Radionuclide Treatment in Pain Palliation
PDF
Cite
Share
Request
Guideline
P: 423-435
November 2020

Radionuclide Treatment in Pain Palliation

Nucl Med Semin 2020;6(3):423-435
1. Gaziantep Üniversitesi, Şahinbey Araştırma ve Uygulama Hastanesi, Nükleer Tıp Anabilim Dalı, Gaziantep, Türkiye
2. Yeditepe Üniversitesi Tıp Fakültesi, Nükleer Tıp Anabilim Dalı, İstanbul, Türkiye
No information available.
No information available
PDF
Cite
Share
Request

ABSTRACT

Skeletal system is the most common metastasis site in patients with advanced cancer. Pain is an important health problem in patients with bone metastasis. Bone seeking radionuclides to treat bone pain due to bone metastasis in patients with advanced stage cancer can be used in selected group of cancer patients. In this review, evaluating patients who might be candidates for radionuclide treatment of bone metastases using β -emitting radionuclides such as Strontium-89, Samarium-153 lexidronam, Rhenium-186-HEDP, Rhenium-188-HEDP, Holmium-166, Phosphor-32 sodium phosphate, Lutetium-177 ethylenediaminetetramethylene phosphonic acid and α-emmiting Radium-223, performing the treatments; and understanding and evaluating the treatment outcome and side effects.

References

1Coleman RE, Rubens RD. The clinical course of bone metastases from breast cancer. Br J Cancer 1987;55:61-66.
2Levy MH. Pharmacologic treatment of cancer pain. N Engl J Med 1996;335:1124-1132.
3Mercadante S. Malignant bone pain: pathophysiology and treatment. Pain 1997;69:1-18.
4Nielsen OS, Munro AJ, Tannock IF. Bone metastases: pathophysiology and management policy. J Clin Oncol 1991;9:509-524.
5Parker C, Nilsson S, Heinrich D, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med 2013;369:213-223.
6Poeppel TD, Handkiewicz-Junak D, Andreeff M, et al. EANM Guideline for radionuclide therapy with radium-223 of metastatic castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging 2017;45:824-845.
7Krishnamurthy GT, Krishnamurthy S. Radionuclides for metastatic bone pain palliation: a need for rational re-evaluation in the new millennium. J Nucl Med 2000;41:688-691.
8Edwards GK, Santoro J, Taylor AJR. Use of bone scintigraphy to select patients with multiple myeloma for treatment with strontium-89. J Nucl Med 1994;35:1992-1993.
9Collins C, Eary JF, Donaldson G, et al. Samarium-153-EDTMP in bone metastases of hormone refractory prostate carcinoma: a phase I/II trial. J Nucl Med 1993;34:1839-1844.
10Farhanghi M, Holmes RA, Volkert WA, Logan KW, Singh A. Samarium-153-EDTMP: pharmacokinetic, toxicity and pain response using an escalating dose schedule in treatment of metastatic bone cancer. J Nucl Med 1992;33:1451-1458.
11De Klerk JM, Zonnenberg BA, Blijham GH, et al. Treatment of metastatic bone pain using the bone seeking radiopharmaceutical re-186-HEDP. Anticancer Res 1997;17:1773-1377.
12Finlay IG, Mason MD, Shelley M. Radioisotopes for the palliation of metastatic bone cancer: a systematic review. Lancet Oncol 2005;6:392-400.
13Taylor Jr AJ. Strontium-89 for the palliation of bone pain due to metastatic disease. J Nucl Med 1994;35:2054.
14Handkiewicz-Junak D, Poeppel TD, Bodei L, et al. EANM guidelines for radionuclide therapy of bone metastases with beta-emitting radionuclides. Eur J Nucl Med Mol Imaging 2018;45:846-859.
15Serafini AN, Houston SJ, Resche I, et al. Palliation of pain associated with metastatic bone cancer using samarium-153 lexidronam: a double-blind placebo-controlled clinical trial. J Clin Oncol 1998;16:1574-1581.
16Tian JH, Zhang JM, Hou QT, et al. Multicentre trial on the efficacy and toxicity of single-dose samarium-153-ethylene diamine tetramethylene phosphonate as a palliative treatment for painful skeletal metastases in China. Eur J Nucl Med 1999;26:2-7.
