Palliation of pain associated with metastatic bone cancer using samarium-153 lexidronam: a double-blind placebo-controlled clinical trial.

Serafini, Aldo N.; Houston, S.; Resche, I.; Quick, Donald P.; Grund, Frank; Ell, Peter J.; Bertrand, Anne Marie; Ahmann, F. R.; Orihuela, Eduardo; Reid, Robert H.; Lerski, R A; Collier, B D; McKillop, J. H.; Purnell, Gary L.; Pecking, A; Thomas, Fridtjof; Harrison, Katherine A.

doi:10.1200/jco.1998.16.4.1574

Cited by 379 publications

(151 citation statements)

References 9 publications

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“…For example, Vina et al reported a high overall therapeutic response 85% of 94 patients over 3 months [8], this response rate is slightly higher as compared with Wang RF study (77.8% after 3 weeks) [9]. The other two studies of González et al [12,13].…”

Section: Discussionmentioning

confidence: 92%

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: 92%

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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“…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: 99%

“…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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“…153 Sm-EDTMP (half-life 1.9 days, 28% gamma emission, which allows the scintigraphic evaluation of dosimetry and biodistribution) penetrates tissue to 0.6 mm, leading to doserelated pain relief although with a mild myelosuppression (12)(13)(14)(15). Pain reduction begins between 1 to 4 weeks and persists as long as 17 weeks (11).…”

Section: Abstract 223 Ra Prolongs Overall Survival In Symptomatic Pamentioning

confidence: 99%

Radium-223: Insight and Perspectives in Bone-metastatic Castration-resistant Prostate Cancer

Buroni

Persico

Pasi

et al. 2016

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Abstract. 223 Prostate cancer (PCa) is the most common malignancy in men (1). In patients affected by advanced PCa, defined as hormonesensitive disease since the tumor still requires androgen for growth, androgen deprivation therapy (ADT), including luteinizing hormone-releasing hormone (LHRH) agonists, antagonists and anti-androgens, represents the first-line treatment. Unfortunately some cancer cells develop resistance to ADT, indicating the progression of the disease to metastatic castration-resistant prostate cancer (mCRPCa). Such resistance to castration occurs in most patients (2) and, despite the approval of new therapeutic agents, mCRPCa remains a lethal disease (3). Nowadays the new therapeutic landscape for patients affected by mCRPCa aims to extend overall survival (OS) and includes cytotoxic, new-generation anti-androgens, immunotherapeutics and radiopharmaceuticals (4, 5).Bones are the preferred site of metastasis. Almost 90% of men who die from PCa have bone-metastatic disease (6), with a 5-year OS rate of 20%. Due to the fragility of bone with metastases, with the related risk of pain, fractures, spinal cord compression and hematological consequences, several drugs have been developed to treat the osseous involvement of this disease. In previous years, the optimal treatment aimed to relieve pain and reduce skeletal morbidity.Besides systemic therapies, bone-targeted agents that focus their activity on bone, such as bisphosphonates, monoclonal antibody and radiopharmaceuticals, have become available. The bisphosphonate zoledronic acid, the antibody to receptor activator of nuclear factor kappa-B ligand (RANKL) denosumab and radiopharmaceuticals [such as 89 Sr and 153 Sm-ethylene diamine tetramethylene phosphonate ( 153 Sm-EDTMP)], were approved for delaying skeletal-related events (SREs) and for the palliation of bone pain from mCRPCa. Radionuclide TherapyRadionuclide therapy is known to deliver ionizing radiation to tumor sites, thereby killing cancer cells (7). Bone-targeted radiopharmaceuticals localize their radiation to sites of high bone remodeling. 5719

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Palliation of pain associated with metastatic bone cancer using samarium-153 lexidronam: a double-blind placebo-controlled clinical trial.

Abstract: A single dose of 1.0 mCi/kg of 153Sm-EDTMP provided relief from pain associated with bone metastases. Pain relief was observed within 1 week of administration and persisted until at least week 16 in the majority of patients who responded.

Cited by 379 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

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

Radium-223: Insight and Perspectives in Bone-metastatic Castration-resistant Prostate Cancer

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