Dolezal, J. (2009). Efficacy and toxicity of 153samarium-EDTMP in painful breast cancer bone metastases. Oncology Research and Treatment, 32, 35–39.
To assess the usefulness of 153Samarium-ethylene-diamino-tetramethylene phosphonic acid (153Sm-EDTMP, a beta and gamma emitter) treatment in the palliation of painful bone metastases from breast cancer.
Study subjects with bone-disseminated breast cancer and bone pain refractory to opioid analgesics received 153Sm-EDTMP. Karnofsky performance status, pain score, analgesic score and blood count were evaluated before treatment and one and three months after treatment.
SITE: Single site
LOCATION: University Hospital Hradec Kralove, Czech Republic
PHASE OF CARE: Active treatment
APPLICATIONS: End of life, palliative care
Prospective, pre-post design
Significant pain relief was observed in 51 (42%) of the patients, mild relief in 30 (30%), and no effect in 19 (28%) of the patients 1 and 3 months after administration, respectively. Mild and transient bone marrow suppression was observed as a side effect (majority had grade 1 or 2 hematologic toxicity, 1 patient had grade 3, and none had grade 4).
Alleviation of pain from bone metastasis can present a challenge, often requiring a multi-modality approach (i.e., palliative external-beam radiation, opioids, biphosphonates). Administration of bone-seeking radiopharmaceuticals have been reported in the literature over the past decade (i.e., 89strontium chloride). 153Sm-EDTMP reportedly has an affinity for skeletal tissue, particularly in osteoblastic bone formations. Patients with bone metastasis from breast cancer often have disseminated, multifocal metastatic sites, which may prove resistant to chemotherapy or endocrine/hormonal therapy. In these situations, external-beam therapy, while beneficial in local treatment, may not be as effective in palliating multiple sites. Therefore, bone radiopharmaceuticals such as 153Sm-EDTMP would be a worthwhile consideration. From this study, it appears to be safe, well-tolerated, and effective in providing pain relief to a varying degree (was observed in 72% of participants).
Bone-seeking radiopharmaceuticals such as 153Sm-EDTMP would be a worthwhile consideration in women with disseminated bone metastatses that have been refractory to chemotherapy or endocrine therapy for palliation of bone pain. Based on this study, it appears to be safe, well-tolerated, and effective in providing pain relief to a varying degree (was observed in 72% of participants).