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Article: Bone pain and radionuclide therapy.

Vande Streek, P / Carretta, R / Weiland, F L

1994 Volume 161, Issue 4, Page(s) 409

Abstract: ... has recently become reasonably firmly established, both as to scientific fact and clinical importance ... The items are presented in simple epitome, and an authoritative reference, both to the item itself and ... is to assist busy practitioners, students, researchers, and scholars to stay abreast of progress ...

Abstract	The Council on Scientific Affairs of the California Medical Association presents the following epitomes of progress in nuclear medicine. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and clinical importance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, and scholars to stay abreast of progress in medicine, whether in their own field of special interest or another. The epitomes included here were selected by the Advisory Panel to the Section on Nuclear Medicine of the California Medical Association, and the summaries were prepared under the direction of Dr Lyons and the panel.
MeSH term(s)	Bone Neoplasms/radiotherapy ; Bone Neoplasms/secondary ; Humans ; Palliative Care ; Strontium Radioisotopes/therapeutic use
Chemical Substances	Strontium Radioisotopes
Language	English
Publishing date	1994-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	189235-6
ISSN	1476-2978 ; 0093-0415 ; 0008-1264
ISSN (online)	1476-2978
ISSN	0093-0415 ; 0008-1264
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Article ; Online: Targeted Radionuclide Therapy of Painful Bone Metastases: Past Developments, Current Status, Recent Advances and Future Directions.

Dash, Ashutosh / Das, Tapas / Knapp, Furn F Russ

Current medicinal chemistry

2019 Volume 27, Issue 19, Page(s) 3187–3249

Abstract: ... Radionuclide therapy using bone-seeking radiopharmaceuticals based on the concept of localization of the agent ... using radiopharmaceuticals for bone pain palliation, and the expected future prospects in this field. ... Bone pain arising from secondary skeletal malignancy constitutes one of the most common types ...

Abstract	Bone pain arising from secondary skeletal malignancy constitutes one of the most common types of chronic pain among patients with cancer which can lead to rapid deterioration of the quality of life. Radionuclide therapy using bone-seeking radiopharmaceuticals based on the concept of localization of the agent at bone metastases sites to deliver focal cytotoxic levels of radiation emerged as an effective treatment modality for the palliation of symptomatic bone metastases. Bone-seeking radiopharmaceuticals not only provide palliative benefit but also improve clinical outcomes in terms of overall and progression-free survival. There is a steadily expanding list of therapeutic radionuclides which are used or can potentially be used in either ionic form or in combination with carrier molecules for the management of bone metastases. This article offers a narrative review of the armamentarium of bone-targeting radiopharmaceuticals based on currently approved investigational and potentially useful radionuclides and examines their efficacy for the treatment of painful skeletal metastases. In addition, the article also highlights the processes, opportunities, and challenges involved in the development of bone-seeking radiopharmaceuticals. Radium-223 is the first agent in this class to show an overall survival advantage in Castration-Resistant Prostate Cancer (CRPC) patients with bone metastases. This review summarizes recent advances, current clinical practice using radiopharmaceuticals for bone pain palliation, and the expected future prospects in this field.
MeSH term(s)	Bone Neoplasms/radiotherapy ; Bone Neoplasms/secondary ; Humans ; Male ; Pain ; Quality of Life ; Radiopharmaceuticals
Chemical Substances	Radiopharmaceuticals
Language	English
Publishing date	2019-02-03
Publishing country	United Arab Emirates
Document type	Journal Article ; Review
ZDB-ID	1319315-6
ISSN	1875-533X ; 0929-8673
ISSN (online)	1875-533X
ISSN	0929-8673
DOI	10.2174/0929867326666190201142814
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Article ; Online: Radionuclide therapy of painful bone metastases--a comparative study between consecutive radionuclide infusions, combination with chemotherapy, and radionuclide infusions alone: an in vivo comparison of their effectiveness.

