Samarium Sm-153 lexidronam for the palliation of bone pain associated with metastases.
BACKGROUND
In patients with bone pain due to metastatic disease, intravenous systemic radioisotope therapy may be a useful adjunct to other methods for palliating pain.


METHODS
Various studies have been performed utilizing a short-lived radioisotope conjugated to a tetraphosphonate (samarium 153 lexidronam) both as an open label and as a double blinded, placebo-controlled study. Patients with varying tumor types including those of the prostate, breast, lung, and other sites were studied. Two dose levels were used (0.5 millicuries (mCi)/kg and 1.0 mCi/kg) with patients monitored for 16 weeks for efficacy (pain scores, opiod analgesic score, and quality of life) parameters and adverse events.


RESULTS
All 3 studies showed that at the 1.0 mCi/kg dose level statistically significant improvement over placebo was observed by 4 weeks with relief of pain noted in many patients by 1 week. The only significant adverse event was transient myelosuppression with a nadir at 4-6 weeks and recovery by 8 weeks. Less than 10% of patients had National Cancer Institute Common Toxicity Criteria Grade III/IV bone marrow toxicity recorded.


CONCLUSIONS
Systemic metabolic radiotherapy with samarium 153 lexidronam appears to be a safe and efficacious method for treating patients with bone pain. The shorter radioisotope half-life allows for a high dose rate to be delivered over a short period, which may have certain biologic benefits.
Serafini
A N
AN
Department of Radiology and Medicine, University of Miami School of Medicine, Florida 33136, USA.
D001859:Bone Neoplasms / Q000503:physiopathology / Q000532:radiotherapy* / Q000556:secondary*; D002986:Clinical Trials as Topic; D006801:Humans; D059408:Pain Management; D010166:Palliative Care; D012493:Samarium / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
D012493:Samarium