89Sr versus 153Sm-EDTMP: comparison of treatment efficacy of painful bone metastases in prostate and breast carcinoma.
OBJECTIVE
Painful bone metastases are most frequent in patients with advanced prostate or breast carcinoma. The aim of this study was to compare the analgesic effect of radionuclide therapy using Sr and Sm-EDTMP in patients with painful bone metastases of these tumours.


METHODS
One hundred patients treated with radionuclide bone palliation therapy were analysed. The study population consisted of 60 male patients with advanced prostate carcinoma and 40 female patients with advanced breast carcinoma. Fifty patients (30 men and 20 women) were treated with Sr (150 MBq). The other 50 patients were treated with Sm-EDTMP (37 MBq x kg). The treatment efficacy was evaluated by a visual analogue scale (VAS), Karnofsky performance scale, and dosage of analgesic drugs used.


RESULTS
Complete pain relief was found in 40% of women and 40% of men treated using Sm-EDTMP and in 25% of women and 33% of men treated with Sr. No analgesic effect occurred in 20% of patients. A better analgesic effect was found in cases of osteoblastic metastases compared to mixed metastases. Statistically significant reduction of pain intensity, use of analgesic drugs and improvement of performance in Karnofsky scale was found in cases of both radionuclides.


CONCLUSIONS
The analgesic effects of Sr and Sm-EDTMP was similar in both prostate and breast carcinoma. However, the effect was dependent on the type of metastases; better response was observed in cases of osteoblastic metastases than in patients with mixed metastases. Severe adverse reactions after this therapy were rare.
Baczyk
Maciej
M
Nuclear Medicine Unit, Department of Endocrinology, Poznań University of Medical Sciences, Poznań, Poland.
Czepczyński
Rafał
R
Milecki
Piotr
P
Pisarek
Marlena
M
Oleksa
Robert
R
Sowiński
Jerzy
J
D000368:Aged; D001859:Bone Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000150:complications / Q000532:radiotherapy; D002277:Carcinoma / Q000150:complications / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000627:therapeutic use*; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods; D011471:Prostatic Neoplasms / Q000150:complications / Q000532:radiotherapy; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D013326:Strontium Radioisotopes / Q000627:therapeutic use*; D016896:Treatment Outcome
D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; D019275:Radiopharmaceuticals; D013326:Strontium Radioisotopes; C061972:samarium Sm-153 lexidronam