[Comparison of rhenium-188, rhenium-186-HEDP and strontium-89 in palliation of painful bone metastases].
OBJECTIVE
Several radiopharmaceuticals were compared previously with regard to the efficiency in pain palliation of bone metastases. Furthermore, first results were reported on the suitability for such kind of therapy of the generator produced radionuclide rhenium-188.


METHODS
Influence of Rhenium-188-HEDP (Re-188), Rhenium-186-HEDP (Re-186) and Strontium-89 (Sr-89) on pain symptoms and bone marrow function were obtained in 44 patients (pts). These were 16 pts. with Re-188 (2943 +/- 609 MBq), 13 pts. with Re-186 (1341 +/- 161 MBq) and 15 pts. with Sr-89 (152 +/- 18 MBq) (6 woman with breast cancer and 38 men with prostata cancer).


RESULTS
81 of pts. after Re-188, 77% after Re-186 and 80% after Sr-89 reported relief of pain. The Karnofsky-Index established by pts. increased from 74 +/- 9% to 85 +/- 11% after Re-188, from 70 +/- 11% to 76 +/- 11% after Re-186 and from 62 +/- 10% to 69 +/- 10% after Sr-89. However, the difference between the pre- and the post-therapeutic value is only statistically significant in the case of Re-188 therapy (p = 0.001). A decrease of platelets of 30 +/- 14% after 2.8 +/- 0.7 for pts. treated with Re-188, of 39 +/- 20% after 3.7 +/- 1.0 weeks for pts. treated with Re-186 and of 34 +/- 26% after 4.4 +/- 1.0 weeks for pts. treated with Sr-89 compared to the value before therapy was observed. The difference was not significant between the 3 groups of pts. (p = 0.125 to 0.862).


CONCLUSIONS
All tried radiopharmaceuticals were effective in pain palliation. The various radionuclides had no significant difference in the pain relief or the bone marrow impairment. If only the Karnofsky-Index after Re-188 HEDP seems to be a little more increase.
Liepe
K
K
Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Carl-Gustav-Carus der Technischen Universität Dresden, Deutschland. liepe@rcs.urz.tu-dresden.de
Franke
W G
WG
Kropp
J
J
Koch
R
R
Runge
R
R
Hliscs
R
R
D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000532:radiotherapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy; D012968:Etidronic Acid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D010146:Pain; D010166:Palliative Care; D010976:Platelet Count; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy; D011868:Radioisotopes / Q000627:therapeutic use*; D012211:Rhenium / Q000627:therapeutic use*; D013326:Strontium Radioisotopes / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D009942:Organometallic Compounds; D011868:Radioisotopes; D013326:Strontium Radioisotopes; C101598:rhenium-186 HEDP; D012211:Rhenium; D012968:Etidronic Acid