Abstract
Background
Although the use of Sr-89 chloride in the treatment of patients with prostate and breast cancer has been widely reported, little information is available about its use for other malignancies. Here, we retrospectively analyzed the clinical profile of Sr-89 chloride in various patients with painful bone metastases.
Methods
Entry criteria were a pathologically proven malignancy, clinically diagnosed multiple bone metastases, and adequate organ function. Sr-89 chloride (Metastron) was given by single intravenous infusion at 2 MBq/kg over 2 min. Self-reported outcome measures were used as a response index, including pain diary data on a 0–10 numeric rating scale (NRS).
Results
Fifty-four consecutive patients with painful bone metastases were treated with Sr-89 chloride at the National Cancer Center Hospital East between March 2009 and July 2011, consisting of 26 with breast/prostate cancer and 28 with other malignancies (lung 8, head and neck 6, colorectal 6, others 8). Thirteen (24 %) patients experienced a transient increase in pain, which was categorized as a flare-up response. Grade 3–4 anemia was observed in 6 patients, 3 of whom required blood transfusion. Regarding efficacy, response rates and complete response rates were 71.2 % and 34.6 %, respectively, and time to response from the initiation of treatment was 36 days (range, 13–217). No significant difference in response rates was seen between patients with breast/prostate cancer and other cancers (breast/prostate 69.2 %, other 73.1 %; p = 0.76).
Conclusions
As in patients with breast and prostate cancer, Sr-89 chloride is a promising agent for the treatment of painful bone metastases in patients with various other malignancies.
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References
Paes FM, Serafini AN (2010) Systemic metabolic radiopharmaceutical therapy in the treatment of metastatic bone pain. Semin Nucl Med 40:89–104
Taylor AJ Jr (1994) Strontium-89 for the palliation of bone pain due to metastatic disease. J Nucl Med 35:2054
Lam MG, de Klerk JM, van Rijk PP et al (2007) Bone seeking radiopharmaceuticals for palliation of pain in cancer patients with osseous metastases. Anticancer Agents Med Chem 7:381–397
Blake GM, Zivanovic MA, Blaquiere RM et al (1988) Strontium-89 therapy: measurement of absorbed dose to skeletal metastases. J Nucl Med 29:549–557
Fuster D, Herranz D, Vidal-Sicart S et al (2000) Usefulness of strontium-89 for bone pain palliation in metastatic breast cancer patients. Nucl Med Commun 21:623–626
Turner SL, Gruenewald S, Spry N et al (2001) Less pain does equal better quality of life following strontium-89 therapy for metastatic prostate cancer. Br J Cancer 84:297–302
Baczyk M, Milecki P, Baczyk E et al (2003) The effectivness of strontium-89 in palliative therapy of painful prostate cancer bone metastases. Ortop Traumatol Rehabil 5:364–368
Ashayeri E, Omogbehin A, Sridhar R et al (2002) Strontium-89 in the treatment of pain due to diffuse osseous metastases: a university hospital experience. J Natl Med Assoc 94:706–711
Kraeber-Bodere F, Campion L, Rousseau C et al (2000) Treatment of bone metastases of prostate cancer with strontium-89 chloride: efficacy in relation to the degree of bone involvement. Eur J Nucl Med 27:1487–1493
Paice JA, Cohen FL (1997) Validity of a verbally administered numeric rating scale to measure cancer pain intensity. Cancer Nurs 20:88–93
Williamson A, Hoggart B (2005) Pain: a review of three commonly used pain rating scales. J Clin Nurs 14:798–804
Gunawardana DH, Lichtenstein M, Better N et al (2004) Results of strontium-89 therapy in patients with prostate cancer resistant to chemotherapy. Clin Nucl Med 29:81–85
Smeland S, Erikstein B, Aas M et al (2003) Role of strontium-89 as adjuvant to palliative external beam radiotherapy is questionable: results of a double-blind randomized study. Int J Radiat Oncol Biol Phys 56:1397–1404
Windsor PM (2001) Predictors of response to strontium-89 (Metastron) in skeletal metastases from prostate cancer: report of a single centre’s 10-year experience. Clin Oncol (R Coll Radiol) 13:219–227
Laing AH, Ackery DM, Bayly RJ et al (1991) Strontium-89 chloride for pain palliation in prostatic skeletal malignancy. Br J Radiol 64:816–822
Schmeler K, Bastin K (1996) Strontium-89 for symptomatic metastatic prostate cancer to bone: recommendations for hospice patients. Hosp J 11:1–10
Firusian N (1978) Endo-osseous isotope therapy of malignant skeletal disease (author’s translation). Z Krebsforsch Klin Onkol Cancer Res Clin Oncol 91:143–156
Silberstein EB, Williams C (1985) Strontium-89 therapy for the pain of osseous metastases. J Nucl Med 26:345–348
Acknowledgments
This study was supported by a Ministry of Education, Culture, Sports, Science and Technology scientific research grant.
Conflict of interest
We have no conflict of interest.
Ethical standard
In the present study, written informed consent for treatment was obtained from all patients before the initiation of treatment. This study was approved in Institutional Review Board of National Cancer Center Hospital, Japan.
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Zenda, S., Nakagami, Y., Toshima, M. et al. Strontium-89 (Sr-89) chloride in the treatment of various cancer patients with multiple bone metastases. Int J Clin Oncol 19, 739–743 (2014). https://doi.org/10.1007/s10147-013-0597-7
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DOI: https://doi.org/10.1007/s10147-013-0597-7