177Lu-EDTMP for Treatment of Bone Pain in Patients with Disseminated Skeletal Metastases

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FIGURE 1.
Individual bone-specific pain scores for 10 patients with skeletal metastases before and after treatment with ¹⁷⁷Lu-EDTMP.
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FIGURE 2.
Comparison of mean pain score of study group.
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FIGURE 3.
Comparison of mean mobility score of study group.
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FIGURE 4.
Comparison of mean Karnofsky performance score of study group.
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FIGURE 5.
^99mTc-methylene diphosphonate bone scan (A) and corresponding ¹⁷⁷Lu-EDTMP scan (B) showing excellent tracer localization in osteoblastic areas. A color version of this figure is available as a supplemental file at http://tech.snmjournals.org.
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FIGURE 6.
^99mTc-methylene diphosphonate scan (A) and corresponding ¹⁷⁷Lu-EDTMP images (B–D) of same patient.
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FIGURE 7.
¹⁷⁷Lu-EDTMP image (B) demonstrating biologic distribution similar to ¹⁵³Sm-EDTMP (A) in same patient.

TABLE 1

Demographic and Clinical Parameters in the 10 Patients of the Study Population

Parameter	Data
Median age (y)	68.5 (range, 52–78)
Mean duration of cancer (mo)	30 (range, 3–120)
Type of cancer (n)
Lung	4
Prostate	3
Breast	2
Esophagus	1
Prior radiotherapy (n)	6 (60%)
Median time since last radiotherapy (mo)	8 (range, 4–10)
Prior chemotherapy (n)	4 (40%)
Median time since last chemotherapy (mo)	18 (range, 2–34)
Prior radionuclide therapy (n)	6 (60%)
Median time since last radionuclide therapy (mo)	8 (range, 5–27)
Median baseline scores
Skeleton-based pain	8.44 (range, 7.2–9.8)
Mobility	2.99 (range, 2–4)
Karnofsky performance	45 (range, 40–50)
Median 4-wk scores
Skeleton-based pain	5.73 (range, 4.8–6.9)
Mobility	1.3 (range, 1–2)
Karnofsky performance	69 (range, 60–80)
Median 8-wk skeleton-based pain score	3.82 (range, 3.3–4.8)
Median 12-wk skeleton-based pain score	1.71 (range, 1.2–2.2)

TABLE 2

Comparison of Mean Scores

	Paired differences
Type of score	Mean	SD	95% confidence interval of difference	P
Mean pain (baseline) – mean pain (week 4)	2.7	1.2	1.8 to 3.6	<0.001
Mean pain (baseline) – mean pain (week 8)	4.6	1.1	3.8 to 5.4	<0.001
Mean pain (baseline) – mean pain (week 12)	6.7	1.3	5.8 to 7.7	<0.001
Karnofsky (baseline) – Karnofsky (week 4)	−24	6.9	−29 to −18.9	<0.001
Mobility (baseline) – mobility (week 4)	1.6	0.6	1.1 to 2.1	<0.001