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European Journal of Nuclear Medicine

, Volume 27, Issue 10, pp 1487–1493 | Cite as

Treatment of bone metastases of prostate cancer with strontium-89 chloride: efficacy in relation to the degree of bone involvement

  • Françoise Kraeber-Bodéré
  • Loïc Campion
  • Caroline Rousseau
  • Sylvain Bourdin
  • Jean-François Chatal
  • Isabelle Resche
Original Article

Abstract.

This retrospective study evaluated the toxicity and efficacy of strontium-89 chloride (Metastron, Amersham) in 94 patients with painful bone metastases of prostate cancer (117 injections of 150 MBq) and compared the efficacy of treatment in patients with moderate and extensive bone involvement. The predictive value of flare response with regard to analgesic response was also studied. High-grade leukothrombopenias were observed after only 5% of injections. An improvement in quality of life was obtained in 65% of cases, a decrease in pain in 78% (31% complete response) and a reduction of analgesics in 60%. Efficacy was significantly better for pain decrease (P=0.005) and reduction of analgesics (P=0.018), and response was significantly longer (P<0.0035) in patients with moderate than in patients with extensive bone involvement. The flare response observed in 23% of cases was not predictive of pain response (P=0.919) or reduction of analgesics (P=0.353). A second dose prolonged analgesia in three-quarters of cases without any apparent increase in toxicity. These results confirm the benefit of 89Sr chloride for the treatment of metastatic bone pain and suggest that internal radiotherapy should be started earlier. A bone scan could be proposed at the time of hormonal escape resulting in bone pain, and internal radiotherapy could be initiated when several metastatic foci exist, even if only one is painful. In this way, pain-free follow-up could be prolonged, and the transition to other therapeutic approaches, particularly opioids, delayed.

Internal radiotherapy Strontium-89 Pain Metastases Prostate cancer 

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Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • Françoise Kraeber-Bodéré
    • 1
  • Loïc Campion
    • 1
  • Caroline Rousseau
    • 1
  • Sylvain Bourdin
    • 1
  • Jean-François Chatal
    • 1
  • Isabelle Resche
    • 1
  1. 1.René Gauducheau Cancer Center, NantesFrance

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