Original Article

Journal of Bone and Mineral Metabolism

, Volume 32, Issue 4, pp 434-440

Palliative treatment of bone metastases with samarium-153 EDTMP at onset of pain

  • Rosj GallicchioAffiliated withIstituto di Ricovero e Cura Carattere Scientifico, Centro di Riferimento Oncologico di Basilicata
  • , Sabrina GiacomobonoAffiliated withIstituto di Ricovero e Cura Carattere Scientifico, Centro di Riferimento Oncologico di Basilicata
  • , Anna NardelliAffiliated withInstitute of Biostructure and Bioimages, National Council of Research
  • , Teresa PellegrinoAffiliated withInstitute of Biostructure and Bioimages, National Council of Research
  • , Vittorio SimeonAffiliated withIstituto di Ricovero e Cura Carattere Scientifico, Centro di Riferimento Oncologico di Basilicata
  • , Domenico GattozziAffiliated withUniversity of Texas, Southwestern
  • , Francesca MaddalenaAffiliated withIstituto di Ricovero e Cura Carattere Scientifico, Centro di Riferimento Oncologico di Basilicata
  • , Pierpaolo MainentiAffiliated withInstitute of Biostructure and Bioimages, National Council of Research
  • , Giovanni StortoAffiliated withIstituto di Ricovero e Cura Carattere Scientifico, Centro di Riferimento Oncologico di Basilicata Email author 

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Abstract

We evaluated the pain response and daily discomfort in patients suffering from a borderline degree of bone pain due to breast or lung cancer bone metastases, who had undergone early palliative radionuclide treatment. The results were compared with those from patients who had received standard analgesic therapy. Twenty-one patients (65.7 ± 3 years; 17 women) with metastatic bone cancer underwent samarium-153 (Sm-153) ethylene diamine tetramethylene phosphonate (EDTMP) administration (group A) and 18 patients (64.3 ± 8 years; 16 women) continued to receive standard analgesics (group B; control group). The patients kept a daily pain diary assessing both their discomfort and the pain at specific sites by means of a visual analog scale, rating from 0 (no discomfort–no pain) to 10 (worst discomfort–pain). These diaries were reviewed weekly for 2 months and three physicians rated the pain response on a scale from −2 (considerable deterioration) to +2 (considerable improvement). Baseline characteristics were similar in both groups. The reduction of total discomfort and of bone pain in group A was significantly greater compared to group B (p < 0.0001). A significant improvement of clinical conditions was observed in group A, where the physician rate changed from −1 to 1, compared to group B in which the rate changed from −1 to 0. Sm-153 EDTMP therapy can be considered for patients with bone pain from breast and lung cancer in advance, i.e., before the establishment of severe pain syndrome.

Keywords

Low degree bone pain Palliation Radionuclide therapy Sm-153 EDTMP