and reconstructed in the transaxial plane. The 32P distribution and the patient body contour were both visualized in these slices. The anteroposterior and lateral patient dimensions were measured by generating count profiles parallel to the anteroposterior and lateral body contour, respectively, at the midline in a transaxial slice. The distance in centimeters between the two centroids of each profile is representative of the anteroposterior and lateral dimensions and was determined for each patient. These anteroposterior and lateral dimensions were compared to the same distance measurements made in these patients by CT in an anatomically comparable transaxial slice. A cylindrical SPECT phantom was also studied to further validate the contour measurements.. The mean percent difference in the patient dimension measurements between SPECT and CT was -0.8% with a range of -8.5% to 9.9%. The percent difference between the known and SPECT measured dimensions in the cylindrical phantom was 0.5%.. The two external Compton scatter source method is accurate for determining the body contour.

Topics: Chromium Compounds; Head and Neck Neoplasms; Humans; Image Processing, Computer-Assisted; Liver Neoplasms; Lung Neoplasms; Pancreatic Neoplasms; Phantoms, Imaging; Phosphates; Phosphorus Radioisotopes; Scattering, Radiation; Technetium; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

In the past, we have clinically evaluated radiolabelled antibodies in Hodgkin's disease and hepatocellular cancer. Increased tumour pressure, reduced vascularity and poor diffusion has limited significant radiolabelled antibody tumour dose deposition. Using intratumoural infusion of macroaggregated albumin to blockade exiting vasculature followed by colloidal chromic 32Phosphorous, we have been able to achieve 75% to 100% tumour dose deposition by interstitial tumour infusion under computerised tomographic guidance. Phase I studies in a variety of solid tumours indicate extremely high doses may be achieved without toxicity (i.e. non-resectable pancreas 900,000 cGy to 1.7 million cGy) with tumour control and remission. This is a review of those studies and how the technique was applied.

Topics: Astrocytoma; Brachytherapy; Brain Neoplasms; Carcinoma, Hepatocellular; Carcinoma, Small Cell; Chemoembolization, Therapeutic; Chromium; Colloids; Dexamethasone; Head and Neck Neoplasms; Hodgkin Disease; Humans; Injections, Intralesional; Liver Neoplasms; Lung Neoplasms; Pancreatic Neoplasms; Phosphorus Radioisotopes; Radiography, Interventional; Radioimmunotherapy; Radiotherapy Dosage; Remission Induction; Serum Albumin; Tomography, X-Ray Computed

Simultaneous 31P-MR spectroscopy (MRS) and MR imaging (MRI) of 10 patients suffering from superficial tumours like carcinoma, lymphoma and adenoma, revealed significantly enhanced concentrations of phosphomonoester, phosphodiester and inorganic phosphorus in the tumour, whereas the concentration of phosphocreatine was lower in comparison to muscle tissue. In all tumours the pH showed a slight alkaline shift. The existing of necrotic regions detected by MRI was accompanied by an increase of inorganic phosphorus in the spectra. A follow-up study of a patient with a lymphoma during chemotherapy showed a tumour regression, whereas the spectra indicated a continuous approach of tumour values to the muscle values.

Topics: Contrast Media; Gadolinium; Gadolinium DTPA; Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Organometallic Compounds; Organophosphorus Compounds; Pentetic Acid; Phosphates; Phosphorus Radioisotopes; Tomography, X-Ray Computed; Ultrasonography