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Targeted radionuclide therapy for bone metastases

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Abstract

Recent advances in targeted radiotherapy offer a new approach for the management of metastatic bone pain. This paper will review the scientific basis for radionuclide therapy and will examine the evidence for clinical efficacy. The therapeutic potential of targeted radiotherapy can only be appreciated by comparison with established treatments. Alternative treatment options will, therefore, be discussed, to bring the potential advantages and hazards of targeted radiotherapy into perspective and to define its place in routine management.

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References

  • Adami S, Salvagno G, Guarrera G, Bianchi G, Dorizzi R, Rosini S (1985) Dichloromethylene disphosphonate in patients with prostatic carcinoma metastatic to the skeleton. J Urol 134:1152–1154

    PubMed  Google Scholar 

  • Blake GM, Zivanovic MA, McEwan AJ, Ackery DM (1986) Sr-89 therapy: Strontium kinetics in disseminated carcinoma of the prostate. Eur J Nucl Med 12:447–454

    PubMed  Google Scholar 

  • Blake GM, Zivanovic MA, McEwan AJ, Batty VB, Ackery DM (1987) Sr-89 radionuclide therapy: dosimetry and haematological toxicity in two patients with metastasising prostatic carcinoma. Bur J Nucl Med 13:41–46

    Google Scholar 

  • Blake GM, Zivanovic MA, Blaquiere RM, Fine DR, McEwan AJ, Ackery DM (1988) Strontium-89 therapy: measurement of absorbed dose to skeletal metastases. J Nucl Med 29:549–557

    PubMed  Google Scholar 

  • Brown AP, Greening WP, McCready VR, Shaw HJ, Harmer CL (1984) Radioiodine treatment of metastatic thyroid carcinoma: the Royal Marsden Hospital experience. Br J Radiol 57:323–327

    PubMed  Google Scholar 

  • Burnet NG, Williams G, Howard N (1990) Phosphorus-32 for intractable bony pain from carcinoma of the prostate. Clin Oncol 2:220–223

    Google Scholar 

  • Carey PO, Lippert MC (1988) Treatment of painful prostatic bone metastases with oral editronate disodium. J Urol 32:403–407

    Article  Google Scholar 

  • Cole DJ (1989) A radiomised trial of a single treatment versus conventional fractionation in the palliative radiotherapy of painful bone metastases. Clin Oncol 1: 59–62

    Google Scholar 

  • Coleman RE, Rubens RD (1987) The clinical course of bone metastases in breast cancer. Br J Cancer 55:61–66

    PubMed  Google Scholar 

  • Davies J, Trask C, Souhami RL (1979) Effect of mithramycin on widespread painful bone metastases in cancer of the breast. Cancer Treat Rep 63:1835–1838

    PubMed  Google Scholar 

  • Eary JF, Collins C, Appelbaum FR, Nemiroff C, Ferency S, Richter KY, Gordon BE (1990) Sm-153 EDTMP treatment of hormone refractory prostate carcinoma. J Nucl Med 31:5;755

    Google Scholar 

  • Eisenhut M (1984) Iodine-131 labeled diphosphonates for the palliative treatment of bone metastases: organ distribution and kinetics of I-131 BDP3 in rats. J Nucl Med 25:1356–1361

    PubMed  Google Scholar 

  • Eisenhut M, Berberich R, Kimmig B, Oberhausen E (1986) Iodine-131 labeled diphosphonates for palliative treatment of bone metastases: II. Preliminary clinical results with iodine-131 BDP3. J Nucl Med 27:1255–1261

    PubMed  Google Scholar 

  • Elomaa I, Blomqvist C, Porkka L (1985) Diphosphonates for skeletal metastases. Lancet 11:1063

    Google Scholar 

  • Evans PJD (1990) Opioids in the treatment of cancer pain. In: Doyle D (ed) Royal Society of Medicine Services International Congress and Symposium Series No 146. Royal Society of Medicine Services Ltd

  • Firusian N, Mellin P, Schmidt CG (1976) Results of strontium-89 therapy in patients with carcinoma of the prostate and incurable pain from bone metastases: a preliminary report. J Urol 116:764–768

    PubMed  Google Scholar 

  • Galasko CSB (1976) Mechanisms of bone destruction in the development of skeletal metastases. Nature 263:507–508

