title: Radiometabolic treatment of bone-metastasizing cancer: from 186rhenium to 223radium.
abstract: Skeletal metastases occur in many patients with different kinds of malignant tumors, especially in advance stage of breast cancer (in 47%-85% of patients), prostate cancer (33-85%), and lung cancer (32%-60%). The management of painful skeletal metastases is complicated and should be carried out by a multidisciplinary approach including conventional analgesics, antitumor therapy (chemo- and hormone therapy), osteoclast-inhibitory agents (bisphosphonates), corticosteroids, external-beam radiotherapy, surgery, and nuclear medicine therapy. The nuclear medicine therapy for palliation of pain from bone metastases is a systemic radionuclide therapy based on the use of radiopharmaceuticals. In several studies the efficacy of bone-seeking radiopharmaceuticals have been demonstrated in terms of pain reduction from diffuse skeletal metastases. In this review, we will summarize the current literature on bone-seeking radiopharmaceuticals for the treatment of painful bone metastases (Phosphorus-32, Strontium-89, Rhenium-186, Rhenium-188, Samarium-153, and Radium-223) and the combination therapy with biphosphonates and chemotherapy.
authors.affiliation: Nuclear Medicine Unit, D.I.M., University of Bari "Aldo Moro," Bari, Italy .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rubini
authors.forename: Adriano
authors.initials: A
authors.lastname: Nicoletti
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubini
authors.forename: Artor Niccoli
authors.initials: AN
authors.lastname: Asabella
mesh_terms: D001859:Bone Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000532:radiotherapy* / Q000556:secondary*; D003131:Combined Modality Therapy; D006801:Humans; D009362:Neoplasm Metastasis; D011868:Radioisotopes / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011883:Radium / Q000627:therapeutic use*; D012211:Rhenium / Q000627:therapeutic use*
chemical_list: D011868:Radioisotopes; D019275:Radiopharmaceuticals; D012211:Rhenium; D011883:Radium