[en] Circulating blood phagocytes, because they can recognize, ingest, kill, and, to a certain extent digest microbes, are of crucial importance in host defense against invading microorganisms. These authors discuss the series of events leading to the final elimination of such microorganisms by these cells, events including ganulopoiesis and maturation, chemotaxis, opsonization, adherence, phagocytosis, and intracellular killing. Abnormalities in any of these events may lead to an undue susceptibility to baterial infection

[en] Full text: Lymphoma is the commonest clinical indication for FDG-PET world wide although published data for its effectiveness is limited. The aim of this study was to assess the incremental staging, restaging and therapy monitoring value of PET vs CT. The case notes and CT scan reports of patients having FDG-PET scans for lymphoma at the RAH were reviewed retrospectively. 625 PET scans on 548 patients had been performed at the RAH between 14 September 2000 and 1 November 2001. 142 scans (23%) were for 'lymphoma' in 99 patients (18%). Excluding remote external referrals, follow-up data was available for 73 patients (112 scans) with confirmed non-CNS lymphoma. Disease demonstrated by CT and PET was compared for each of the three major clinical indications for PET which were: 1) primary staging, 2) restaging for suspected recurrence and 3) assessment of therapy response. In 3 patients both CT and PET showed discordant and incremental disease sites. The most dramatic discordant additional disease findings usually occurred in PET scans performed for restaging. The major additional information provided by PET so far has been in restaging for suspected relapse where it frequently shows much more extensive disease than does conventional CT. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

[en] Two case studies of locally extensive clinical stage IIA Hodgkin's disease (HD) were presented to radiation oncologists at a meeting of the Australasian Radiation Oncology Lymphoma Group, and subsequently to non-attending members who were asked to indicate their recommended treatment. This paper discusses the 25 responses which were notable by considerable heterogeneity in philosophy and detail. There is clearly no consensus among Australasian radiation oncologists at present, although combined modality therapy (CMT) with Adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by low-medium-dose involved field radiotherapy (25-36 Gy) was the most popular response. The literature on radiation dose and chemotherapy in CMT for HD is then reviewed. It seems very likely that low doses in the range of 25-30 Gy (at 1.5-2.0 Gy per fraction) are sufficient. The ABVD should be considered as the 'standard' regimen at present, although the optimal sequencing with radiation and number of cycles remain unknown. The heterogeneity of responses to management of the case studies raises questions about ongoing education processes in radiation and medical oncology. Hypothetical case management review may complement currently proposed methods of assessing continuing medical education. (authors)

[en] Background: incidental irradiation of the prostate may affect serum prostate-specific antigen (PSA). However, scarce data exist on PSA changes after irradiation of noncancerous prostatic tissue. This is an update of a study on PSA after pelvic irradiation. Material and methods: from 1997 to 2007, blood samples of 38 men were examined who had undergone pelvic irradiation for rectal or anal cancer. The planning target volume included the prostate in all cases. No patient had clinical evidence of prostatic disease. Radiotherapy was applied in fractions of 1.8-2 Gy up to 40-50 Gy (n = 3), 50-60 Gy (n = 21), and 60-65 Gy (n = 2). Seven patients received 5 x 5 Gy. Serum PSA was measured before, during, and after radiotherapy periodically. Median log (PSA) changes were calculated according to elapsed time from starting radiotherapy. The significance was tested with χ²-test. Results: 18 patients died during follow-up. For 15 patients, long-term PSA data with a median follow-up of 9 years (2,546-3,528 days) are available. PSA levels rose during the first weeks of irradiation peaking at 2-4 weeks with a significant 2.7-fold increase (p < 0.01). 1 year after radiation therapy, PSA declined below (90%) the preirradiation level, but this difference was not significant (p = 0.36). On further follow-up PSA did not change up to 8.9 years after radiotherapy (p 0.36). Conclusion: irradiation of the prostate causes transient increase of serum PSA. By 1 year, PSA has returned near the preirradiation value and stays there for at least 9 years. A major interference with prostate cancer screening or surveillance after radiotherapy is therefore unlikely. (orig.)

[en] The purpose of this study was to prospectively examine the effectiveness and tolerability of a simple radiotherapy technique for the palliation of symptomatic liver metastases. Twenty-eight patients with symptomatic liver metastases were enrolled from seven centres, and received targeted (partial or whole) liver irradiation consisting of 10 Gy in two fractions over 2 days. Symptoms at baseline were hepatic pain (27 patients), abdominal distension (19), night sweats (12), nausea (18) and vomiting (eight). Twenty-two patients (76%) had failed previous treatment with chemotherapy, hormonal therapy and/or high-dose steroids. Symptoms and potential toxicities were prospectively assessed at the time of treatment, then 2, 6 and 10 weeks later. Individual symptom response rates were 53-66% at 2 weeks. Partial or complete global symptomatic responses were noted in 15 patients (54%) overall. The treatment was well tolerated with two patients (7%) experiencing grade 3 toxicity (one vomiting and one diarrhoea); however, four patients reported temporary worsening of pain shortly after treatment. This simple and well-tolerated treatment achieves useful palliation. Copyright (2003) Blackwell Science Pty Ltd