High-activity samarium-153-EDTMP therapy in unresectable osteosarcoma.
Despite highly efficacious chemotherapy, patients with osteosarcomas still have a poor prognosis if adequate surgical control cannot be obtained. We applied high-activity Sm-153-EDTMP therapy within a multimodal therapy concept to improve local control of an unresectable osteosarcoma with poor response to initial polychemotherapy. A 21-year-old woman with an extended, unresectable pelvic osteosarcoma and multiple pulmonary metastases was treated with high-activity of Sm-153- EDTMP (150 MBq/kg BW, total 8.1 GBq). Afterwards external radiotherapy of the primary tumor site was performed and polychemotherapy was continued, followed by autologous peripheral blood stem cell reinfusion. Within 48 h after Sm-153-EDTMP application the patient had complete pain relief. After three weeks the response was documented by 3-phase Tc-99m-MDP bone scintigraphy (primary tumor and metastases: decreased tracer uptake), whole-body F-18-FDG-PET (primary tumor and metastases: diminution of glucose metabolism) and thoracic CT (metastases: reduction of size). The present case warrants further evaluation of feasibility and efficacy of this multimodal therapy combination of high-activity Sm-153-EDTMP therapy, external radiation, polychemotherapy and stem cell support for unresectable osteosarcomas.
Franzius
C
C
Department of Nuclear Medicine, University Hospital, Münster, Germany. franziu@uni-muenster.de
Bielack
S
S
Sciuk
J
J
Vollet
B
B
Jürgens
H
H
Schober
O
O
D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000556:secondary; D008279:Magnetic Resonance Imaging; D009942:Organometallic Compounds / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000627:therapeutic use*; D012516:Osteosarcoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D010146:Pain; D010166:Palliative Care; D010386:Pelvic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000532:radiotherapy; D011868:Radioisotopes / Q000627:therapeutic use*; D011877:Radionuclide Imaging; D012493:Samarium / Q000627:therapeutic use*
D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; D011868:Radioisotopes; D012493:Samarium; C061972:samarium Sm-153 lexidronam