title: Bone scan flare phenomenon in non-small-cell lung cancer patients treated with gefitinib.
abstract: OBJECTIVE
  The bone scan flare phenomenon has been evaluated in various cancers in the presence of positive response to therapy. The aim of this study was to determine whether flare phenomenon occurs in non-small-cell lung cancer patients, especially adenocarcinoma in East-Asians, who respond dramatically and promptly to gefitinib.
  
  
  METHODS
  We retrospectively evaluated the radiographic and scintigraphic images of 125 lung cancer patients who had previous gefitinib treatment between July 2003 and October 2005. Those patients who had the first post-treatment scan done within 3 months and the second scan performed after 3 months after starting the therapy were included. New lesions or increased intensity observed on the first follow-up bone scan with improvement on the second one during gefitinib treatment was defined as positive for flare phenomenon. The results were correlated with clinical disease status.
  
  
  RESULTS
  Thirty-three non-small-cell lung cancer patients were included. Seven (21.2%) of them showed bone scan flare phenomenon. Of these seven, 5 had adenocarcinoma and 2 had unclassified non-small-cell lung cancer. Partial response was achieved after treatment in all these cases, and flare phenomena were detected between 29 and 77 days (median: 34 days) after treatment.
  
  
  CONCLUSIONS
  The findings show that the flare is common during the first 3 months of gefitinib initiation; hence, a repeat bone scan should be reserved for later in the treatment course.
authors.affiliation: Zhongxing Branch, Taipei City Hospital, and Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.
authors.forename: Heng-Sheng
authors.initials: HS
authors.lastname: Chao
authors.forename: Cheng-Pei
authors.initials: CP
authors.lastname: Chang
authors.forename: Chao-Hua
authors.initials: CH
authors.lastname: Chiu
authors.forename: Lee-Shing
authors.initials: LS
authors.lastname: Chu
authors.forename: Yuh-Min
authors.initials: YM
authors.lastname: Chen
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Tsai
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D000368:Aged; D016477:Artifacts; D001706:Biopsy; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011799:Quinazolines / Q000627:therapeutic use*; D011877:Radionuclide Imaging; D012189:Retrospective Studies
chemical_list: D011799:Quinazolines; D000077156:Gefitinib