Abstract | PURPOSE: The aim of this study was to evaluate the degree of metastatic bone pain palliation and medullar toxicity associated with samarium-153-EDTMP treatment. METHODS: Seventy-three patients with metastatic bone pain having previously undergone therapy with samarium-153-EDTMP (1 mCi/kg) were retrospectively evaluated. Routine follow-up included pain evaluation and blood counts for 2 months after treatment. Pain was evaluated using a subjective scale (from 0 to 10) before and for 8 weeks after the treatment. Blood counts were obtained before treatment and once a week for 2 months during follow-up. Dosimetry, based upon the urinary excretion of the isotope, was estimated in 41 individuals, and the resulting radiation absorbed doses were correlated with hematological data. RESULTS: Reduction in pain scores of 75% to 100% was obtained in 36 patients (49%), with a decrease of 50% to 75%, 25% to 50%, and 0% to 25% in, respectively, 20 (27%), 10 (14%), and 7 (10%) patients. There was no significant relationship between the pain response and location of the primary tumor (breast or prostate cancer). Mild to moderate myelosuppression was noted in 75.3% of patients, usually with hematological recovery at 8 weeks. The mean bone marrow dose was 347 +/- 65 cGy, and only a weak correlation was found between absorbed dose and myelosuppression (Pearson coefficient = .4). CONCLUSIONS:
Samarium-153-EDTMP is a valuable method for metastatic bone pain palliation. A mild to moderate and transitory myelosuppression is the main toxicity observed after samarium therapy, showing a weak correlation with dosimetric measures.
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Authors | Marcelo Tatit Sapienza, Carla Rachel Ono, Maria Inês Cury Guimarães, Tomoco Watanabe, Paulo Aguirre Costa, Carlos Alberto Buchpiguel |
Journal | Revista do Hospital das Clinicas
(Rev Hosp Clin Fac Med Sao Paulo)
Vol. 59
Issue 6
Pg. 321-8
(Dec 2004)
ISSN: 0041-8781 [Print] Brazil |
PMID | 15654484
(Publication Type: Evaluation Study, Journal Article)
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Chemical References |
- Analgesics, Non-Narcotic
- Organometallic Compounds
- Organophosphorus Compounds
- samarium Sm-153 lexidronam
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Analgesics, Non-Narcotic
(administration & dosage, adverse effects)
- Bone Marrow
(radiation effects)
- Bone Neoplasms
(complications, radiotherapy, secondary)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Organometallic Compounds
(administration & dosage, adverse effects)
- Organophosphorus Compounds
(administration & dosage, adverse effects)
- Pain
(etiology, radiotherapy)
- Pain Measurement
- Palliative Care
(methods)
- Retrospective Studies
- Time Factors
- Treatment Outcome
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