Short- and long-term effects of 186Re-1,1-hydroxyethylidene diphosphonate in the treatment of painful bone metastases

Rosa Sciuto, Anna Tofani, Anna Festa, Diana Giannarelli, Rosella Pasqualoni, Carlo L. Maini

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Abstract

This study evaluates the short- and long-term therapeutic efficacy of 186Re-1,1-hydroxyethylidene diphosphonate (HEDP) in the palliation of painful bone metastases and the influence of variables before therapy in determining the characteristics of pain palliation. Methods: Sixty patients with painful bone metastases from different tumor types were treated with 1406 MBq 186Re-HEDP. After treatment, the patients were followed up clinically at weekly intervals for the first month and monthly thereafter up to 1 y, until death or pain relapse. Pain response was graded as complete, partial, minimal, or absent using the Wisconsin test scoring system. Duration of pain relief, performance status, tumor markers, serum alkaline phosphatase levels, hematologic toxicity, and metastatic bone progression were also evaluated. Results: Overall, 80% of individuals experienced prompt relief of pain, with 31% complete, 34% partial, and 15% minimal responses. Transient World Health Organization grade 1-2 hematologic toxicity was apparent, with a decrease in the mean platelet (32%) and mean leukocyte (18%) counts at 3 and 4 wk, respectively. The degree of pain response did not correlate with any pretreatment variable. The duration of pain relief ranged from 3 wk to 12 mo and correlated positively with the degree of response (P = 0.02) and negatively with pretreatment scintigraphic scores and alkaline phosphatase levels (P = 0.02). Conclusion: 186Re-HEDP is effective for fast palliation of painful bone metastases from various tumors. The effect tends to last longer if patients are treated early in the course of their disease.

Original languageEnglish
Pages (from-to)647-654
Number of pages8
JournalJournal of Nuclear Medicine
Volume41
Issue number4
Publication statusPublished - Apr 2000

Fingerprint

Diphosphonates
Neoplasm Metastasis
Bone and Bones
Pain
Therapeutics
Alkaline Phosphatase
Tumor Biomarkers
Leukocyte Count
Neoplasms
Blood Platelets
Recurrence
Serum

Keywords

  • Re-hydroxyethylidene diphosphonate
  • Bone metastases
  • Radionuclide therapy

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Short- and long-term effects of 186Re-1,1-hydroxyethylidene diphosphonate in the treatment of painful bone metastases. / Sciuto, Rosa; Tofani, Anna; Festa, Anna; Giannarelli, Diana; Pasqualoni, Rosella; Maini, Carlo L.

In: Journal of Nuclear Medicine, Vol. 41, No. 4, 04.2000, p. 647-654.

Research output: Contribution to journalArticle

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abstract = "This study evaluates the short- and long-term therapeutic efficacy of 186Re-1,1-hydroxyethylidene diphosphonate (HEDP) in the palliation of painful bone metastases and the influence of variables before therapy in determining the characteristics of pain palliation. Methods: Sixty patients with painful bone metastases from different tumor types were treated with 1406 MBq 186Re-HEDP. After treatment, the patients were followed up clinically at weekly intervals for the first month and monthly thereafter up to 1 y, until death or pain relapse. Pain response was graded as complete, partial, minimal, or absent using the Wisconsin test scoring system. Duration of pain relief, performance status, tumor markers, serum alkaline phosphatase levels, hematologic toxicity, and metastatic bone progression were also evaluated. Results: Overall, 80{\%} of individuals experienced prompt relief of pain, with 31{\%} complete, 34{\%} partial, and 15{\%} minimal responses. Transient World Health Organization grade 1-2 hematologic toxicity was apparent, with a decrease in the mean platelet (32{\%}) and mean leukocyte (18{\%}) counts at 3 and 4 wk, respectively. The degree of pain response did not correlate with any pretreatment variable. The duration of pain relief ranged from 3 wk to 12 mo and correlated positively with the degree of response (P = 0.02) and negatively with pretreatment scintigraphic scores and alkaline phosphatase levels (P = 0.02). Conclusion: 186Re-HEDP is effective for fast palliation of painful bone metastases from various tumors. The effect tends to last longer if patients are treated early in the course of their disease.",
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