A dose-controlled study of 153Sm-Ethylenediaminetetramethylenephosphonate (EDTMP) in the treatment of patients with painful bone metastase

Resche, I.; Chatal, Jean‐François; Pecking, A; Ell, Peter J.; Duchesne, Gillian; Rubens, Robert; Fogelman, Ignac; Houston, S.; Fauser, Axel A.; Fischer, M.; Wilkins, David E.

doi:10.1016/s0959-8049(97)00155-x

Cited by 239 publications

(102 citation statements)

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“…After injection of 153Sm-EDTMP, response was recognized in 90.3% prostate cancer and 97.9% of breast cancer patients, a total of 7/110 prostate and breast cancer patients did not respond to therapy. As compared with other studies showed 40 to 85.5% response rates in cancer breast and 70 to 80% response rate in cancer prostate [16][17][18], we reported insignificant difference in therapeutic response rate between prostate and breast cancer (90.5% and 97.8% respectively), this finding also recorded by Tripathi et al as well as Baczyk et al who did not show any significant difference in response rate among prostate and breast cancer patients (80.6% and 80.4%) respectively [11,19].…”

Section: Discussionmentioning

confidence: 62%

Assessment of Bone Pain Response in Cancer Patients Receiving Single Dose of Sm-153 EDTMP Therapy

Elzahry¹,

Diab²,

Sinzinger³

2017

J Nucl Med Radiat Ther

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Section: Discussionmentioning

confidence: 62%

Assessment of Bone Pain Response in Cancer Patients Receiving Single Dose of Sm-153 EDTMP Therapy

Elzahry¹,

Diab²,

Sinzinger³

2017

J Nucl Med Radiat Ther

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“…Sm has a wide therapeutic scale and dose-finding studies have shown that doses up to 111 MBq/kg are safe, but associated with an increased number of episodes of reversible hematological events [15]. What is interesting that in our study EBRT in dose range from 8 Gy to 20 Gy didn't influenced the level of hematological toxicities.…”

mentioning

confidence: 49%

A prospective randomized trial: A comparison of the analgesic effect and toxicity of 153Sm radioisotope treatment in monotherapy and combined therapy including local external beam radiotherapy (EBRT) among metastatic Castrate Resistance prostate cancer (m

Bączyk

Milecki²,

Pisarek³

et al. 2013

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Bone metastases in prostate cancer constitute the most frequent cause of systemic failure in treatment, which results in numerous complications and finally leads to patient's death. Pain is one of the first and most important clinical symptoms of bone metastases and can be found among more than 80% of patients. Therefore, the most analgetic effective and simultaneously the least toxic treatment is an important point of therapeutic management in this group of patients. The aim of this prospective clinical trial was a comparison of analgetic effectiveness and toxicity of monotherapy with 153 Sm isotope to combined therapy ( 153 Sm + EBRT) among patients diagnosed with multiple painful bone metastases due to CRPC (mCRPC). 177 patients with mCRPC were included into the prospective randomised clinical trial in which 89 patients were assigned to the 153 Sm isotope monotherapy, while 88 patients were assigned to the combined therapy including 153 Sm isotope therapy and EBRT. All patients were diagnosed (bone scan and X-ray or/and CT or/and MRI) with painful bone metastases (bone pain intensity >= 6 according to VAS classification). The following additional inclusion criteria were established: histologically confirmed adenocarcinoma of prostate, multifocal bone metastases, no prior chemotherapy or palliative radiotherapy to bone. All patients signed informed consent.The combination of the isotope therapy with EBRT was more effective analgetic treatment than isotope therapy alone. The highest pain decline was noticed in the first weeks after treatment termination. In the whole group, a total or partial analgesic effect was observed among 154 (87%) patients while among 23 (13%) patients there was a lack of analgesic effect or even pain intensification.The results of this clinical trial demonstrated that for patients with multiple mCRPC it is recommended to combine the 153 Sm isotope therapy with local EBRT because of a greater analgetic effect. It is important to note that combined therapy did not intensify the toxicity of treatment. Key words: prostate cancer, bone metastases, isotope therapy, radiotherapy, mCRPCProstate cancer belongs to the most frequently diagnosed malignant tumors among males in the United States and Europe [1,2]. Unfortunately, despite the recent improvement in results of treatment, we are still faced with a significant number of patients with biochemical progression, and subsequent distant metastases. Prostate cancer distant metastases are first diagnosed in the bone, with more than 80% of all patients in the metastatic stage of disease [3,4]. The characteristic feature of prostate cancer bone metastases is their multifocal nature with related pain, which is one of the first symptoms of metastases reported by patients. Pain affects the quality of life, and often does not respond to standard available pharmacological pain therapeutic options [5]. Thus, relief of pain remains the primary goal of therapy. Current treatment options for painful bone lesions include systemic therapy (hormonal therapy,...

