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Greater access to the European Union (EU) market for particular Central and Eastern European Countries (CEECs) will possibly have more effect on the exports of other CEECs than upon the exports and output of present EU member countries. This indicates that a primary component of the Commission's move in choosing members should be to see to it that the rule of segregation among Central and Eastern European countries does not result in any discrimination between them in their access to the EU market.

Purpose: In the 2010 WHO classification, a Ki-67 proliferation index of 20% is the cut-off between intermediate-grade and high-grade gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN). However, in clinical practice, tumours with a Ki-67 index of >15% are often considered high grade and treated with chemotherapy. In 40-70% of high-grade NENs, somatostatin receptors are overexpressed, enabling peptide receptor radionuclide therapy (PRRT) to be performed. We investigated the role of PRRT with 177Lu-DOTATATE in patients with GEP-NEN and a high Ki-67 proliferation index.Methods: A total of 33 patients with advanced GEP-NENs, positive somatostatin receptor imaging (SRI+) and a Ki-67 proliferation index ranging from 15% to 70% were treated with Lu-PRRT. A cumulative activity of 18.5 GBq or 27.8 GBq of 177Lu-DOTATATE was administered in four or five cycles. Receiver operating characteristic (ROC) curve analysis was used to determine the best threshold of Ki-67 expression to predict disease progression.Results: All patients completed the intended treatment. The median follow-up was 43 months (range 3-69 months). Two patients (6%) achieved a partial response and 21 (64%) showed stable disease, giving a disease control rate (DCR) of 70%. The median progression-free survival (PFS) was 23 months (95% CI 14.9-31.0 months) and the median overall survival was 52.9 months (95% CI 17.1-68.9 months). ROC curve analysis at 23 months revealed that the best Ki-67 index cut-off was 35%. In 23 patients (70%) the Ki-67 index was ≤35% and in 10 patients (30%) the Ki-67 index was in the range 36-70%. The DCR in the former group was 87% and 30% in the latter. The median PFS was 26.3 months (95% CI 18.4-37.7 months) and 6.8 months (95% CI 2.1-27 months), respectively (p = 0.005).Conclusions: Lu-PRRT showed antitumour activity in SRI+ GEP-NENs of intermediate and high-grade. DCR and PFS were significantly better in patients with a Ki-67 index of ≤35% than in those with a Ki-67 index of >35%. On the basis of these results, PRRT should be considered as a therapeutic option in patients with high-grade SRI+ GEP-NENs, in particular those with a Ki-67 proliferation index of ≤35%. [ABSTRACT FROM AUTHOR]

We report two cases of malignant external otitis (MEO) evaluated with Technetium-99m(Tc)-labelled sulesomab. Two patients affected by MEO are presented, together with a literature review. Both patients were studied with clinical examination, ear discharge culture, radiological imaging, blood exams, Tc Sulesomab, and treated with antibiotic therapy. Tc-Sulesomab would appear to be an useful tool for diagnosis and follow-up of MEO, highlighting the site and extension of the inflammatory process, and evaluating course and treatment efficacy. Tc-Sulesomab shows promise as a rapid, effective and safe imaging agent for treatment response evaluation and follow-up of patients with MEO. Further studies are warranted to validate the inclusion of Tc-Sulesomab scan in the imaging follow-up of patients with MEO. [ABSTRACT FROM AUTHOR]