Experience of bone pain palliation therapy at SGPGIMS, Lucknow (Uttar Pradesh)

Full text: Radionuclide pain palliation therapy was done in 156 patients (1995-2007). Total 176 therapy were done. Mean age at the time of presentation was 56 yrs (13-81) with 114 patients were male. Most common referral diagnosis was Carcinoma prostate (86 patients) followed by Breast (38), lung (6) and other malignancies. Earlier oral Phosphorus-32 was used in a mean dose 3.15 mCi (2.5-4 mCi) in 20 patients, intravenous Phosphorus-32 6.7 mCi (4.5-7 mCi) in 138 pts and Samarium-153 52.8 mCi (45-95 mCi) in 14 patients. Most of the patients were referred at very advanced stage so follow up rate was low 25∼30% (40 patients only). Mean follow up duration was 3.75 months. Out of 40 patients significant pain relief was noted in 33 patients while no change was noted in 7 patients. Pre-treatment pain score and narcotic score were 7.6 and 4.5. Average hemoglobin, white blood cell and platelet count was 10.8, 7,800 and 2,05,000 respectively. After administration of radionuclide therapy there was a predictive fall in platelet count only. It decreased to 1,43,000 at around 4-5 weeks. Post-treatment pain score and narcotic score were 5 and 3.5 (P<0.005 as compared with pretreatment level). No serious toxicity was noted in any patient. Despite of most of the patient being in very advance stage of cancer significant relief was noted in 83% patients. Radionuclide therapy is a safe option even in advanced cancer with minimal toxicity