By B. W. Hancock, F. E. Neal (auth.), B. W. Hancock MD, DCH, MRCP (eds.)
The overview of tumour reaction after therapy is among the most vital demanding situations in Oncology and the image is so usually complex by means of the consequences of treatment itself. scientific evaluation remains to be by way of a ways an important approach to overview at our disposal yet there's expanding dependence on investigations of every kind as indices of reaction. This depen dence should be lost if beside the point investigations are pursued and we have now attempted to emphasize during this ebook the significance of selectivity. a few indices of overview (e. g. tumour markers, organ imaging) have an important position to play; others (e. g. histopathology, genetics) are assuming larger impor tance as tumour behaviour turns into higher understood. One topic, Immu nology, continues to be in its infancy as regards tumour follow-up, yet indicates a lot promise in order that an entire account of tumour immunology and tendencies in immu notherapy has been integrated. i'm thankful to Dr. Brian Ross for his support with the bankruptcy on Organ Imaging, to the dept of scientific representation for his or her ever-ready co-operation with illustrations and images and to overlook Shirley Francis for doing a lot of the typing. B. W. HANCOCK checklist of members HANCOCK, B. W. , MD, DCH, MRCP, Senior Lecturer in drugs, Hon orary advisor medical professional, Royal Hallamshire & Weston Park Hospitals, Sheffield, U. okay. NEAL, F. E. , KSG, MBChB, FRCR, DMRT, advisor Radiotherapist & Oncologist, Weston Park clinic, Sheffield, u. ok. POTTER, AM.
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Additional info for Assessment of Tumour Response
The size of the spleen may be measured and serial measurements may provide an index of tumour response . Angiography is occasionally carried out for primary liver tumours both as a diagnostic procedure and therapeutically to allow either embolisation or infusion of cytotoxic drugs into the tumour.
In this clinical situation ultrasound examination may be of great value (Fig. 25), and the same abnormalities may also be demonstrated by CT. Mass lesions m'ay occur in the kidneys in the lymphomas and may be detected by intravenous urography and by ultrasound (Fig. 26). As in the case of lymph nodes, lymphoma deposits in the kidneys have a transonic appearance. Renography using 131 1 hippuran or some similar agent is a useful and non-invasive method of assessing renal function. Obstructive uropathy may be readily diagnosed and objective measurements of renal function may be made allowing accurate assessment of the response to treatment.
Metastases appear as localised areas of high isotope uptake (Fig. 32) and response to treatment may be accompanied by a diminution or disappearance of the affected area. Initially there may, however, be increased isotope uptake due to repair, particularly in those cases treated by chemotherapy. In breast cancer, abnormal bone scans may return to normal following endocrine therapy . Myeloma deposits, since they produce little or no reactive changes in the surrounding bone, may be unaccompanied by any localised area of isotope uptake.