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“…10,11,23 With this activity, various authors describe the radiation absorbed dose in the marrow to be between 230 and 590 cGy 16,18,21,24 (a range that includes the results of this study, ie, 347 ± 65 cGy). Administration of doses above 1 mCi/kg seems not to lead to better pain control, 9 even though it results in higher marrow toxicity.…”

Section: Discussionmentioning

confidence: 82%

“…Grade III toxicity is described in approximately 10% of the patients treated with doses of 1 mCi/kg, 9,10,11,12 and grade IV toxicity occurs in less than 1% of cases. In addition to betaparticle emission (energy = 810 keV), samarium-153 emits gamma radiation (energy = 103 keV), which may be used for biodistribution and dosimetric measures.…”

Section: Sistema úNico De Saúde)mentioning

confidence: 99%

Retrospective evaluation of bone pain palliation after samarium-153-EDTMP therapy

et al. 2004

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PURPOSE:The aim of this study was to evaluate the degree of metastatic bone pain palliation and medullar toxicity associated with samarium-153-EDTMP treatment.METHODS: Seventy-three patients with metastatic bone pain having previously undergone therapy with samarium-153-EDTMP (1 mCi/kg) were retrospectively evaluated. Routine follow-up included pain evaluation and blood counts for 2 months after treatment. Pain was evaluated using a subjective scale (from 0 to 10) before and for 8 weeks after the treatment. Blood counts were obtained before treatment and once a week for 2 months during follow-up. Dosimetry, based upon the urinary excretion of the isotope, was estimated in 41 individuals, and the resulting radiation absorbed doses were correlated with hematological data.RESULTS: Reduction in pain scores of 75% to 100% was obtained in 36 patients (49%), with a decrease of 50% to 75%, 25% to 50%, and 0% to 25% in, respectively, 20 (27%), 10 (14%), and 7 (10%) patients. There was no significant relationship between the pain response and location of the primary tumor (breast or prostate cancer). Mild to moderate myelosuppression was noted in 75.3% of patients, usually with hematological recovery at 8 weeks. The mean bone marrow dose was 347 ± 65 cGy, and only a weak correlation was found between absorbed dose and myelosuppression (Pearson coefficient = .4).CONCLUSIONS: Samarium-153-EDTMP is a valuable method for metastatic bone pain palliation. A mild to moderate and transitory myelosuppression is the main toxicity observed after samarium therapy, showing a weak correlation with dosimetric measures. KEYWORDS: Samarium. Pain. Scintigraphy. Palliative. Care. Neoplasm. Metastasis.Bone metastases are common in the progression of various tumors such as prostate, breast, and lung carcinoma, and they often entail an occurrence of progressive pain. 1 Control of pain and its consequences (eg, depression, movement constraint, and dependence) are important goals in oncological treatment requiring a multidisciplinary approach to the patient.The use of ionizing radiation is one of the alternatives for pain treatment, together with the administration of drugs (eg, anti-inflammatories, opioids, chemotherapeutic drugs, receptor blockades, phosphonates) and surgical interventions. Local radiotherapy results in a good clinical response in approximately 80% of the cases (complete in 30% to 60%) lasting for over 4 months, although with an effect confined to the irradiated site. 2,3 Hemibody radiotherapy (isolated or sequential) may be used in patients with widespread metastases, resulting in a complete response in approximately 20% of the cases, and a partial one for 50% to 100%. Radiation on wide areas is limited by hematopoietic, pulmonary, and gastrointestinal toxicity produced by the high radiation absorbed dose. 2,3 The irradiation of multiple bone lesions can also be achieved by the intravenous administration of beta-emitting isotopes with a high affinity for

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A dose-controlled study of 153Sm-Ethylenediaminetetramethylenephosphonate (EDTMP) in the treatment of patients with painful bone metastase

Cited by 239 publications

References 9 publications

Assessment of Bone Pain Response in Cancer Patients Receiving Single Dose of Sm-153 EDTMP Therapy

Assessment of Bone Pain Response in Cancer Patients Receiving Single Dose of Sm-153 EDTMP Therapy

A prospective randomized trial: A comparison of the analgesic effect and toxicity of 153Sm radioisotope treatment in monotherapy and combined therapy including local external beam radiotherapy (EBRT) among metastatic Castrate Resistance prostate cancer (m

Retrospective evaluation of bone pain palliation after samarium-153-EDTMP therapy

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A dose-controlled study of 153Sm-Ethylenediaminetetramethylenephosphonate (EDTMP) in the treatment of patients with painful bone metastase

Cited by 239 publications

References 9 publications

Assessment of Bone Pain Response in Cancer Patients Receiving Single Dose of Sm-153 EDTMP Therapy

Assessment of Bone Pain Response in Cancer Patients Receiving Single Dose of Sm-153 EDTMP Therapy

A prospective randomized trial: A comparison of the analgesic effect and toxicity of 153Sm radioisotope treatment in monotherapy and combined therapy including local external beam radiotherapy (EBRT) among metastatic Castrate Resistance prostate cancer (m

Retrospective evaluation of bone pain palliation after samarium-153-EDTMP therapy

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A prospective randomized trial: A comparison of the analgesic effect and toxicity of 153Sm radioisotope treatment in monotherapy and combined therapy including local external beam radiotherapy (EBRT) among metastatic Castrate Resistance prostate cancer (m