Samarium-153 Oksabifor in the treatment of metastatic bone disease

Full text of publication follows. Aim. Bone metastases (BM) are one of the most common complications of solid cancers. Frequency of metastatic bone breast cancer (BC) at different stages of the disease ranges from 47 to 85%, for prostate cancer (PC) - from 33 to 85%, for lung cancer - from 30 to 60%, kidneys - from 33 to 40%, thyroid cancer - from 28 to 60%. Initial stages of BM are often clinically asymptomatic, but later manifested with fractures and pain which greatly reduces patients' quality of life. In world practice for palliative treatment of BM are widely used isotopes ³²P, ⁸⁹Sr, ¹⁸⁶Re, ¹⁸⁸Re, ¹⁵³Sm, and ¹⁷⁷Lu. Materials and methods. The results of examination and treatment with ¹⁵³Sm of 25 BM patients were analyzed. Among them 5 men and 20 women, mean age 61.2 ± 7.9 (min - 51.1, max 73.0). In 4 patients PC was diagnosed, 2 - lung cancer, 17 - BC, 1 - kidney cancer, 1 - cervical cancer. All patients after preliminary survey (bone scan, blood count, blood biochemical analysis) have got administration of ¹⁵³Sm Oksabifor in doses of 1 mCi (37 MBq) per 1 kg of weight. To determine the dynamics of BM re-scan with ^99mTc Tehnefor carried out in 1.5 and 3 months after starting treatment. Results. Reduction of pain intensity appeared at 6 + 4.6 days (min 2, max-18). There was a decline consumption of analgetics. According to the assessment of bone pain scales and efficiency, we can say that the therapy was effective and 90% of patients have got pain relief for 3 months and only in 2 patients pain-free period lasted 70 days. Quality of life was assessed by Karnofsky scale and improved statistically significantly. Most patients return to normal life. Only one patient's quality of life did not change (remained at 50%) and one - has changed slightly (from 50% to 60% on the Karnofsky scale). However, this is due to progression of primary disease and not related to pain symptoms. According to our data, 10 patients had stabilization process, in 15 patients - reducing the number of foci and the level of radiopharmaceutical uptake in them. Conclusions: radionuclide therapy in patients with BM can effectively suppress pain and significantly reduce the number of analgesics. Post-treatment patients, life quality statistically significantly improved. Samarium-153 has the ability to reduce BM number and intensity of radiopharmaceutical accumulation in spots in the control study. (authors)