Palliative treatment of osseous metastases

Currently, two radiopharmaceuticals are available in France to treat painful bone metastases Metastron for prostate cancers and Quadramet whatever is the primitive tumour. Efficacy is high since 70% of response is observed with 30% of complete response, allowing diminution and even withdrawal of antalgic medication. Toxicity is purely hematologic and is predictable in time, moderate and always transient. The interest is to use internal radiotherapy very early in the course of disease, as soon as there is one painful osseous site (and several metastatic localizations on bone scan), to treat pain, to prevent pain on other sites, and to delay recourse to other forms of therapy (such as morphinic with their side effects) and thus to ensure adequate quality of life for as long as possible. (author)