Clinical oncology : a journal of the Royal College of Radiologists
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Clin Oncol (R Coll Radiol) · Dec 2003
The impact of FDG PET on the management of occult primary head and neck tumours.
The aim of this study was to investigate the impact of positron-emission tomography (PET) with 18F-labelled fluoro-2-deoxy-D-glucose (FDG) in the management of occult primary head and neck tumours. ⋯ FDG PET suggested a primary site in eight of the 17 patients (tongue base 5; nasopharynx 1; tonsil 1: supraglottis 1). Pathological confirmation was obtained in four patients and one patient died of progressive disease at the primary site. In nine patients, the primary site was not identified on FDG PET. In six of these patients, no primary site was found during follow-up (range 8-36 months: mean 20 months). One patient died before treatment commenced, and there were two histologically confirmed false-negative FDG PET results: one tonsil SCC and one lateral pharyngeal wall SCC. FDG PET affected treatment plans in nine of the 17 (53%) patients in whom a primary site was suggested (altered radiotherapy plan 6; radiotherapy with curative intent to palliative radiotherapy 1; radiotherapy to surgery and post-operative radiotherapy 1), and in one patient where no occult primary was localised (radiotherapy to surgery 1). FDG PET had a sensitivity, specificity, positive and negative predictive value of 62%, 66%, 62% and 62%, respectively.
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Clin Oncol (R Coll Radiol) · Sep 2003
ReviewPalliation of metastatic bone pain: single fraction versus multifraction radiotherapy--a systematic review of randomised trials.
Recent randomised studies have reported that single fraction radiotherapy is as effective as multifraction radiotherapy in relieving pain caused by bone metastasis. However, there are concerns about the higher re-treatment rates and the efficacy of preventing future complications, such as pathological fracture and spinal cord compression, by single fraction radiotherapy. A systematic review of randomised studies, examining the effectiveness of single fraction radiotherapy versus multiple fraction radiotherapy for metastatic bone pain relief and prevention of bone complications, was conducted to help answer this controversy. ⋯ Single fraction radiotherapy was as effective as multifraction radiotherapy in relieving metastatic bone pain. However, the re-treatment rate and pathological fracture rate were higher after single fraction radiotherapy. Studies with quality of life and health economic end points are warranted to find out the optimal treatment option.
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Clin Oncol (R Coll Radiol) · Dec 2002
Case ReportsCoeliac disease following high-dose chemotherapy.
This report describes an interesting case of severe diarrhoea following high-dose chemotherapy for non-Hodgkin's lymphoma. This caused significant morbidity and resolved on a gluten-free diet.