Sideras, Panagiotis A / Stavraka, Anastasia / Gouliamos, Athanasios / Limouris, Georgios S

The American journal of hospice & palliative care

2013 Volume 30, Issue 8, Page(s) 745–751

Abstract: ... in patients with high chance of bone pain relapse and compared it with (89)Sr-Cl and chemotherapy group and ... Radionuclides have been long used for the palliation of skeletal-related metastatic pain. They are ... administration of 2 different radionuclides such as (186)Re-1,1-hydroxyethylidenediphosphonate ((186)Re-HEDP) and ...

Abstract	Radionuclides have been long used for the palliation of skeletal-related metastatic pain. They are almost invariably used as the last resource for pain palliation. Their use as single agents with dose escalations, in combination with biphosphonates or chemotherapy is well known in the peer-reviewed literature; however, little is known about the combination between different agents. In our study, we used consecutive administration of 2 different radionuclides such as (186)Re-1,1-hydroxyethylidenediphosphonate ((186)Re-HEDP) and (89)Strontium Chloride ((89)Sr-Cl) separated by adequate period of time to allow bone marrow recovery in patients with high chance of bone pain relapse and compared it with (89)Sr-Cl and chemotherapy group and (186)Re-HEDP with bisphosphonates. The end result was that treatment with consecutive radionuclides was much more effective and safe than the other 2 groups.
MeSH term(s)	Bone Neoplasms/secondary ; Etidronic Acid ; Humans ; Organometallic Compounds ; Pain/drug therapy ; Palliative Care ; Prostatic Neoplasms/drug therapy ; Radioisotopes
Chemical Substances	Organometallic Compounds ; Radioisotopes ; Etidronic Acid (M2F465ROXU)
Language	English
Publishing date	2013-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	1074344-3
ISSN	1938-2715 ; 1049-9091
ISSN (online)	1938-2715
ISSN	1049-9091
DOI	10.1177/1049909112469719
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Article: Bone Metastasis in Bladder Cancer.

Yi, Lei / Ai, Kai / Li, Xurui / Li, Zhihong / Li, Yuan

Journal of personalized medicine

2022 Volume 13, Issue 1

Abstract: ... immunotherapy, targeted therapy, antibody-drug conjugates, bisphosphonates, denosumab, radioisotopes, and ... reduce skeletal-related events, relieve pain, and improve the quality of life of patients. ... to completely explain the process. As different imaging mechanisms, PET-CT cannot replace a radionuclide bone ...

Abstract	Bladder cancer (BCa) is the 10th most common and 13th most deadly malignancy worldwide. About 5% of BCa patients present initially with metastatic disease, with bone being the most diagnosed site for distant metastasis. The overall one-year survival of patients with BCa is 84%, whereas it is only 21% in patients with bone metastasis (BM). Metastasis of BCa cells to bone occurs by epithelial-to-mesenchymal transition, angiogenesis, intravasation, extravasation, and interactions with the bone microenvironment. However, the mechanism of BCa metastasis to the bone is not completely understood; it needs a further preclinical model to completely explain the process. As different imaging mechanisms, PET-CT cannot replace a radionuclide bone scan or an MRI for diagnosing BM. The management of BCa patients with BM includes chemotherapy, immunotherapy, targeted therapy, antibody-drug conjugates, bisphosphonates, denosumab, radioisotopes, and surgery. The objective of these treatments is to inhibit disease progression, improve overall survival, reduce skeletal-related events, relieve pain, and improve the quality of life of patients.
Language	English
Publishing date	2022-12-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm13010054
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Article ; Online: EORTC QLQ-BM22 and QLQ-C30 quality of life scores in patients with painful bone metastases of prostate cancer treated with strontium-89 radionuclide therapy.

Kurosaka, Shinji / Satoh, Takefumi / Chow, Edward / Asano, Yuji / Tabata, Ken-ichi / Kimura, Masaki / Tsumura, Hideyasu / Matsumoto, Kazumasa / Ishiyama, Hiromichi / Inoue, Yusuke / Hayakawa, Kazushige / Baba, Shiro

Annals of nuclear medicine

2012 Volume 26, Issue 6, Page(s) 485–491

Abstract: ... for the palliation of bone pain in prostate cancer. We aimed to assess the effect of Sr-89 radionuclide therapy ... response and toxicity of the Sr-89 therapy.: Results: The pain characteristics subscale of the EORTC QLQ ... patient had grade 3 platelet toxicity.: Conclusion: Sr-89 radionuclide therapy can provide not only ...

