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Strontium-89 (Sr-89) chloride in the treatment of various cancer patients with multiple bone metastases

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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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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Correspondence to Sadamoto Zenda.

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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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Keywords

  • Palliative care
  • Radiation oncology
  • Radiation therapy
  • Radionuclide
  • Pain control