A Systematic Overview of Radiation Therapy Effects in Skeletal Metastases

Falkmer, Ursula Gerda Inge; Järhult, Johannes; Wersäll, Peter; Cavallin‐Ståhl, Eva

doi:10.1080/02841860310014895

Cited by 152 publications

(85 citation statements)

References 22 publications

(31 reference statements)

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“…External radiotherapy is widely used to relieve pain from skeletal metastases (7,8). However, lack of tumor selectivity limits its use as normal cells within the target volume receive the same radiation dose as the tumor cells.…”

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confidence: 99%

First Clinical Experience with α-Emitting Radium-223 in the Treatment of Skeletal Metastases

Nilsson

Larsen

Fosså

et al. 2005

Clinical Cancer Research

404

272

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Purpose: The main goals were to study the safety and tolerability of the a-emitter radium-223 ( 223 Ra) in breast and prostate cancer patients with skeletal metastases. In addition, pain palliation was evaluated. Experimental Design: Fifteen prostate and 10 breast cancer patients enrolled in a phase I trial received a single i.v. injection of 223 Ra. Five patients were included at each of the dosages: 46, 93, 163, 213, or 250 kBq/kg and followed for 8 weeks. Palliative response was evaluated according to the pain scale of the European Organization for Research andTreatment of Cancer QLQ C30 questionnaire at baseline and at 1, 4, and 8 weeks after injection. Results: Weekly blood sampling during follow-up revealed mild and reversible myelosuppression with nadir 2 to 4 weeks after the injection. Importantly, for thrombocytes only grade 1toxicity was reported. Grade 3 neutropenia and leucopenia occurred in two and three patients, respectively. Mild, transient diarrhea was observed in 10 of the 25 patients. Nausea and vomiting was more frequently observed in the highest dosage group. Serum alkaline phosphatase decreased with nadir averages of 29.5% in females and 52.1% in males. Pain relief was reported by 52%, 60%, and 56% of the patients after 7 days, 4, and 8 weeks, respectively.

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confidence: 99%

First Clinical Experience with α-Emitting Radium-223 in the Treatment of Skeletal Metastases

Nilsson

Larsen

Fosså

et al. 2005

Clinical Cancer Research

404

272

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“…An overview of all external radiation treatment trials concerning mainly the number of fractions given (McQuay et al, 2003) was brought up to date in this review through an extensive literature search (Falkmer et al, 2003 andSze et al, 2003) and summarized in Table 4. All of the studies were randomized but blinding was often impossible.…”

Section: Results Of Published Controlled Clinical Trials On Dose and mentioning

confidence: 99%

Pain control by ionizing radiation of bone metastasis

Vakaet¹,

Boterberg²

2004

Int. J. Dev. Biol.

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Pain treatment due to cancer is a large fraction of the care in a radiotherapy department. While radiation treatment is very effective in reducing pain, the pathophysiology of bone metastases remains very complex. Reducing the number of tumour cells by radiation will reduce the pressure in bone marrow, but the very rapid response to radiation treatment seen in some patients is probably related to the presence of highly radiosensitive inflammatory cells. In this review we give an overview of the pathophysiological mechanisms which lead to pain associated with bone metastasis and the impact of radiation treatment and other treatments on this mechanism.

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“…Modern radiotherapy schedules also are rarely associated with permanent spinal cord damage, i.e. radiation myelopathy [2,3]. The risk of chemotherapy-induced spinal cord damage is also low, whereas peripheral neuropathy occurs frequently after administration of certain drugs, including cisplatin and taxanes [7,8].…”

Section: Discussionmentioning

confidence: 99%