Download PDF
TumorDiagnostik & Therapie 2001; 22(4): 41-47
DOI: 10.1055/s-2001-16996
ÜBERSICHT/REVIEW

© Georg Thieme Verlag Stuttgart · New York

Nuklearmedizinische Schmerztherapie von Skelettmetastasen

Radionuclide therapy in metastatic bone diseaseC. Muhle, W. Brenner, W. U. Kampen, N. Czech, E. Henze
  • Klinik für Nuklearmedzin, Universitätsklinikum Kiel (Direktor: Prof. Dr. med. E. Henze)
Further Information

Publication History

Publication Date:
12 September 2001 (online)

Also available at
    Permissions and Reprints

Zusammenfassung.

Patienten mit schmerzhaften Knochenmetastasen sind ein häufig zu beobachtendes Phänomen in vielen onkologischen Abteilungen. Neben der medikamentösen Schmerztherapie und perkutanen Strahlentherapie stellt die nuklearmedizinsche Schmerztherapie mit Samarium-153 EDTMP, Rhenium-186 HEDP und Strontium-89 ein effektives Therapieverfahren in der Behandlung von Patienten mit multilokulärer osteoblastischer Metastasierung und ausgeprägter Schmerzsymptomatik dar. Bei richtiger Indikationsstellung und Durchführung weist dieses palliative Verfahren eine hohe Ansprechrate mit Schmerzlinderung und Verbesserung der Lebensqualität auf.

Radionuclide therapy in metastatic bone disease.

In a high number of patients bone pain from osteoblastic metastases is a frequently observed problem at an Oncology Department. Besides medical treatment and percutaneous irradiation, systemic radionuclide therapy is an effective treatment for patients with cancer metastatic to bone which presents with progressive pain. Used in the appropriate setting, this form of palliative therapy in patients with painful osteoblastic metastases can be of great benefit to a large number of patients by pain relief and increase of life quality.

Schlüsselwörter:

Radionuklid-Therapie - Skelettmetastasen - 89Sr - 186Re-HEDP - 153Sm-EDTMP

Key words:

