title: Less pain does equal better quality of life following strontium-89 therapy for metastatic prostate cancer.
abstract: 93 patients with hormone refractory metastatic prostate cancer were entered on a prospective study to measure reduction in pain and changes in quality of life (QoL) after the administration of 150 MegaBequerel (MBq) Strontium-89 (Sr-89). QoL was assessed using a validated instrument, the Functional Living Index - Cancer (FLIC) questionnaire. Pain response was measured using the Radiation Therapy Oncology Group scoring system. Overall there was limited QoL improvement over 3 months following Sr-89. However, in the 53 patients (63%) achieving pain responses, QoL did significantly improve within 6 weeks of receiving Sr-89 compared to patients with stable or worsening bone pain, and this was independent of other parameters that might influence QoL outcomes, such as performance status, baseline PSA and extent of skeletal disease (P = 0.004). PSA 'response' occurred in 30 patients (37%) over 4 months after Sr-89. This did not appear to correlate with clinical improvement. This study supports the presumption that improvement in pain following Sr-89 is accompanied by better QoL. The lack of correlation of PSA response and clinical parameters indicates that in the palliative setting, PSA may not provide a useful surrogate for treatment outcome.
authors.affiliation: Department of Radiation Oncology, Westmead Hospital, NSW, 2145, Australia.
authors.forename: S L
authors.initials: SL
authors.lastname: Turner
authors.forename: S
authors.initials: S
authors.lastname: Gruenewald
authors.forename: N
authors.initials: N
authors.lastname: Spry
authors.forename: V
authors.initials: V
authors.lastname: Gebski
mesh_terms: D001859:Bone Neoplasms / Q000150:complications* / Q000556:secondary; D003967:Diarrhea / Q000139:chemically induced; D005500:Follow-Up Studies; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D008297:Male; D009325:Nausea / Q000139:chemically induced; D009362:Neoplasm Metastasis; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood / Q000187:drug effects; D011471:Prostatic Neoplasms / Q000473:pathology*; D011788:Quality of Life; D013117:Spinal Cord Compression / Q000139:chemically induced; D013324:Strontium / Q000009:adverse effects / Q000627:therapeutic use*; D013326:Strontium Radioisotopes / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
chemical_list: D013326:Strontium Radioisotopes; D017430:Prostate-Specific Antigen; C025700:strontium chloride; D013324:Strontium