    Article  PubMed  Google Scholar 

  • Gennari C, Francini G, Chierichetti SM, Nami R, Gonelli S, Poilini M (1989) Salmon calcitonin treatment in bone metastases. Curr Ther Res 45:804–812

    Google Scholar 

  • Goeckler WE, Edwards B, Volkert WA, Holmes RA, Simon J, Wilson D (1987) Skeletal localisation of samarium-153 chelates: potential therapeutic bone agents. J Nucl Med 28:495–504

    PubMed  Google Scholar 

  • Hall EJ (1978) Radiobiology for the radiologist. Harper & Row, Philadelphia, p 145

    Google Scholar 

  • Hertz S (1950) Modifying effect of steroid hormone therapy on human neoplastic disease as judged by radioactive phosphorus (P32). J Clin Invest 29:821

    Google Scholar 

  • Hoefnagel CA, Voute PA, de Kraker J, Marcuse HR (1987) Radionuclide diagnosis and therapy of nueroectodermal tumours using 1-131 metaiodobenzylguanidine. J Nucl Med 28:308–314

    PubMed  Google Scholar 

  • Hoskin PJ (1991) Radiotherapy in the management of bone metastases. In: Rubens RD, Fogelman I (eds) Bone metastases: diagnosis and treatment. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Hoskin PJ, Ford HT, Harmer CL (1989) Hemibody irradiation for metastatic bone pain in two histologically distinct groups of patients. Clin Oncol 1:67–69

    Article  Google Scholar 

  • Hoyan DL (1988) Damage and protection of the human gastric mucosa. Am J Med 84[2A]:35–40

    Google Scholar 

  • Kasi LP, Fossella F, Holoye P, Podoloff D, Kim E, Crane J, Cordon EE (1991) Evaluation of multiple dose Sm-153-EDTMP for bone pain palliation in cancer patients. Proc. 7th international symposium of radiopharmacology. Boston, Mass, p 11

  • Laing AH, Ackery DM, Bayly RJ, Buchanan RB, Lewington VJ, McEwan AJ, Macleod PM, Zivanovic MA (1991) Strontium-89 therapy for pain palliation in prostatic skeletal malignancy. Br J Radiol 64:816–822

    PubMed  Google Scholar 

  • Lewington VJ, McEwan AJ, Ackery DM, Bayly RJ, Keeling DH, Macleod PM, Porter AT, Zivanovic MA (1991) A prospective randomised double blind corssover study to examine the efficacy of strontium-89 in pain palliation in patients with advanced prostate cancer metastatic to bone. Bur J Cancer 27:954–958

    Google Scholar 

  • Lewington VJ, Zivanovic MA, Tristam M, McEwan AJ, Ackery DM (1991b) I-131 mlBG therapy for malignant phaeochromocytoma. J Nucl Biol Med 35:280–283

    PubMed  Google Scholar 

  • Lewington VJ, Bolger PJ, Dearnaley DP, Kirk D, Quilty PM, Yardley J, Zivanovic MA (1992) Is strontium-89 an effective alternative to radiotherapy for prostatic metastases? Nucl Med Commun [Abs] 13:211–212 (abstr)

    Google Scholar 

  • Masud T, Slevin ML (1989) Pamidronate to reduce bone pain in a normocalcaemic patient with disseminated prostatic carcinoma. Lancet I:1021–1022

    Article  Google Scholar 

  • Maxfield JR, Maxfield JCS, Maxfield WS (1958) The use of radioactive phosphorus and testosterone in metastatic bone lesions from breast and prostate. South Med J 51:937–327

    Google Scholar 

  • Maxon HR, Schroder LE, Thomas SR (1990) Re-186[Sn]HEDP for treatment of painful osseous metastases: initial clinical experience in 20 patients with hormone resistant prostate cancer. Radiology 176:155–159

    PubMed  Google Scholar 

  • Maxon III HR, Schroder LE, Hertzberg VS, Thomas SR, Englaro BE, Samaratunga R, Smith H, Moulton JS, Williams CC, Ehrhardt GJ, Schneider HJ (1991) Rhenium-186[Sn]HEDP for treatment of painful osseous metastases: results of a double blind crossover comparison with placebo. J Nucl Med 32:1877–1881

    PubMed  Google Scholar 

  • McEwan AJB, Porter A, Venner P, Amyotte G (1990) An evaluation of the safety and efficacy of treatment with Sr-89 in patients who have previously received wide field radiotherapy. Antibodies, Immunoconjugates and Radiopharmaceuticals 3[2]:91–98