17Dolezal J. Systemic radionuclide therapy with samarium-153-EDTMP for painful bone metastases. Nucl Med Rev Cent East Eur 2000;3:161-163.
18Wang RF, Zhang CL, Zhu SL, Zhu M. A comparative study of samarium-153-ethylenediaminetetramethylene phosphonic acid with pamidronate disodium in the treatment of patients with painful metastatic bone cancer. Med Princ Pract 2003;12:97-101.
19Sapienza MT, Ono CR, Guimarães MI, Watanabe T, Costa PA, Buchpiguel CA. Retrospective evaluation of bone pain palliation after samarium-153-EDTMP therapy. Rev Hosp Clin Fac Med Sao Paulo 2004;59:321-328.
20Etchebehere EC, Pereira Neto CA, Lima MC, et al. Treatment of bone pain secondary to metastases using samarium-153-EDTMP. Sao Paulo Med J 2004;122:208-212.
21Sartor O, Reid RH, Hoskin PJ, et al. Samarium-153-lexidronam complex for treatment of painful bone metastases in hormone-refractory prostate cancer. Urology 2004;63:940-945.
22Tripathi M, Singhal T, Chandrasekhar N, et al. Samarium-153 ethylenediamine tetramethylene phosphonate therapy for bone pain palliation in skeletal metastases. Indian J Cancer 2006;43:86-92.
23Ripamonti C, Fagnoni E, Campa T, Seregni E, Maccauro M, Bombardieri E. Incident pain and analgesic consumption decrease after samarium infusion: a pilot study. Support Care Cancer 2007;15:339-342.
24Olea E, Gil MC, Tomicic M, et al. Nationally produced 153SmEDTMP in the palliative treatment of metastatic bone cancer pain. Rev Med Chil 1996;124:805-812.
25Handkiewicz-Junak D, Poeppel TD, Bodei L, et al. EANM guidelines for radionuclide therapy of bone metastases with beta-emitting radionuclides. Eur J Nucl Med Mol Imaging 2018;45:846-859.
26Lewington VJ, McEwan AJ, Ackery DM, et al. A prospective, randomised double-blind crossover study to examine the efficacy of strontium-89 in pain palliation in patients with advanced prostate cancer metastatic to bone. Eur J Cancer 1991;27:954-958.
27Kraeber-Bodéré F, Campion L, Rousseau C, Bourdin S, Chatal JF, Resche I. Treatment of bone metastases of prostate cancer with strontium-89 chloride: efficacy in relation to the degree of bone involvement. Eur J Nucl Med 2000;27:1487-1493.
28Turner SL, Gruenewald S, Spry N, Gebski V. Metastron users group. Less pain does equal better quality of life following strontium-89 therapy for metastatic prostate cancer. Br J Cancer 2001;84:297-302.
29Zorga P, Birkenfeld B. Strontium-89 in palliative treatement of painfull bone metastases. Ortop Traumatol Rehabil 2003;5:369-373.
30Dafermou A, Colamussi P, Giganti M, Cittanti C, Bestagno M, Piffanelli A. A multicentre observational study of radionuclide therapy in patients with painful bone metastases of prostate cancer. Eur J Nucl Med 2001;28:788-798.
31Ashayeri E, Omogbehin A, Sridhar R, Shankar RA. Strontium 89 in the treatment of pain due to diffuse osseous metastases: a university hospital experience. J Natl Med Assoc 2002;94:706-711.
32Baczyk M, Milecki P, Baczyk E, Sowinski J. The effectiveness of strontium 89 in palliative therapy of painful prostate cancer bone metastases. Ortop Traumatol Rehabil 2003;5:364-368.
33Oosterhof GO, Roberts JT, de Reijke TM, et al. Strontium (89) chloride versus palliative local field radiotherapy in patients with hormonal escaped prostate cancer: a phase III study of the European Organisation for Research and Treatment of Cancer, Genitourinary Group. Eur Urol 2003;44:519-526.
34Gunawardana DH, Lichtenstein M, Better N, Rosenthal M. Results of strontium-89 therapy in patients with prostate cancer resistant to chemotherapy. Clin Nucl Med 2004;29:81-85.
35Liepe K, Kotzerke J. A comparative study of 188Re-HEDP, 186Re-HEDP, 153Sm-EDTMP and 89Sr in the treatment of painful skeletal metastases. Nucl Med Commun 2007;28:623-630.
