Results of strontium-89 therapy in patients with prostate cancer resistant to chemotherapy.
OBJECTIVE
Strontium-89 (Sr-89) chloride is an effective palliative treatment of the bone metastases of prostate cancer. Chemotherapy has also been shown to have a palliative benefit in this disease. We aimed to determine the benefits and complications of Sr-89 therapy in patients with prostate cancer who had become refractory to chemotherapy. We conducted a retrospective review of 14 treatments administered to 13 patients with chemotherapy-resistant and hormone-resistant prostate cancer.


RESULTS
Of the 14 administered treatments, 8 (57%) resulted in improved pain control, with 2 patients able to stop analgesia. The median duration of response was 56 days. No prostate-specific antigen response was seen in the 8 patients tested. There was significant and prolonged bone marrow toxicity, with 6 patients requiring red blood cell transfusion. Prolonged thrombocytopenia was seen, with platelet counts remaining below baseline levels after treatment in all but one patient. Leukopenia was generally mild and not associated with infection.


CONCLUSIONS
Sr-89 is an effective treatment of patients with chemotherapy-refractory prostate cancer, but careful and prolonged monitoring of hematologic parameters after therapy is required.
Gunawardana
Dishan H
DH
Nuclear Medicine Department, Royal Melbourne Hospital, Parkville, Victoria, Australia. dgun@ozemail.com.au
Lichtenstein
Meir
M
Better
Nathan
N
Rosenthal
Mark
M
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000209:etiology; D015331:Cohort Studies; D019008:Drug Resistance, Neoplasm; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000532:radiotherapy*; D010166:Palliative Care / Q000379:methods*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D012189:Retrospective Studies; D013326:Strontium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D015996:Survival Rate; D013921:Thrombocytopenia / Q000209:etiology; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D006728:Hormones; D019275:Radiopharmaceuticals; D013326:Strontium Radioisotopes; D017430:Prostate-Specific Antigen