title: ¹⁷⁷Lu-EDTMP for treatment of bone pain in patients with disseminated skeletal metastases.
abstract: (177)Lu-labeled ethylenediaminetetramethylene phosphonic acid ((177)Lu-EDTMP) is an agent that concentrates in areas of enhanced osteoblastic activity. The potential of (177)Lu-EDTMP for palliation of metastatic bone pain has been documented in the recent literature. The objective of the present work was to study the efficacy and safety of the agent after administration to a limited number of patients.
  
  
  METHODS
  Ten patients (median age, 68.5 y) with disseminated skeletal metastases received a single bolus infusion of (177)Lu-EDTMP (3.7 GBq). All patients had painful bone metastases in more than one anatomic region that were not relieved by narcotic analgesics. The efficacy of the agent was studied by following pain scores assessed at baseline and at 4, 8, and 12 wk after therapy, by using Karnofsky indices and mobility scores, and by determining the requirement for analgesics at baseline and 4 wk after therapy. The toxicity of the agent was assessed by analyzing complete blood counts.
  
  
  RESULTS
  A significant reduction in the mean pain score was noted in all patients. The initial mean pain score of 8.44 dropped to 5.73 within 1 mo of treatment. Six patients who required analgesics for pain management had either reduced or completely withdrawn from their use by 4 wk. Compared with initial scans, scans obtained 1 mo after therapy also showed a decreased uptake of the radiotracer. The mobility scores of all patients were higher at 4 wk. The mean Karnofsky performance score of all patients was initially 45 and increased markedly to 69 at 4 wk. None of the patients experienced blood-related toxicity.
  
  
  CONCLUSIONS
  (177)Lu-EDTMP, with only low bone marrow toxicity, provided significant pain relief to patients and considerably increased their mobility, resulting in an overall improvement in the quality of life. The results of the preliminary clinical studies indicate that (177)Lu-EDTMP can be considered an effective and safe therapeutic radiopharmaceutical for pain palliation of patients with disseminated skeletal disease.
authors: Nuclear Medicine Department, KMCH, Coimbatore, Tamil Nadu, India.
authors: Ajit S
authors: AS
authors: Shinto
authors: Deepu
authors: D
authors: Shibu
authors: Koramadai Karuppusamy
authors: KK
authors: Kamaleshwaran
authors: Tapas
authors: T
authors: Das
authors: Sudipta
authors: S
authors: Chakraborty
authors: Sharmila
authors: S
authors: Banerjee
authors: Palanisamy
authors: P
authors: Thirumalaisamy
authors: Pravin
authors: P
authors: Das
authors: Ganesh
authors: G
authors: Veersekar
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000150:complications* / Q000473:pathology / Q000556:secondary*; D006801:Humans; D008875:Middle Aged; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D010146:Pain / Q000150:complications* / Q000532:radiotherapy*; D012449:Safety
chemical_list: D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; C119503:lutetium ethylenediaminetetramethylene phosphonic acid
keywords: 177Lu-EDTMP; bone pain palliation; osseous metastases; therapeutic radiopharmaceutical