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ULTIMO FASCICOLOTHE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Rivista di Medicina Nucleare e Imaging Molecolare

A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413

Periodicità: Trimestrale

ISSN 1824-4785

Online ISSN 1827-1936

 

The Quarterly Journal of Nuclear Medicine 2001 Marzo;45(1):100-107

NUCLEAR MEDICINE APPLICATIONS FOR BONE METASTASES 

Radionuclide therapy for painful bone metastases. An Italian Multicentre Observational Study

Piffanelli A., Dafermou A., Giganti M., Colamussi P., Pizzocaro C. *, Bestagno M. *

From the Service of Nuclear Medicine University of Ferrara
*Spedali Civili, Brescia, Italy

Background. It has ­been ­affirmed ­that obser­va­tion­al stud­ies ­give anal­o­gous ­results to ran­dom­ised con­trolled ­ones.
Methods. A mul­ti­cen­tre obser­va­tion­al ­trial was con­duct­ed ­between 1996-1998 in ­order to eval­u­ate the effi­ca­cy of pal­li­a­tive radio­nu­clide ther­a­py for ­bone metas­ta­ses in a ­large num­ber of ­patients. An eval­u­a­tion was ­made on 510 ­patients ­with pros­tate can­cer and pain­ful ­bone metas­ta­ses, treat­ed ­with a sin­gle i.v. ­dose of 89Sr-chlo­ride (527 treat­ments) or 186Re-­HEDP (83 treat­ments), in 29 Italian Nuclear Medicine Departments. Eighty-one ­patients ­received up to ­five injec­tions, total­ling 100 retreat­ments. Patients ­were fol­lowed up for a peri­od of 3 ­months-2 ­years. Results ­were ­expressed at ­four lev­els of ­response: excel­lent, ­good, ­mild, and nil.
Results. Responses ­were excel­lent in 26.4%, ­good in 33.3%, ­mild in 21.3% and nil in 19% of all treat­ments, ­while ­good and excel­lent respons­es ­were ­obtained in 48% of retreat­ments. No sta­tis­ti­cal­ly sig­nif­i­cant cor­re­la­tions ­were ­found ­between ­response and age of ­patients, skel­e­tal exten­sion of ­tumour, prether­a­peu­tic PSA lev­els, evi­dence of non-­bony metas­ta­ses, pre­vi­ous chem­o­ther­a­py and/or exter­nal-­beam radio­ther­a­py; oste­o­lyt­ic ­lesions respond­ed ­worse ­than oste­o­blas­tic or ­mixed ­ones. Hematological tox­ic­ity (­mild to mod­er­ate), main­ly affect­ing plate­lets, was ­observed in 25.5% of all treat­ments and in 38.9% of retreat­ments. No ­clear dif­fer­enc­es ­were ­found ­between the two radio­phar­ma­ceu­ti­cals ­employed.
Conclusions. Bearing in ­mind ­that obser­va­tion­al stud­ies can pro­vide ­just as accu­rate ­results as ran­dom­ised con­trolled ­trials, ­this ­study con­firms the ­main find­ings of var­i­ous lim­it­ed mono­cen­tre ­trials.

lingua: Inglese


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