Targeted "bone-seeking" radiopharmaceuticals for palliative treatment of bone metastases: A systematic review and meta-analysis

G. D'Angelo, R. Sciuto, M. Salvatori, I. Sperduti, G. Mantini, C. L. Maini, G. Marian

Research output: Contribution to journalArticlepeer-review


Aim. The aim of the study was to assess the state of the art of the use of bone-seeking radiopharmaceuticals for palliation therapy of pain from bone metastases. Methods. A systematic literature search was conducted about therapy with 89Sr-chloride and 153Sm-EDTMP between 2001-2011. The primary outcomes were efficacy and toxicity. Descriptive and quantitative data were extracted from each study, calculating event rates and odds ratio (OR) with 95% confidence intervals (CI) for pooled analysis. Subgroup analyses were performed. Results. Fifty-seven studies contributed to the systematic review. Forty-six studies used radiopharmaceuticals as a single agent, 15 investigated therapeutic combinations. Most of the studies included patients with prostate cancer. The overall efficacy of bone-seeking radiopharmaceuticals as single agents was 70%, whereas it was 74% when used in combination with other therapies. Complete response was reported in 27% of patients. Efficacy resulted to be 70% for prostate cancer and 79% for breast cancer. The overall toxicity of radiopharmaceuticals was 15%: the toxicity was 11% selecting only studies reporting on the use of radiopharmaceuticals as a single agent. No significant difference was found between bone-seeking radiopharmaceuticals and other oncological treatments regarding efficacy or toxicity. Reports of objective response outcomes suggest that bone-seeking radiopharmaceuticals have some cytotoxic activity, either alone or combination with chemotherapy. Conclusion. This literature analysis emphasizes multiple evidences of high efficacy and low toxicity of bone seeking radiopharmaceuticals; moreover, this therapy may have a therapeutic potential beyond simple palliation of bone pain.

Original languageEnglish
Pages (from-to)538-543
Number of pages6
JournalQuarterly Journal of Nuclear Medicine and Molecular Imaging
Issue number6
Publication statusPublished - Dec 2012


  • Painful bone metastasis
  • Palliative care
  • Radiopharmaceuticals

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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