title: A phase II study of treatment of painful multifocal skeletal metastases with single and repeated dose samarium-153 ethylenediaminetetramethylene phosphonate.
abstract: A phase II study of 153Sm ethylenediaminetetramethylene phosphonate (153Sm-EDTMP) palliative treatment was conducted on 23 patients with painful disseminated skeletal metastases. The administered activity of 153Sm-EDTMP was determined by prospective dosimetry and the radiation absorbed dose to bone marrow was fixed at 2 Gy. Symptomatic relief of bone pain was experienced by 14 of 23 evaluable patients (61%) with a median duration of 8 weeks (range 0-40). Toxicity was limited to myelosuppression with median nadir counts of leucocytes 3.3 x 10(9)/1 (range 1.0-7.5) and platelets 133 x 10(9)/1 (range 24-176) occurring at 2 weeks and 4 weeks, respectively. Retreatment with 153Sm-EDTMP was studied in 15 patients, including in 4 of the 23 patients treated with a single dose. The retreatment median radiation absorbed dose to red marrow was 1.9 Gy given at a median of 9 weeks (range 6-38) after initial treatment. Good control of pain was obtained in 13 of these patients (87%). Both the median duration of pain control (24 weeks) and survival (9 months) in the retreated group were substantially greater than for patients treated with a single dose, where duration was 8 weeks and survival 4 months. Additional toxicity in the retreated patients was confined to anaemia which required blood transfusion in 9 of the 15 patients (60%).
authors.affiliation: Department of Nuclear Medicine, Fremantle Hospital, Western Australia.
authors.forename: J H
authors.initials: JH
authors.lastname: Turner
authors.forename: P G
authors.initials: PG
authors.lastname: Claringbold
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality / Q000556:secondary*; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D009943:Organophosphorus Compounds / Q000008:administration & dosage*; D010146:Pain / Q000532:radiotherapy*; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D011879:Radiotherapy Dosage; D013921:Thrombocytopenia / Q000209:etiology
chemical_list: D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; C061972:samarium Sm-153 lexidronam