Abstract	Purpose: Approximately 80% of patients with prostate cancer will develop bone metastases, which often lead to bone pain and skeletal-related events. Sr-89 is an established alternative for the palliation of bone pain in prostate cancer. We aimed to assess the effect of Sr-89 radionuclide therapy on quality of life (QOL) in prostate cancer patients with painful bone metastases. Materials and methods: Thirteen patients received a single intravenous injection of Sr-89 at a dose of 2.0 MBq/kg. All patients underwent QOL evaluation prior to Sr-89 treatment and 1, 2, and 3 months afterward using the Japanese version of the EORTC QLQ-BM22, EORTC QLQ-C30, a VAS, and face scale. We also evaluated PSA and ALP response and toxicity of the Sr-89 therapy. Results: The pain characteristics subscale of the EORTC QLQ-BM22 was significantly reduced from 1 month onward compared with the baseline. The functional interference and psychosocial aspects subscales were significantly higher than baseline from 2 months onward. At 2 months, VAS indicated a significant reduction in pain as compared to the baseline. Sr-89 therapy caused a nonsignificant reduction in PSA and ALP levels. No patients had leukocyte toxicity, and one patient had grade 3 platelet toxicity. Conclusion: Sr-89 radionuclide therapy can provide not only reduced pain characteristics but also better psychosocial aspects and functional interference in patients with painful bone metastases of prostate cancer.
MeSH term(s)	Alkaline Phosphatase/blood ; Bone Neoplasms/blood ; Bone Neoplasms/complications ; Bone Neoplasms/radiotherapy ; Bone Neoplasms/secondary ; Humans ; Male ; Pain/complications ; Pain/radiotherapy ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/pathology ; Quality of Life ; Strontium Radioisotopes/therapeutic use
Chemical Substances	Strontium Radioisotopes ; Alkaline Phosphatase (EC 3.1.3.1) ; Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2012-07
Publishing country	Japan
Document type	Clinical Trial ; Journal Article
ZDB-ID	1146984-5
ISSN	1864-6433 ; 0914-7187
ISSN (online)	1864-6433
ISSN	0914-7187
DOI	10.1007/s12149-012-0598-z
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Article: Hemibody Irradiation for Bone Metastases: A Systematic Review and Meta-Analysis.

Berk, Lawrence / Scarantino, Charles / Finkelstein, Steven / Finkelstein, Mitchell

Cureus

2024 Volume 16, Issue 1, Page(s) e51925

Abstract: ... of bone metastases and for radionuclide treatment of bone metastases. The toxicity of the treatments ... identified and analyzed. Our findings show that 80% of the patients had complete or partial pain relief and ... bone metastases from solid tumors. It was primarily utilized in the 1980s and 1990s and has ...

Abstract	Hemibody irradiation (HBI) is a radiation therapy technique that involves treating one-half of the patient's skeletal system in a single radiation field. It is mostly given as upper hemibody irradiation (UHBI), lower hemibody irradiation (LHBI), or sequential UHBI and LHBI. It is used to treat extensive bone metastases from solid tumors. It was primarily utilized in the 1980s and 1990s and has since fallen out of favor. However, it is a potentially cost-effective treatment for widespread bone metastases. To determine its efficacy, we performed a meta-analysis of all available published articles on the efficacy of HBI to relieve pain from bone metastases. Twenty-seven articles involving 1318 patients were identified and analyzed. Our findings show that 80% of the patients had complete or partial pain relief and 29% had complete pain relief. The trials were of poor quality, but the results showed minimal heterogeneity in the response rates. These response rates are consistent with those seen with focal irradiation of bone metastases and for radionuclide treatment of bone metastases. The toxicity of the treatments decreased when delivered with modern treatment techniques. In light of this, we propose that this technique warrants re-evaluation with modern treatment methods.
Language	English
Publishing date	2024-01-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.51925
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Article ; Online: Advancements in the development of radiopharmaceuticals for nuclear medicine applications in the treatment of bone metastases.

