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Shinto AS, Mallia MB, Kameswaran M, Kamaleshwaran KK, Joseph J, Radhakrishnan ER, Upadhyay IV, Subramaniam R, Sairam M, Banerjee S, Dash A. Clinical utility of 188Rhenium-hydroxyethylidene-1,1-diphosphonate as a bone pain palliative in multiple malignancies. World J Nucl Med 2018; 17:228-235. [PMID: 30505219 PMCID: PMC6216741 DOI: 10.4103/wjnm.wjnm_68_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
188Rhenium-hydroxyethylidene-1,1-diphosphonate (188Re-HEDP) is a clinically established radiopharmaceutical for bone pain palliation of patients with metastatic bone cancer. Herein, the effectiveness of 188Re-HEDP for the palliation of painful bone metastases was investigated in an uncontrolled initial trial in 48 patients with different types of advanced cancers. A group of 48 patients with painful bone metastases of lung, prostate, breast, renal, and bladder cancer was treated with 2.96–4.44 GBq of 188Re-HEDP. The overall response rate in this group of patients was 89.5%, and their mean visual analog scale score showed a reduction from 9.1 to 5.3 (P < 0.003) after 1 week posttherapy. The patients did not report serious adverse effects either during intravenous administration or within 24 h postadministration of 188Re-HEDP. Flare reaction was observed in 54.2% of patients between day 1 and day 3. There was no correlation between flare reaction and response to therapy (P < 0.05). Although bone marrow suppression was observed in patients receiving higher doses of 188Re-HEDP, it did not result in any significant clinical problems. The present study confirmed the clinical utility and cost-effectiveness of 188Re-HEDP for palliation of painful bone metastases from various types of cancer in developing countries.
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Affiliation(s)
- Ajit S Shinto
- Department of Nuclear Medicine and PET/CT, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Madhava B Mallia
- Division of Radiopharmaceuticals, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
| | - Mythili Kameswaran
- Division of Radiopharmaceuticals, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
| | - K K Kamaleshwaran
- Department of Nuclear Medicine and PET/CT, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Jephy Joseph
- Department of Nuclear Medicine and PET/CT, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - E R Radhakrishnan
- Department of Nuclear Medicine and PET/CT, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Indira V Upadhyay
- Department of Nuclear Medicine and PET/CT, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - R Subramaniam
- Department of Radiation Oncology, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Madhu Sairam
- Department of Radiation Oncology, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Sharmila Banerjee
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
| | - Ashutosh Dash
- Division of Radiopharmaceuticals, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
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Vaez-Tehrani M, Zolghadri S, Yousefnia H, Afarideh H. Human absorbed dose estimation for a new (175)Yb-phosphonate based on rats data: Comparison with similar bone pain palliation agents. Appl Radiat Isot 2016; 115:55-60. [PMID: 27337650 DOI: 10.1016/j.apradiso.2016.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 06/07/2016] [Accepted: 06/12/2016] [Indexed: 10/21/2022]
Abstract
In this work, the absorbed dose to human organs for (175)Yb-BPAMD was evaluated based on the biodistribution studies in rats. The results showed that the bone surface would receive the highest absorbed dose after injection of (175)Yb-BPAMD with 13.32mGy/MBq, while the other organs receive insignificant absorbed dose. Also, the comparison of (175)Yb-BPAMD with other therapeutic phosphonate complexes demonstrated noticeable characteristics for this new agent. Generally, based on the obtained results, (175)Yb-BPAMD can be considered as a promising agent for bone pain palliative therapy in near future.
