Samarium-153-EDTMP in bone metastases.
Thirty-five patients with painful bone metastases arising from a variety of tumor types underwent a clinical trial in which 153Sm-EDTMP was injected as a single intravenous dose. The injection ranged in amount from 330 MBq to 1110 MBq of 153Sm-EDTMP. Pain relief usually occurred within one week after administration. The duration of pain relief lasted from 2 to 17 weeks. A detectable degree of pain palliation was experienced by 80% of the treated patients; 54% reported substantial or complete pain relief. Due to the small number of patients, no clear-cut dose-related response was detectable. Moderate myelosuppression was observed in one patient (WHO grade III). The metastatic lesion-to-normal bone ratios remained constant (varying from 1.5 to 4.8) for at least 5 days post-injection. 153Sm cleared very rapidly from the blood. Less than 1% of the injected dose remained in circulation at 4 hours post-injection. No local accumulation of the tracer could be detected outside the skeleton. Urinary excretion was quite complete at 6 hours post-injection. The biodistributions of 153Sm-EDTMP and 99mTc-DPD are very similar in metastatic and normal bone; thus, bone scanning can be used for patient selection and followup. According to our results, it seems that higher doses of 153Sm-EDTMP can be given safely and without any irreversible myelosuppression.
Ahonen
A
A
Department of Clinical Chemistry, Oulu University Central Hospital, Finland.
Joensuu
H
H
Hiltunen
J
J
Hannelin
M
M
Heikkilä
J
J
Jakobsson
M
M
Jurvelin
J
J
Kairemo
K
K
Kumpulainen
E
E
Kulmala
J
J
D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D004164:Diphosphonates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000627:therapeutic use*; D015609:Organotechnetium Compounds; D010166:Palliative Care / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology; D011868:Radioisotopes / Q000627:therapeutic use*; D011877:Radionuclide Imaging; D012493:Samarium / Q000627:therapeutic use*
D004164:Diphosphonates; D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011868:Radioisotopes; C033905:technetium Tc 99m 1,1-diphosphonopropane-2,3-dicarboxylic acid; D012493:Samarium; C061972:samarium Sm-153 lexidronam