Dyer, Michael R / Jing, Zhenghan / Duncan, Kathleen / Godbe, Jacqueline / Shokeen, Monica

Nuclear medicine and biology

2024 Volume 130-131, Page(s) 108879

Abstract: ... metastases, including osteocytes, osteoblasts, and metastatic cells. The applications of radionuclide-based ... Bone metastases are a painful and complex condition that overwhelmingly impacts the prognosis and ... therapies, such as strontium-89 (Sr-89) and radium-223 (Ra-223), are also discussed. This review also ...

Abstract	Bone metastases are a painful and complex condition that overwhelmingly impacts the prognosis and quality of life of cancer patients. Over the years, nuclear medicine has made remarkable progress in the diagnosis and management of bone metastases. This review aims to provide a comprehensive overview of the recent advancements in nuclear medicine for the diagnosis and management of bone metastases. Furthermore, the review explores the role of targeted radiopharmaceuticals in nuclear medicine for bone metastases, focusing on radiolabeled molecules that are designed to selectively target biomarkers associated with bone metastases, including osteocytes, osteoblasts, and metastatic cells. The applications of radionuclide-based therapies, such as strontium-89 (Sr-89) and radium-223 (Ra-223), are also discussed. This review also highlights the potential of theranostic approaches for bone metastases, enabling personalized treatment strategies based on individual patient characteristics. Importantly, the clinical applications and outcomes of nuclear medicine in osseous metastatic disease are discussed. This includes the assessment of treatment response, predictive and prognostic value of imaging biomarkers, and the impact of nuclear medicine on patient management and outcomes. The review identifies current challenges and future perspectives on the role of nuclear medicine in treating bone metastases. It addresses limitations in imaging resolution, radiotracer availability, radiation safety, and the need for standardized protocols. The review concludes by emphasizing the need for further research and advancements in imaging technology, radiopharmaceutical development, and integration of nuclear medicine with other treatment modalities. In summary, advancements in nuclear medicine have significantly improved the diagnosis and management of osseous metastatic disease and future developements in the integration of innovative imaging modalities, targeted radiopharmaceuticals, radionuclide production, theranostic approaches, and advanced image analysis techniques hold great promise in improving patient outcomes and enhancing personalized care for individuals with bone metastases.
MeSH term(s)	Humans ; Radiopharmaceuticals/therapeutic use ; Nuclear Medicine ; Radium/therapeutic use ; Quality of Life ; Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/radiotherapy ; Radioisotopes/therapeutic use ; Biomarkers
Chemical Substances	Radiopharmaceuticals ; Radium-223 (8BR2SOL3L1) ; Radium (W90AYD6R3Q) ; Radioisotopes ; Biomarkers
Language	English
Publishing date	2024-02-03
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1138098-6
ISSN	1872-9614 ; 0883-2897 ; 0969-8051
ISSN (online)	1872-9614
ISSN	0883-2897 ; 0969-8051
DOI	10.1016/j.nucmedbio.2024.108879
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Article ; Online: Paget's disease of bone: A clinical update.

Cook, Sheila J / Wall, Chris

Australian journal of general practice

2021 Volume 50, Issue 1-2, Page(s) 23–29

Abstract: ... agent. A single infusion of zoledronic acid leads to a sustained reduction in bone pain and markers ... features on plain films, while a radionuclide bone scan may be used to assess the extent of disease ... as an isolated elevation of serum alkaline phosphatase. Symptomatic patients present with bone pain, fractures ...

