Radionuclide re-therapy is a practical option in bone pain palliation therapy

Full text: After giving first dose of radionuclide pain palliation therapy in 20 patients, re-therapy was considered again in these patients. 2nd therapy was done in 20 patients followed by 3rd therapy in 11 of them which was subsequently followed by 4th therapy in 4 patients (total 35 re-therapy doses). Phosphorus-32 was used in a mean dose 6.15 mCi (4.5-7 mCi) in 15 pts. and Samarium-153, 60 mCi (45-95 mCi) in 20 therapies. Strict follow up data was available in all patients. Mean follow up duration was 13.75 months (6 month - 20 months). Re-therapy was done after an interval of 4.7 months on an average. Pre-treatment pain score and narcotic score were 6.8 and 3.5. Average Hemoglobin, white blood cell and platelet count was 11.2, 8,600 and 1,89,000 respectively. After administration of radionuclide therapy there was a predictive but fully recovered fall in platelet counts only. It decreased to a mean 1,63,000 at around 4-5 weeks. Post-treatment pain score and narcotic score were 4.1 and 2.5 (P<0.005 as compared with pretreatment level). No serious toxicity was noted in any patient. Radionuclide pain palliation remains a very safe and effective option. Retherapy can be done very easily will equally good effects. No hematological toxicity was seen in any of the patient