Diagnostic Demands in Clinical and Experimental Oncology: Application of Substrates Labeled with Positron-Emitting Radionuclides

Abstract

In recent years, new regimens for the treatment of a variety of malignant tumors have led to greatly increased disease-free survival rates. For example, the introduction of high-dose methotrexate (HDMTX) with citrovorum factor rescue by Jaffe (1) for osteogenic sarcoma was a major breakthrough in the treatment of that highly malignant bone tumor. Later, Jaffe et al. (2), Rosen et al. (3) and Sutow et al. (4) found that primary osteogenic sarcoma, and its systemic metastases, could be better controlled by using HDMTX in combination with other drugs such as doxorubicin (adriamycin) and cyclophosphamide (cytoxan). In 1976, Rosen and co-workers reported their results in a series of patients who were treated with HDMTX and adriamycin preoperatively in an attempt to control and shrink the primary tumor and to eradicate metastatic disease at an early point in the regimen. These patients were noted to have a better disease-free survival than patients treated with post-operative adjuvant chemotherapy (5). Recent regimens for osteogenic sarcoma and Ewing sarcoma have further increased the survival of patients with these diseases (6, 7, 8). Today, more than 80% of patients with osteogenic sarcoma can expect to survive 5 years following intensive chemotherapy (9), compared to less than 20% in 1970 (10).