Radionuclide therapy - Skeletal metastases - 89Sr - 186Re-HEDP - 153Sm-EDTMP

Literatur

  • 1 Zykla-Menhorn. . Zeitbombe des Alterns.  Deutsches Ärztebl. 2000;  97 (6) 253
    PubMedGoogle Scholar
  • 2 Twycross R G, Fairfielda S. Pain in far-advanced cancer.  Pain. 1982;  14 303-310
    CrossrefPubMedGoogle Scholar
  • 3 Nielsen O D, Munro A J, Tannock I F. Bone metastases: physiology and management policy.  J Clin Oncol. 1991;  9 509
    PubMedGoogle Scholar
  • 4 Hortobagyi G N. Bone metastases in breast cancer patients.  Semin Oncol. 1991;  18 11
    PubMedGoogle Scholar
  • 5 CIS Bio International . Metastases osseuses: prise en charge de la doulur metastatique.  Internal Report. 1993;  14
    PubMedGoogle Scholar
  • 6 Coleman R E, Rubens S. The clinical course of bone metastases from breast cancer.  Br J Cancer. 1987;  55 61
    CrossrefPubMedGoogle Scholar
  • 7 McEwan A J. Palliation of bone pain. In: Murray IPC, Ell PJ (eds) Nuclear medicine in Clinical Diagnosis and Treatment. Edinburgh; Churchill Livingston 1994: 877-892
    Google Scholar
  • 8 Averbuch S D. New bisphosphonates in the treatment of bone metastases.  Cancer. 1993;  72 3443-3452
    PubMedGoogle Scholar
  • 9 Fischer M, Böhme K. Nuklearmedizinische Schmerztherapie bei metastasiertem Prostatakarzinom.  Der Nuklearmediziner. 1996;  5 (19) 339-344
    PubMedGoogle Scholar
  • 10 Heoderath A, Schüle-Hein K, Sack H. Palliative Strahlentherapie. In: Scherer E, Ack H (Hrsg) Strahlentherapie: Radiologische Onkologie. Berlin, Heidelberg; Springer 1996: 897-920
    Google Scholar
  • 11 World Health Organization. Cancer pain relief Geneva; World Health Organization 1991
  • 12 Hoskin P J. Radiotherapy in the management of bone metastases. In: Rubens, Fogelman (eds) Bone metastases. London; Springer 1991: 171-185
    Google Scholar
  • 13 Mertens W C, Reid R H, Porter A T, Powe J E. Recent advances in radionuclide therapy of bone metastases. In: Freeman LM (ed) Nuclear medicine annual. New York; Raven Press 1992: 69-89
    Google Scholar
  • 14 Pons F, Herranz R, Garcia A, Vidal-Sicart S, Conill C, Grau J J, Alcover J, Fuster D, Setoain J. Strontium-89 for palliation of pain from bone metastases in patients with prostate and breast cancer.  Eur J Nuc Med. 1997;  24 1210-1214
    PubMedGoogle Scholar
  • 15 Silberstein E B. Systemic radiopharmaceutical therapy of painful osteoblastic metastases.  Semin Radiat Oncol. 2000;  10 240-249
    CrossrefPubMedGoogle Scholar
  • 16 Silberstein E B, Eugene L, Saenger S R. Painful osteoblastic metastases: the role of nuclear medicine.  Oncology. 2001;  15 157-163
    PubMedGoogle Scholar
  • 17 Pecher C. Biological investigations with radioactive calcium and strontium.  Proc Soc Exp Biol Med. 1941;  46 86-91
    PubMedGoogle Scholar
  • 18 Blake G M, Zivanovic M A, McEwan A J, Ackery D M. Sr-89 therapy: Strontium kinetics in disseminated carcinoma of the prostate.  Eur J Nuc Med. 1986;  12 447-454
    PubMedGoogle Scholar
  • 19 Kasalicky J, Krajska V. The effect of repeated strontium-89 chloride therapy on bone pain palliation in patients with skeletal cancer metastases.  Eur J Nuc Med. 1998;  25 1362-1367
    CrossrefPubMedGoogle Scholar
  • 20 Nair N. Relative efficacy of 32P and 89Sr in palliation in skeletal metastases.  J Nuc Med. 1999;  40 256-261
    PubMedGoogle Scholar
  • 21 Bolger J J, Dearnaley D P, Kirk D, et al. Strontium-89 (Metastron) versus external beam radiotherapy in patients with painful bone metastases secondary to prostatic cancer: preliminary report of a multicenter trial. UK Metastron investigators group.  Semin Oncol. 1993;  20 32-33
    PubMedGoogle Scholar
  • 22 Quilty P M, Kirk D, Bolger J J, et al. A comparison of the palliative effects of strontium-89 and external beam radiotherapy in metastatic prostate cancer.  Radiother Oncol. 1994;  31 33-40
    CrossrefPubMedGoogle Scholar
  • 23 Kaplan E, Fels I G, Kotlowski B R. Therapy of carcinoma of the prostate metastatic to bone with P-32-labeled condensed phosphate.  J Nuc Med. 1960;  1 1-13
    PubMedGoogle Scholar
  • 24 Kutzner J, Dahnert W, Schreyer T. Yittrium-90 zur Schmerztherapie von Knochenmetastasen.  Nuc Med. 1981;  20 229-235
    PubMedGoogle Scholar
  • 25 Han S H, Zonnenberg B A, De Klerk J MH, Qurijnen J MSP, Van Het Ship A D, Van Dijk A, Blijham G H, Van Rijk P P. 186 Re-Etidronat in breast cancer patients with metastatic bone pain.  J Nuc Med. 1999;  40 639-642
    PubMedGoogle Scholar
  • 26 Preston D F, Baxter K G. Therapy for painful skeletal metastases. In: Henkin RE (ed) Nuclear medicine. St. Louis; Mosby 1996: 1583-1593
    Google Scholar
  • 27 Maxon H R, Deutsch E A, Thomas S R, Libson K. Re-186 HEDP for treatment of multiple metastatic foci in bone: human biodistribution and dosimetric studies.  Radiology. 1988;  166 501-507
    PubMedGoogle Scholar
  • 28 Farhanghi M, Holmes R A, Volkert W A, Logan W, Singh A. Samarium-153-EDTMP: Pharmacokinetic, toxicity and pain response using an escalating dose schedule in treatment of metastatic bone cancer.  J Nuc Med. 1992;  33 1451-1458
    PubMedGoogle Scholar
  • 29 Bayouth J E, Macey D J, Kasi L P, Fosella F V. Dosimetry and toxicity of Samarium-153-EDTMP administered for bone pain due to skeletal metastases.  J Nuc Med. 1994;  35 63-69
    PubMedGoogle Scholar
  • 30 Resche I, Chatal J F, Pecking A, et al. A dose-controlled study of 153-Sm-Ethylenediaminetetramethylenphosphonate (EDTMP) in the treatment of patients with painful bone metastases.  Eur J Cancer. 1997;  33 1583-1591
    CrossrefPubMedGoogle Scholar
  • 31 Serafini A N, Houston S, Resche I, et al. Palliation of pain associated with metastatic bone cancer using Samarium-153 Lexidronam: a double-blind placebo-controlled clinical trial.  J Clin Oncol. 1998;  16 1574-1581
    PubMedGoogle Scholar
  • 32 Tian J, Zhang J, Hou Q, et al. Multicentre trial on the efficacy and toxicity of single-dose samarium-153-ethylene diamine tetramethylene phosphonate as a palliative treatment for painful skeletal metastases in China.  Eur J Nuc Med. 1999;  26 2-7
    PubMedGoogle Scholar
  • 33 Singh A, Holmes R A, Farhangi M, Volkert W A. Human pharmacokinetics of Samarium-153 EDTMP in metastatic cancer.  J Nuc Med. 1989;  30 1814-1818
    PubMedGoogle Scholar
  • 34 Geldof A A, De Rooij L, Versteegh R T, Newling D WW, Teule G JJ. Combination 186Re-HEDP and Cisplatin supra-additive treatment effects in prostate cancer cells.  J Nuc Med. 1999;  40 667-671
    PubMedGoogle Scholar
  • 35 Geldof A A, Van den Tillaar P LM, Newling D MW, Teule G JJ. Radionuclide therapy for prostate cancer lumbar metastasis prolongs symptom-free survival in a rat model.  Urology. 1997;  49 795-801
    CrossrefPubMedGoogle Scholar
  • 36 Palmedo H, Grünwald F, Wagner U, Köhler S, Krebs D, Biersack H J. Remission of bone metastases after combined chemotherapy and radionuclide therapy with Re-186-HEDP.  Clin Nuc Med. 1998;  23 (8) 501-504
    PubMedGoogle Scholar
  • 37 McCready R, Al-Deen A, Treleaven J, Dearnalay D. Response of skeletal metastases to high activities of Rhenium-186-HEDP.  Eur J Nuc Med. 1999;  26 (9) PS-642
    PubMedGoogle Scholar

Priv.-Doz. Dr. med. Claus Muhle

Klinik für Nuklearmedizin
Universitätsklinikum Kiel

Arnold-Heller-Straße 9
24105 Kiel

Phone: + 49-431-5973022

Fax: + 49-431-5973065

Email: cmuhle@nucmed.uni-kiel.de

      >