Home > Journals > The Quarterly Journal of Nuclear Medicine and Molecular Imaging > Past Issues > The Quarterly Journal of Nuclear Medicine 2001 March;45(1) > The Quarterly Journal of Nuclear Medicine 2001 March;45(1):78-83

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions

 

  NUCLEAR MEDICINE APPLICATIONS FOR BONE METASTASES 

The Quarterly Journal of Nuclear Medicine 2001 March;45(1):78-83

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Bone pain palliation with Strontium-89 in cancer patients with bone metastases

Giammarile F. *, Mognetti T. **, Resche I. ***

From the Nuclear Medicine Department, *Centre Léon Bérard, Lyon, France **Centre Hospitalier Universitaire Edouard Herriot, Lyon, France ****Centre René Gauducheau, Nantes, France


PDF


Strontium-89 is a ­pure ­β-emit­ting radio­iso­tope, a chem­i­cal ana­logue of cal­cium, and it is there­fore avid­ly con­cen­trat­ed by are­as of ­high oste­o­blas­tic activ­ity. Selective ­uptake and pro­longed reten­tion at ­sites of ­increased ­bone min­er­al turn­over pro­vide pre­cise ­bone ­lesions tar­get­ing. 89Sr chlo­ride (com­mer­cial­ised as Metastron®) is typ­i­cal­ly admin­is­tered in a sin­gle 150 MBq paren­ter­al ­dose. Its radio­ac­tive emis­sion pos­es ­very lit­tle radio­pro­tec­tion con­cerns. Overall, stud­ies ­show ­pain ­relief in up to 80% of ­patients, of ­which 10 to 40% ­became effec­tive­ly ­pain ­free. The ­mean dura­tion of pal­li­a­tion was 3-4 ­months. The mech­a­nism of ­pain ­relief is con­tro­ver­sial ; it is prob­ably, but not ­only, relat­ed to the ­absorbed ­dose in the ­tumour and ­bone. There is no ­clear ­dose-­response rela­tion­ship. The ­only report­ed tox­ic­ity is tem­po­rary mye­lo­sup­pres­sion. WBC and plate­lets ­should be mon­i­tored at ­least on a week­ly ­basis ­until ­they ­return to base­line. It ­seems ­that ­only ­patients ­with a rea­son­ably ­good gen­er­al con­di­tion ­stand to ben­e­fit ­from ­this treat­ment. In con­clu­sion, system­ic radio­nu­clide ther­a­py ­using 89Sr rep­re­sents a fea­sible, ­safe, effec­tive, ­well tol­er­at­ed and ­cost-effec­tive pal­li­a­tive treat­ment in ­patients ­with refrac­to­ry ­bone ­pain.

top of page