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REVIEWS  BONE METASTASES 2011:NEW ACHIEVEMENTS OF DIAGNOSTIC AND THERAPEUTIC NUCLEAR MEDICINE 

The Quarterly Journal of Nuclear Medicine and Molecular imaging 2011 August;55(4):420-30

Copyright © 2011 EDIZIONI MINERVA MEDICA

language: English

The Vienna protocol and perspectives in radionuclide therapy

Sinzinger H. 1, 2, Palumbo B. 3, Özker K. 4, 5

1 Department of Nuclear Medicine, Medical University of Vienna, Vienna, Austria; 2 ISOTOPIX - Institute for Nuclear Medicine, Vienna, Austria; 3 Institute of Nuclear Medicine, University of Perugia, Perugia, Italy; 4 Dubai Health Authority, Dubai Hospital, Dubai, United Arab Emirates; 5 Medicheck, Istanbul, Turkey


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The Vienna protocol for [153]Sm-EDTMP-therapy is based on the experience of the last two decades. Repeated treatments at a low dose are applied by several authors in order to achieve the maximum therapeutic effect with the lowest haematological toxicity. Significant benefits on pain palliation and some regression are documented. In contrast to earlier claims, [153]Sm-EDTMP treatment should be started as soon as more than 1 bone lesion appears in bone scintigraphy and/or bone pain becomes evident. Prospective randomized controlled studies, however, are urgently warranted in order to assess benefits beyond bone pain palliation on an evidence base. The combination with chemotherapy as well as radiotherapy may further improve the clinical results. Further research should be directed to identify underlying mechanisms of response and predictors of benefit and to elaborate an improved therapeutic schedule for further enhancing the response rate.

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