Therapeutic efficiency of rhenium-188-HEDP in human prostate cancer skeletal metastases.
Rhenium-188-HEDP ((188)Re-HEDP) is a new and attractive radiopharmaceutical for the treatment of metastatic bone pain. As a product of (188)W/(188)Re generator, it is convenient for clinical therapeutic use with a short physical half-life of 16.9 h and a maximal beta-energy of 2.1 MeV. We investigated the effect of (188)Re-HEDP on pain relief, analgesic intake and impairment of bone marrow function in 27 patients with bone metastases induced from prostate cancer. All patients were interviewed using a standardised set of questions before, and after therapy for 12 weeks. The patients were treated with 2700-3459 MBq of (188)Re-HEDP. Blood samples were taken weekly for 12 weeks, and a blood count was performed. Patients described an improvement on the Karnofsky performance scale from 74+/-7 to 85+/-9% 12 weeks after therapy (P=0.001). The pain score showed a maximum decrease from 44+/-18 to 27+/-20% in the third to the eight week after therapy (P=0.009). Seventy-six percent of the patients described a pain relief without increase of analgesic intake. Twenty percent of the patients could discontinue their analgesics and were pain free. Mean platelet count decreased from (286+/-75)*10(3) microl(-1) to (215+/-92)*10(3) microl(-1), and mean leucocyte count from (7.7+/-1.5)*10(3) microl(-1) to (6.0+/-1.9)*10(3) microl(-1) in the second to the fourth week after therapy. The maximal differences between the values of platelets and leucocytes before and after therapy were not statistically significant (P=0.021 and 0.094). In conclusion, (188)Re-HEDP is an effective radiopharmaceutical used in the palliative treatment of metastatic bone pain in prostate cancer and shows minimal bone marrow toxicity.
Liepe
K
K
Department of Nuclear Medicine, University Hospital Dresden, Fetscherstr 74, 01307 Dresden, Germany. liepe@rcs.urz.tu-dresden.de
Kropp
J
J
Runge
R
R
Kotzerke
J
J
D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D012968:Etidronic Acid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009942:Organometallic Compounds; D010146:Pain / Q000000981:diagnostic imaging* / Q000209:etiology / Q000532:radiotherapy*; D010147:Pain Measurement; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D011868:Radioisotopes / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011877:Radionuclide Imaging; D012211:Rhenium / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome
D009942:Organometallic Compounds; D011868:Radioisotopes; C101598:rhenium-186 HEDP; D012211:Rhenium; D012968:Etidronic Acid