title: Effective and economical option for pain palliation in prostate cancer with skeletal metastases: 32P therapy revisited.
abstract: The role of phosphorus-32 (32P) was evaluated in patients experiencing pain due to skeletal metastases from prostate cancer and refractory to other modes of treatment. Twenty patients received 185 MBq (5 mCi)32P intravenously; 12 patients received a single dose each, five patients were injected twice and three patients three times at 3-month intervals. A blood count and clinical assessment for bone pain, tender sites, mobility and analgesic intake were performed before and 4, 8 and 12 weeks after the administration of 32P. A bone scan was performed before and 12 weeks after therapy. The results showed a significant decrease in pain at 4 weeks and a palliative response persisted for up to 12 weeks. Analgesic medication intake decreased significantly (F = 13.2213, P < 0.0001) and mobility improved after therapy. Quantitative analysis of the bone scans showed a statistically significant reduction in osteoblastic activity in metastatic lesions after therapy (t = -3.80, P < 0.001). Transient myelosuppression after 4 weeks, which was statistically significant for WBC and platelet counts only (F = 3.0226, P = 0.0358; F = 6.2514, P = 0.0009 respectively), returned within normal limits by 8 weeks. We conclude that 32P is an effective and safe therapy for pain palliation.
authors.affiliation: Department of Nuclear Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. gmsyed@brain.net.pk
authors.forename: G M
authors.initials: GM
authors.lastname: Shah Syed
authors.forename: R N
authors.initials: RN
authors.lastname: Maken
authors.forename: N
authors.initials: N
authors.lastname: Muzzaffar
authors.forename: M A
authors.initials: MA
authors.lastname: Shah
authors.forename: F
authors.initials: F
authors.lastname: Rana
mesh_terms: D000368:Aged; D001853:Bone Marrow / Q000528:radiation effects; D001859:Bone Neoplasms / Q000503:physiopathology / Q000532:radiotherapy* / Q000556:secondary*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000532:radiotherapy*; D010166:Palliative Care / Q000191:economics / Q000379:methods*; D010761:Phosphorus Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D011471:Prostatic Neoplasms; D012449:Safety
chemical_list: D010761:Phosphorus Radioisotopes