    Google Scholar 

  • Merlini G, Parrinello GA, Piccinini L (1990) Long term effects of parenteral dichloromethylene bisphosphonate (CL2MBP) on bone disease of myeloma patients treated with chemotherapy. Haematol Oncol 8:23–30

    Google Scholar 

  • Pecher C (1942) Biological investigations with radioactive calcium and strontium. Preliminary report on the use of radioactive strontium in the treatment of metastatic bone cancer. University of California Publications in Pharmacology 2:117–149

    Google Scholar 

  • Podoloff DA, Kasi LP, Kim BE, Fossella F, Bhadkamkar VA (1991) Evaluation of Sm-153 EDTMP as a bone imaging agent during a therapeutic trial (abstr). J Nucl Med 32:918

    Google Scholar 

  • Price P, Hoskin PJ, Easton P, Austin D, Palmer SG, Yarnold JR (1986) Prospective randomised trial of single and multifraction radiotherapy schedules in the treatment of painful bone metastases. Radiother Oncol 6:247–255

    PubMed  Google Scholar 

  • Robinson RG, Spicer JA, Preston DF, Wegst AV, Martin NL (1987) Treatment of metastatic bone pain with strontium-89. Int J Rad Appl Instrum [B] 1:219–222

    Google Scholar 

  • Roth A, Kolaric K (1986) Analgesic activity of calcitonin in patients with painful osteolytic metastases of breast cancer. Results of a controlled randomized study. Oncology 43:283–287

    PubMed  Google Scholar 

  • Silberstein EB, Williams C (1985) Strontium 89 therapy for the pain of osseous metastases. J Nucl Med 26:345–348

    PubMed  Google Scholar 

  • Siris ES, Hyman GA, Canfield RE (1983) Effects of dichloromethylene bisphosphonate in women with breast carcinoma metastatic to the skeleton. Am J Med 74:401–406

    Article  PubMed  Google Scholar 

  • Stoll BA (1983) Natural history, prognosis and staging of bone metastases. In: Stoll BA, Parbhoo S (eds) Bone metastases: monitoring and treatment. Raven, New York, pp 1–4

    Google Scholar 

  • Tong ECK (1971) Parathormone and P-32 therapy in prostatic cancer with bone metastases. Radiology 98:343–351

    PubMed  Google Scholar 

  • Turner JH, Claringbold PG (1991) A phase II study of treatment of painful multifocal skeletal metastases with single and repeated dose samarium-153 ethylenediaminetetramethylene phosphate. Eur J Cancer 27:1084–1086

    PubMed  Google Scholar 

  • Turner JH, Martindale AA, Sorby P, Hetherington EL, Fleay RF, Hoffman RF, Claringbold PG (1989) Samarium-153 EDTMP of disseminated skeletal metastasis. Eur J Nucl Med 15:784–795

    Article  PubMed  Google Scholar 

  • Twycross RG, Fairfield S (1982) Pain in far advanced cancer. Pain 14:303–310

    Article  PubMed  Google Scholar 

  • van Holten-Verzantvoort AT, Bijvoet OLM, Hermens J (1987) Reduced morbidity from skeletal metastases in breast cancer patients during long term bisphosphonate (APD) treatment. Lancet II:983–985

    Article  Google Scholar 

  • Ventafridda V (1989) Continuing care: a major issue in pain management. Pain 36:137–144

    Article  PubMed  Google Scholar 

  • Ventafridda V, Sbanotto A, De Conno F (1990) Review article: pain in prostate cancer. Palliative Medicine 4:173–184

    Google Scholar 

  • World Health Organisation (1986) Cancer pain relief. World Health Organisation, Geneva

    Google Scholar 

  • Zonnenberg BA, de Klerk JMH, van Rijk PP, Quirijnen JMSP, van het Schip AD, van Dijk A, ten Kroode NFJ (1991) Re-186HEDP for treatment of painful bone metastases in patients with metastatic prostate or breast cancer. Preliminary results (abstract). J Nucl Med 32:1082

    Google Scholar 

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  1. Department of Nuclear Medicine, Southampton General Hospital, S09 4XY, Southampton, UK

    Valerie J. Lewington

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  1. Valerie J. Lewington
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Lewington, V.J. Targeted radionuclide therapy for bone metastases. Eur J Nucl Med 20, 66–74 (1993). https://doi.org/10.1007/BF02261248

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