title: Treatment of painful bone metastases in prostate and breast cancer patients with the therapeutic radiopharmaceutical rhenium-188-HEDP. Clinical benefit in a real-world study.
abstract: OBJECTIVE
  Rhenium-188-HEDP ((188)Re-HEDP) is an effective radiopharmaceutical for the palliative treatment of osteoblastic bone metastases. However, only limited data on its routine use are available and its effect on quality of life (QoL) has not been studied. Therefore, we evaluated the clinical benefit of (188)Re-HEDP in routine clinical care.
  
  
  METHODS
  Prostate or breast cancer patients with painful bone metastases receiving (188)Re-HEDP as a routine clinical procedure were eligible for evaluation. Clinical benefit was assessed in terms of efficacy and toxicity. Pain palliation and QoL were monitored using the visual analogue scale (VAS), corrected for opioid intake, and the EORTC QLQ-C30 Global health status/QoL-scale. Thrombocyte and leukocyte nadirs were used to assess haematological toxicity.
  
  
  RESULTS
  45 and 47 patients were evaluable for pain palliation and QoL, respectively. After a single injection of (188)Re-HEDP, the overall pain response rate was 69% and mean VAS-scores decreased relevantly and significantly (p < 0.05). Repeated treatment resulted in similar pain response. The overall QoL response rate was 68% and mean Global health status/QoL-scores increased relevantly and significantly. Haematological side effects were mild and transient.
  
  
  CONCLUSIONS
  The clinically relevant response on pain and quality of life and the limited adverse events prove clinical benefit of treatment with (188)Re-HEDP and support its use in routine clinical care. Its effectiveness appears comparable to that of external beam radiotherapy.
authors.affiliation: Rogier Lange, PharmD, Hospital Pharmacist/Radiopharmacist, Maatweg 3, PO Box 1502, 3800 BM Amersfoort the Netherlands, Tel. +31/33/850-44 33, Fax -23 06, r.lange@meandermc.nl.
authors.forename: Rogier
authors.initials: R
authors.lastname: Lange
authors.forename: Floor
authors.initials: F
authors.lastname: Overbeek
authors.forename: John M H
authors.initials: JM
authors.lastname: de Klerk
authors.forename: Pieternel C M
authors.initials: PC
authors.lastname: Pasker-de Jong
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: van den Berk
authors.forename: Rob
authors.initials: R
authors.lastname: Ter Heine
authors.forename: Cees J
authors.initials: CJ
authors.lastname: Rodenburg
authors.forename: Anko
authors.initials: A
authors.lastname: Kooistra
authors.forename: N Harry
authors.initials: NH
authors.lastname: Hendrikse
authors.forename: Haiko J
authors.initials: HJ
authors.lastname: Bloemendal
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000523:psychology / Q000532:radiotherapy* / Q000556:secondary*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D000072716:Cancer Pain / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology*; D015897:Comorbidity; D012968:Etidronic Acid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009942:Organometallic Compounds / Q000627:therapeutic use*; D010166:Palliative Care; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000523:psychology / Q000532:radiotherapy; D011788:Quality of Life / Q000523:psychology; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C101598:rhenium-186 HEDP; D012968:Etidronic Acid
keywords: Bone metastases; haematological toxicity; pain palliation; quality of life; radionuclide therapy; rhenium-188-HEDP