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Radionuclide Therapy

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Bone Metastases

Part of the book series: Cancer Metastasis - Biology and Treatment ((CMBT,volume 21))

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Abstract

Bone pain due to skeletal metastases constitutes the most common type of chronic pain among patients with cancer. Almost 65 % of patients with prostate or breast cancer and 35 % of those with advanced lung, thyroid and kidney cancers will have symptomatic skeletal metastases. Painful osseous metastases are known to significantly decrease the patient’s quality of life and are associated with co-morbidities such as spinal cord and nerve injury, hypercalcemia, depression and pathologic fractures. The treatment of bone pain is challenging and involves a multidisciplinary approach with a combination of therapeutic modalities. In patients with extensive osseous metastases, systemic radionuclide therapy should be part of the adjunctive therapy for pain palliation. In this chapter, we discuss the most common approved and clinically used radionuclides for bone pain palliation, focusing on indications, patient selection, efficacy, and different biochemical characteristics and toxicity. We will cover Strontium-89 chloride (Sr-89), Samarium-153 lexidronam (Sm-153) and Rhenium-186 etidronate (Re-186). A brief discussion on the available data on Rhenium-188 (Re-188) is also presented focusing on its major advantages and disadvantages. In the end, we perform a concise appraisal of the available data on combination therapy of radiopharmaceuticals with biphosphonates or chemotherapy.

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  1. Department of Radiology, University of Miami/Jackson Memorial Medical Center, 1611 N.W. 12th Avenue, West Wing - 279, Miami, FL, 33136, USA

    Fabio M. Paes M.D.

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  1. Fabio M. Paes M.D.
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Correspondence to Fabio M. Paes M.D. .

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  1. Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus

    Vassilios Vassiliou

  2. Dept. Radiation Oncology, University of Toronto Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

    Edward Chow

  3. Dept. Radiation Oncology, University of Patras Medical School, Patras, Greece

    Dimitrios Kardamakis

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Paes, F.M. (2014). Radionuclide Therapy. In: Vassiliou, V., Chow, E., Kardamakis, D. (eds) Bone Metastases. Cancer Metastasis - Biology and Treatment, vol 21. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7569-5_10

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