Radionuclide Therapy in Palliation of Bony Metastases

Radionuclide Therapy: Palliative, not curative

Historical Approach

              1. Na₃³²PO₄ in 1940’s and 1950’s

§        long history

§        60-75% response rate in literature

§        significant marrow depression- end point is toxicity

§        infrequently used

2.    ⁸⁹SrCl₂ in late 1980’s and ¹⁵³Sm EDTMP in late 1990’s

Indications for Therapy with these drugs:

§        Documented malignancy w/ bone metastases from any primary malignancy- must have a bone scan positive for metastatic disease

§        Significant use of analgesics

§        Life expectancy greater than three months

§        Multiple sites of disease or failure of other therapy

§        May be used in combination with radiotherapy at first painful metastasis or In combination with multi-modality pain therapy
 

Eligibility Criteria: Patient may NOT be treated if

•   WBC count is less than 2,400

•   Platelet count is less than 60,000

•   Patient is pregnant/lactating

•   Patient is moribund (life expectancy < 3 months)