Combined therapy of Sr-89 and zoledronic acid in patients with painful bone metastases.
OBJECTIVE
We evaluated the pain response and daily discomfort in patients with painful bone metastases treated by merging 89Sr-chloride and zoledronic acid. The results were compared with those of patients who received 89Sr-chloride or zoledronic acid separately.


METHODS
25 patients (12 women; mean age 65+/-13 years) chronically treated with zoledronic acid underwent bone pain palliation with 150 MBq of 89Sr-chloride at least 6 months later that bisphoshonate therapy started (group A). 13 patients (6 women; mean age 70+/-12 years) received 89Sr-chloride alone (group B) and 11 patients (5 women; mean age 69+/-12 years) were chronically treated and continued to receive only zoledronic acid therapy (group C), both constituted the control groups. Patients kept a daily pain diary assessing both their discomfort and the pain of specific sites by using a visual analog scale (VAS), rating from 0 (no d iscomfort-no pain) to 10 (worst discomfort-pain). These diaries were reviewed weekly for 2 months and three different physicians rated the pain response on a scale of -2 (considerable deterioration) to +2 (considerable improvement).


RESULTS
Baseline characteristics were similar in the three groups. The reduction of total discomfort and of bone pain in the group A was significantly greater as compared to group B (P<0.01) and group C (P<0.01). During the monitored period, a significant improvement of clinical conditions was observed in the group A, varying the rate from -1 to 1 as compared to both groups B and C in which the rate changed from -1 to 0.


CONCLUSIONS
Our findings indicate that combined therapy of 89Sr-chloride and zoledronic acid in patients with painful bone metastases is more effective in treating pain and improving clinical conditions than 89Sr-chloride or zoledronic acid used separately.
Storto
Giovanni
G
Institute of Biostructures and Bioimages, National Council of Research, Naples, Italy. giosto24@hotmail.com
Klain
Michele
M
Paone
Gaetano
G
Liuzzi
Raffaele
R
Molino
Leonardo
L
Marinelli
Alfredo
A
Soricelli
Andrea
A
Pace
Leonardo
L
Salvatore
Marco
M
D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000188:drug therapy / Q000532:radiotherapy; D010146:Pain; D010166:Palliative Care; D011471:Prostatic Neoplasms / Q000473:pathology; D013326:Strontium Radioisotopes / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D000077211:Zoledronic Acid
D004164:Diphosphonates; D007093:Imidazoles; D013326:Strontium Radioisotopes; D000077211:Zoledronic Acid