title: 153Samarium-EDTMP administration followed by hematopoietic stem cell support for bone metastases in osteosarcoma patients.
abstract: BACKGROUND
  Bone metastatic patients with osteosarcoma have a very poor prognosis. Targeted radiation therapy has been pursued as a valid alternative. The primary end point of this study was progression-free survival (PFS) at 4 months.
  
  
  METHODS
  Twenty-two osteosarcoma patients were treated with Samarium-153 ethylenediaminetetramethylene phosphonic acid (153Sm-EDTMP) at various dosages. Administered activities ranged from 150 (3 mCi/kg) to 1140 MBq/kg (30 mCi/kg). Autologous hematopoietic stem cell infusion was carried out on day 14 after the (153)Sm-EDTMP infusion.
  
  
  RESULTS
  The median PFS was 61 days (18-436 days) and the median overall survival (OS) was 189 days (31-1175 days). PFS and OS for the entire patient population were 32% [95% confidence interval (CI) 16-50] and 76% (95% CI 52-89) at 4 months, respectively. No statistical differences emerged according to 153Sm-EDTMP administered or 24-h retained activity. One-month pain palliation was only observed in a minority of subjects and in none at 4 months.
  
  
  CONCLUSIONS
  Based on our series, the PFS is dramatically short even when higher activity of (153)Sm-EDTMP is administered. This would mean that, even at high level, 153Sm-EDTMP is itself ineffective against relapsed osteosarcoma or the residual activity is too low to be active on these particular subsets of patients.
authors: Department of Pediatric Onco-Hematology, Regina Margherita Children's Hospital, Turin. massimo.berger@unito.it
authors: M
authors: M
authors: Berger
authors: G
authors: G
authors: Grignani
authors: A
authors: A
authors: Giostra
authors: S
authors: S
authors: Ferrari
authors: V
authors: V
authors: Ferraresi
authors: A
authors: A
authors: Tamburini
authors: G
authors: G
authors: Cefalo
authors: F
authors: F
authors: Carnevale-Schianca
authors: E
authors: E
authors: Vassallo
authors: P
authors: P
authors: Picci
authors: M
authors: M
authors: Pagano
authors: M
authors: M
authors: Aglietta
authors: R E
authors: RE
authors: Pellerito
authors: F
authors: F
authors: Fagioli
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009942:Organometallic Compounds / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D009943:Organophosphorus Compounds / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D012516:Osteosarcoma / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D011829:Radiation Dosage; D019275:Radiopharmaceuticals / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; D019275:Radiopharmaceuticals; C061972:samarium Sm-153 lexidronam