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Affiliation(s)
- Mahdokht Vaez-Tehrani
- Energy Engineering and Department of Physics, Amir Kabir University of Technology, Tehran, Iran
| | - Samaneh Zolghadri
- Nuclear Science and Technology Research Institute (NSTRI), 14155-1339 Tehran, Iran
| | - Hassan Yousefnia
- Nuclear Science and Technology Research Institute (NSTRI), 14155-1339 Tehran, Iran
| | - Hossein Afarideh
- Energy Engineering and Department of Physics, Amir Kabir University of Technology, Tehran, Iran
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Scarpi E, Calistri D, Klepstad P, Kaasa S, Skorpen F, Habberstad R, Nanni O, Amadori D, Maltoni M. Clinical and genetic factors related to cancer-induced bone pain and bone pain relief. Oncologist 2014; 19:1276-83. [PMID: 25342315 DOI: 10.1634/theoncologist.2014-0174] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The study objective was to evaluate whether there are clinical or genetic differences between patients with cancer-induced bone pain (CIBP) and patients with non-CIBP, and, in the CIBP group, in those with good versus poor opioid response. MATERIALS AND METHODS A total of 2,294 adult patients with cancer who were receiving opioids for moderate or severe pain were included in the European Pharmacogenetic Opioid Study. Pain intensity and pain relief were measured using the Brief Pain Inventory. Linkage disequilibrium of 112 single nucleotide polymorphisms was evaluated in 25 candidate genes, and 43 haplotypes were assessed. Correlations among demographical factors, disease-related factors, genetic factors, CIBP, and pain relief were analyzed by logistic regression models corrected for multiple testing. Patients with bone metastases and bone/soft tissue pain were defined as having prevalent bone pain (CIBP population). This population was compared with patients who had other types of cancer pain (non-CIBP). RESULTS A total of 577 patients (26.2%) had CIBP, and 1,624 patients (73.8%) had non-CIBP. Patients with CIBP had more breakthrough cancer pain episodes (64.2% vs. 56.4%, p = .001), had significantly higher pain interference in "walking ability in the past 24 hours" (p < .0001), used more adjuvant drugs (84.1% vs. 78.3%, p = .003), and had a higher, albeit nonsignificant, median overall survival (3.8 vs. 2.9 months, p = .716) than patients with non-CIBP. None of the examined haplotypes exceeded p values corrected for multiple testing for the investigated outcomes. CONCLUSION Patients with CIBP who were taking opioids had a clinical profile slightly different from that of the non-CIBP group. However, no specific genetic pattern emerged for CIBP versus non-CIBP or for responsive versus nonresponsive patients with CIBP.
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Affiliation(s)
- Emanuela Scarpi
- Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Daniele Calistri
- Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Pål Klepstad
- Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stein Kaasa
- Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Frank Skorpen
- Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ragnhild Habberstad
- Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Oriana Nanni
- Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dino Amadori
- Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marco Maltoni
- Biostatistics and Clinical Trials Unit, Biosciences Laboratory, Department of Medical Oncology, and Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy; Department of Anesthesiology and Intensive Care Medicine and Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway; European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Department of Circulation and Medical Imaging, and Department of Laboratory Medicine, Children's and Women's Health and European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Ratasvuori M, Wedin R, Hansen BH, Keller J, Trovik C, Zaikova O, Bergh P, Kalen A, Laitinen M. Prognostic role of en-bloc resection and late onset of bone metastasis in patients with bone-seeking carcinomas of the kidney, breast, lung, and prostate: SSG study on 672 operated skeletal metastases. J Surg Oncol 2014; 110:360-5. [PMID: 24889389 DOI: 10.1002/jso.23654] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/24/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES In metastatic disease, decisions regarding potential surgery require reliable data about the patient's survival. In this study, we evaluated different prognostic factors and their impact in four common primary tumors causing bone metastases. METHODS Data were acquired from the Scandinavian Sarcoma Group (SSG) metastasis registry. The patients underwent surgery between July 1999 and July 2009. This study included breast, prostate, lung, and kidney cancer cases, with a total of 672 operated non-spinal metastases. Differences in prognostic factors were evaluated using the Kaplan-Meier method with long-rank test. Cox regression multivariate analysis was performed to identify statistically independent prognostic factors. RESULTS Significant factors affecting survival were the presence of organ metastases, overall heath status, and disease load. In kidney cancer, en bloc resection of solitary metastases was associated with a significant fourfold longer survival compared to intralesional surgery. Preoperative radiotherapy was associated with higher complication and reoperation rates. CONCLUSIONS This data summary is important tool for clinicians to evaluate survival and choose treatment options for patients suffering from metastatic bone disease.
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Affiliation(s)
- Maire Ratasvuori
- Departement of Surgery, South Karelian Central Hospital, Lappeenranta, Finland; Department of Orthopedics, Unit of Musculoskeletal Surgery, Tampere University Hospital, Tampere, Finland
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