36Zenda S, Nakagami Y, Toshima M, et al. Strontium-89 (Sr-89) chloride in the treatment of various cancer patients with multiple bone metastases. Int J Clin Oncol 2014;19:739-743.
37D’Angelo G, Sciuto R, Salvatori M, et al. Targeted “bone-seeking” radiopharmaceuticals for palliative treatment of bone metastases: a systematic review and meta-analysis. Q J Nucl Med Mol Imaging 2012;56:538-543.
38Roque M, Martinez MJ, Alonso P, Catala E, Garcia JL, Ferrandiz M. Radioisotopes for metastatic bone pain. Cochrane Database Syst Rev 2003;4:CD003347.
39Bauman G, Charette M, Reid R, Sathya J. Radiopharmaceuticals for the palliation of painful bone metastasis - a systemic review. Radiother Oncol 2005;75:258-270.
40Christensen MH, Petersen LJ. Radionuclide treatment of painful bone metastases in patients with breast cancer: a systematic review. Cancer Treat Rev 2012;38:164-171.
41Nilsson S, Strang P, Aksnes AK, et al. A randomized, dose-response, multicenter phase II study of radium-223 chloride for the palliation of painful bone metastases in patients with castration-resistant prostate cancer. Eur J Cancer 2012;48:678-686.
42Porter AT, McEwan AJ, Powe JE, et al. Results of a randomized phase-III trial to evaluate the efficacy of strontium-89 adjuvant to local field external beam irradiation in the management of endocrine resistant metastatic prostate cancer. Int J Radiat Oncol Biol Phys 1993;25:805-813.
43Kurosaka S, Satoh T, Chow E, et al. EORTC QLQ-BM22 and QLQ-C30 quality of life scores in patients with painful bone metastases of prostate cancer treated with strontium-89 radionuclide therapy. Ann Nucl Med 2012;26:485-491.
44Tu SM, Millikan RE, Mengistu B, et al. Bone-targeted therapy for advanced androgen-independent carcinoma of the prostate: a randomised phase II trial. Lancet 2001;357:336-341.
45Resche I, Chatal JF, Pecking A, et al. A dose-controlled study of 153Sm-ethylenediaminetetramethylenephosphonate (EDTMP) in the treatment of patients with painful bone metastases. Eur J Cancer 1997;33:1583-1591.
46Paszkowski AL, Hewitt DJ, Taylor AJR. Disseminated intravascular coagulation in a patient treated with strontium-89 for metastatic carcinoma of the prostate. Clin Nucl Med 1999;24:852-854.
47Silberstein EB, Williams C. Strontium-89 therapy for the pain of osseous metastases. J Nucl Med 1985;26:345-348.
48Bouchet LG, Bolch WE, Goddu SM, et al. Considerations in the selection of radiopharmaceuticals for palliation of bone pain from metastatic osseous lesions. J Nucl Med 2000;41:682- 687.
49Cheung A, Driedger AA. Evaluation of radioactive phosphorus in the palliation of metastatic bone lesions from carcinoma of the breast and prostate. Radiology 1980;134:209-212.
50Fuster D, Herranz D, Vidal-Sicart S, et al. Usefulness of strontium-89 for bone pain palliation in metastatic breast cancer patients. Nucl Med Commun 2000;21:623-626.
51Chopra A. 177Lu-Labeled methylene diphosphonate. 2011 May 24 [Updated 2011 Jun 30]. In: Molecular Imaging and Contrast Agent Database (MICAD) [Internet]. Bethesda (MD): National Center for Biotechnology Information (US); 2004-2013.
52Blake GM, Zivanovic MA, McEwan AJ, et al. Sr-89 therapy: Strontium kinetics in disseminated carcinoma of the prostate. Eur J Nucl Med 1986;12:447-454.
53Fettich J, Padhy A, Nair N, et al. Comparative clinical efficacy and safety of phosphorus-32 and strontium-89 in the palliative treatment of metastatic bone pain: results of an IAEA coordinated research project. World J Nucl Med 2003;2:226-231.
54Mertens WC, Stitt L, Porter AT. Strontium 89 therapy and relief of pain in patients with prostatic carcinoma metastatic to bone: a dose response relationship? Am J Clin Oncol 1993;16:238-242.
55Han SH, de Klerk JM, Tan S, et al. The PLACORHEN study: a double-blind, placebo-controlled, randomized radionuclide study with (186)Re-etidronate in hormone-resistant prostate cancer patients with painful bone metastases. Placebo Controlled Rhenium Study. J Nucl Med 2002;43:1150-1156.
