Murata H, Kusuzaki K, Takeshita H, Hirata M, Hashiguchi S, Emoto K, Ashihara T, Hirasawa Y
Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
Anticancer Res. 2000 Sep-Oct;20(5C):3967-70.
This study was performed to compare the accumulation of thallium (Tl)-201 which is correlated with malignancy and the doxorubicin binding ability, which is correlated with chemosensitivity, in nine patients who received preoperative chemotherapy with doxorubicin and cisplatin. Tl-201 scintigraphy was performed at 15 minutes (early image) and 3 hours (delayed image) after injection of 111 MBq of Tl-201. The change of degree of the radionuclide uptake between the early and delayed images was evaluated before and after preoperative chemotherapy. The doxorubicin binding ability (%DB) to nuclear DNA in living tumor cells isolated from biopsy materials was assessed by doxorubicin binding assay. The histologic response to preoperative chemotherapy was evaluated by the percentage of tumor necrosis. Before preoperative chemotherapy no changes of Tl-201 uptake between the early and delayed images was detected in any tumors. Five patients, who had no change of Tl-201 uptake after preoperative chemotherapy, showed a poor histologic response and had a %DB ranging from 10% to 70% (mean: 36.0%). The other four patients, who had a %DB greater than 90%, showed a good histologic response. All of these four patients had decreased Tl-201 uptake after preoperative chemotherapy. This study demonstrated that doxorubicin binding assay and midcourse Tl-201 scintigraphy are useful methods to assess the response to chemotherapy early in malignant bone and soft tissue tumors.
本研究旨在比较9例接受阿霉素和顺铂术前化疗患者中与恶性肿瘤相关的铊（Tl）-201的蓄积情况以及与化疗敏感性相关的阿霉素结合能力。在注射111MBq的Tl-201后15分钟（早期图像）和3小时（延迟图像）进行Tl-201闪烁扫描。评估术前化疗前后早期和延迟图像之间放射性核素摄取程度的变化。通过阿霉素结合试验评估从活检材料中分离出的活肿瘤细胞中阿霉素与核DNA的结合能力（%DB）。通过肿瘤坏死百分比评估术前化疗的组织学反应。术前化疗前，在任何肿瘤中均未检测到早期和延迟图像之间Tl-201摄取的变化。5例术前化疗后Tl-201摄取无变化的患者，组织学反应较差，%DB范围为10%至70%（平均：36.0%）。其他4例%DB大于90%的患者，组织学反应良好。这4例患者在术前化疗后均出现Tl-201摄取减少。本研究表明，阿霉素结合试验和术中Tl-201闪烁扫描是早期评估恶性骨和软组织肿瘤化疗反应的有用方法。
