title: Pain palliative therapy in women with breast cancer osseous metastatic disease and the role of specific serum cytokines as prognostic factors.
abstract: OBJECTIVE
  To evaluate the efficacy of radionuclide palliative therapy (RPT) in women suffering from painful metastatic bone disease (MBD) due to breast cancer (BrCa), and to investigate the possible relationship between the RPT efficacy and cytokines levels.
  
  
  METHODS
  Sixty-three BrCa women patients with MBD enrolled in a prospective, nonrandomized study. Thirty were treated with Rhenium-186-hydroxyethylidenediphosphonic acid ((186)Re-HEDP), 21 with Strontium-89-Chloride ((89)Sr-Cl2), and 12 with Samarium-153-thylenediaminetetramethylenephosphonic acid ((153)Sm-EDTMP). Blood samples were collected pre- and post-therapy to assess the interleukin (IL)-2, IL-6 and tumor necrosis factor (TNF)-a titers. The palliative effect of the treatment was evaluated using a modified Wisconsin test.
  
  
  RESULTS
  All three radiopharmaceuticals were equally effective in pain relief. Pain palliation was complete in 52% of patients, partial in 31%, and absent in 16%. Responders to therapy had higher IL-2 and lower IL-6/TNF-a concentrations, compared with nonresponders, even though statistically significant difference in cytokines levels between responders and nonresponders before treatment was noted only for IL-6.
  
  
  CONCLUSIONS
  All used radiopharmaceuticals had the same therapeutic effect. Pretherapy low titers of IL-6 levels seems to have a favorable prognostic value for the therapeutic outcome, while IL-2 and TNF-a alterations pre- and post-therapy can only serve as markers of a better RPT response.
authors.affiliation: 1 3rd Nuclear Medicine Department in Papageorgiou Hospital, Aristotle University , Thessaloniki, Greece .
authors.forename: Ioannis
authors.initials: I
authors.lastname: Iakovou
authors.forename: Argyrios
authors.initials: A
authors.lastname: Doumas
authors.forename: Kosmas
authors.initials: K
authors.lastname: Badiavas
authors.forename: Vassileios
authors.initials: V
authors.lastname: Mpalaris
authors.forename: Savvas
authors.initials: S
authors.lastname: Frangos
authors.forename: Georgios
authors.initials: G
authors.lastname: Farmakis
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000276:immunology / Q000503:physiopathology / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000627:therapeutic use*; D010148:Intractable Pain / Q000517:prevention & control*; D010166:Palliative Care; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012211:Rhenium / Q000627:therapeutic use*; D013326:Strontium Radioisotopes / Q000627:therapeutic use*
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; D019275:Radiopharmaceuticals; D013326:Strontium Radioisotopes; D012211:Rhenium; C061972:samarium Sm-153 lexidronam