Treatment of bone metastases.

early stages of investigation and available only in major medical centers. The treatment of hepatocellular carcinoma, melanoma, neuroblastoma, B-cell and T-cell lymphomas, and ovarian carcinoma has been tried with varied but encouraging results. In one study about 50% of 105 patients with hepatocellular carcinoma responded to the treatment of '3'I-antiferritin antibody. Large doses (more than 200 mCi [7,400 MBq]) of '3'I-Lym-l or anti-pan-B cell antibody were used to treat B-cell lymphoma with good responses in more than 30 patients. The possible advantages of using monoclonal antibodies to detect and treat cancer are a binding of tumor-specific monoclonal antibody to the tumor site, providing high-intensity target to background images for tumor detection; a single imaging procedure and a single radiation exposure providing the information of disease in the whole body and eliminating the need for many procedures to stage the cancer; and giving a high radiation dose to tumor while sparing the normal tissue in the radioimmunotherapy. There are several disadvantages in that only a small amount of injected labeled monoclonal antibody accumulates in the tumor. There is some nonspecific organ binding that varies with different antibodies and labeling methods. Also, all have a short shelf-life, which requires a fresh preparation. Immunoscintigraphy and radioimmunotherapy may become an essential part of cancer staging and therapy for tumors such as melanoma, lymphoma, and carcinomas of the lung, breast, colon, and prostate. DAVID C.P. CHEN, MD MICHAEL E. SIEGEL, MD Los Angeles