56Sartor O. Overview of samarium sm 153 lexidronam in the treatment of painful metastatic bone disease. Rev Urol 2004;6(Suppl 10):S3-S12.
57Silberstein EB. Teletherapy and radiopharmaceutical therapy of painful bone metastases. Semin Nucl Med 2005;35:152-158.
58Palmedo H, Guhlke S, Bender H, et al. Dose escalation study with rhenium-188 hydroxyethylidene diphosphonate in prostate cancer patients with osseous metastases. Eur J Nucl Med 2000;27:123-130.
59Loeb DM, Hobbs RF, Okoli A, et al. Tandem dosing of samarium-153 ethylenediamine tetramethylene phosphoric acid with stem cell support for patients with high-risk osteosarcoma. Cancer 2010;116:5470-5478.
60Breitz HB, Wendt RE 3rd, Stabin MS, et al. 166Ho-DOTMP radiation-absorbed dose estimation for skeletal targeted radiotherapy. J Nucl Med 2006;47:534-542.
61Pedraza-López M, Ferro-Flores G, de Murphy CA, et al. Preparation of (166)Dy/(166)Ho-EDTMP: a potential in vivo generator system for bone marrow ablation. Nucl Med Commun 2004;25:615-621.
62Agarwal KK, Singla S, Arora G, et al. (177)Lu-EDTMP for palliation of pain from bone metastases in patients with prostate and breast cancer: a phase II study. Eur J Nucl Med Mol Imaging 2015;42:79-88.
63Zolghadri S, Jalilian AR, Naseri Z, et al. Production, quality control and biological evaluation of 166Ho-PDTMP as a possible bone palliation agent. Iran J Basic Med Sci 2013;16:719-725.
64Pillai MR, Chakraborty S, Das T, Venkatesh M, Ramamoorthy N. Production logistics of Lu-177 for radionuclide therapy. Appl Radiat Isot 2003;59:109-118.
65Chakraborty S, Das T, Banerjee S, et al. Lu-177 EDTMP: a viable bone pain palliative in skeletal metastasis. Cancer Biother Radiopharm 2008;23:202-213.
66Yuan J, Liu C, Liu X, et al. Efficacy and safety of Lu-177 EDTMP in bone metastatic pain palliation in breast cancer and hormone refractory prostate cancer: a phase II study. Clin Nucl Med 2013;38:88-92.
67Nilsson S, Larsen RH, Foss SD, et al. First clinical experience with α-emitting radium-223 in the treatment of skeletal metastases. Clin Cancer Res 2005;11:4451-4459.
68Ritter MA, Cleaver JE, Tobias CA. High-LET radiations induce a large proportion of non-rejoining DNA breaks. Nature 1977;266:653-655.
69Lassmann M, Nosske D. Dosimetry of 223Ra-chloride: dose to normal organs and tissues. Eur J Nucl Med Mol Imaging 2013;40:207-212.
70Bruland OS, Nilsson S, Fisher DR, Larsen RH. High-linear energy transfer irradiation targeted to skeletal metastases by the alpha-emitter 223Ra: adjuvant or alternative to conventional modalities? Clin Cancer Res 2006;12:6250-6257.
71Saad F, Carles J, Gillessen S, et al. Radium-223 and concomitant therapies in patients with metastatic castration-resistant prostate cancer: an international, early access, open-label, single-arm phase 3b trial. Lancet Oncol 2016;17:1306-1316.
72Hoskin P, Sartor O, O’Sullivan JM, et al. Efficacy and safety of radium-223 dichloride in patients with castration-resistant prostate cancer and symptomatic bone metastases, with or without previous dosetaksel use: a prespecified subgroup analysis from the randomised, double-blind, phase 3 ALSYMPCA trial. Lancet Oncol 2014;15:1397-1406.
73Nilsson S, Cislo P, Sartor O, et al. Patient-reported quality of life analysis of radium-223 dichloride from the phase 3 ALSYMPCA study. Ann Oncol 2016;27:868-874.
74Sartor O, Hoskin P, Coleman RE, et al. Chemotherapy following radium-223 dichloride treatment in ALSYMPCA. Prostate 2016;76:905-916.
Article is only available in PDF format. Show PDF
2024 ©️ Galenos Publishing House