The palliation of osseous metastasis with 32P or 89Sr compared with external beam and hemibody irradiation: a historical perspective.
Radiation is an effective modality for palliation of osseous metastases. In patients with a limited number of lesions, local external beam irradiation is the most expedient method of delivering radiation therapy. Complete or partial relief of pain will occur in 80-90% of patients. When metastases are widespread or when new sites continue to appear, localized external irradiation becomes logistically difficult. In such cases, hemibody irradiation has been effective with an overall response rate of 85%. However, nausea, vomiting, diarrhea, and bone marrow and pulmonary toxicity may complicate therapy. In these cases, an effective alternative is systemic phosphorus-32 (32P) or strontium-89 (89Sr). Relief of pain in the range of 60-90% has been reported. Toxicity of 32P is largely that of bone marrow suppression, while 89Sr appears to be relatively marrow-sparing. In this review, we consider systemic 32P or 89Sr as viable options to external beam or hemibody irradiation in the presence of numerous bone metastases.
Montebello
J F
JF
Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis 46223.
Hartson-Eaton
M
M
D001859:Bone Neoplasms / Q000532:radiotherapy / Q000556:secondary*; D006801:Humans; D010166:Palliative Care; D010761:Phosphorus Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D011879:Radiotherapy Dosage; D013326:Strontium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D014916:Whole-Body Irradiation
D010761:Phosphorus Radioisotopes; D013326:Strontium Radioisotopes