Abstract	Background: Paget's disease of bone (PDB) is a common destructive condition of bone that affects 1-2% of the population, most typically those over the age of 55 years. It is usually asymptomatic. Objective: The aim of this article is to describe the clinical presentation, diagnosis and management of patients with PDB. Discussion: Most cases of PDB are diagnosed incidentally on radiographs or as an isolated elevation of serum alkaline phosphatase. Symptomatic patients present with bone pain, fractures, arthritis and features of compression neuropathy. Diagnosis is made on the basis of typical radiological features on plain films, while a radionuclide bone scan may be used to assess the extent of disease. The mainstay of treatment for PDB is bisphosphonate therapy, with zoledronic acid being the most effective agent. A single infusion of zoledronic acid leads to a sustained reduction in bone pain and markers of bone turnover. However, bisphosphonates should be reserved for symptomatic patients, as treatment with these agents has been associated with an increase in rates of fracture in patients with asymptomatic PDB.
MeSH term(s)	Diphosphonates/therapeutic use ; Fractures, Bone ; Humans ; Middle Aged ; Osteitis Deformans/diagnostic imaging ; Osteitis Deformans/drug therapy ; Radiography ; Zoledronic Acid
Chemical Substances	Diphosphonates ; Zoledronic Acid (6XC1PAD3KF)
Language	English
Publishing date	2021-01-22
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2924889-9
ISSN	2208-7958 ; 2208-794X
ISSN (online)	2208-7958
ISSN	2208-794X
DOI	10.31128/AJGP-10-20-5690
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Article ; Online: Dosimetry of Bone Seeking Beta Emitters for Bone Pain Palliation Metastases.

Liepe, K / Murray, I / Flux, G

Seminars in nuclear medicine

2021 Volume 52, Issue 2, Page(s) 178–190

Abstract: ... metastases and provide palliative pain relief. In this article we describe the different physical ... Amongst cancer patients, bone pain due to skeletal metastases is a major cause of morbidity ... of radiation transport within bone and bone marrow are reviewed alongside the practical steps that must be ...

Abstract	Amongst cancer patients, bone pain due to skeletal metastases is a major cause of morbidity. A number of beta-emitting radiopharmaceuticals have been used to provide internal radiotherapy of bone metastases and provide palliative pain relief. In this article we describe the different physical characteristics of the various beta emitting radionuclides which have been used in this clinical setting and the potential impact of differences in dose-rate on radiobiological outcomes. A detailed review of the biodistribution of these treatments, based on both in-vivo clinical investigations and post mortem autoradiography assessments is provided. These treatments result in physiological delivery of radiation doses to the target disease as well as to critical healthy organs. Particular attention is paid to the radiation doses received by normal bone tissue, bone marrow as well as metastatic bone disease. The underlying models of radiation transport within bone and bone marrow are reviewed alongside the practical steps that must be taken to acquire and analyse the information require for clinical dosimetry assessments. The role of whole body measurements, blood and faecal assays as well as both planar and tomographic gamma camera imaging are considered. In addition we review the rationale for allocating measured bone uptake between trabecular and cortical bone tissue. The difference between bone volume and bone surface seeking radiopharmaceuticals are also discussed. This review also extends to the development of preclinical models of bone metastases which may inform future dosimetric calculations. Finally, we also present a comprehensive review of the dosimetry of the established treatments
MeSH term(s)	Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/radiotherapy ; Bone and Bones ; Humans ; Lutetium ; Pain/drug therapy ; Pain/etiology ; Pain/radiotherapy ; Radiopharmaceuticals/therapeutic use ; Rhenium/therapeutic use ; Tissue Distribution ; Zoledronic Acid
Chemical Substances	Radiopharmaceuticals ; Lutetium (5H0DOZ21UJ) ; Zoledronic Acid (6XC1PAD3KF) ; Rhenium (7440-15-5)
Language	English
Publishing date	2021-12-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	120248-0
ISSN	1558-4623 ; 0001-2998
ISSN (online)	1558-4623
ISSN	0001-2998
DOI	10.1053/j.semnuclmed.2021.11.005
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Article ; Online: The effectiveness of bone scintigraphy in the management of low back pain.

Akgun, Elife / Akgun, Mehmet Yigit

Clinical neurology and neurosurgery

2022 Volume 222, Page(s) 107440

Abstract: ... modalities may have low predictive value in detecting the source of back pain. Thanks to radionuclide bone ... Background: Back and low back pain have been reported as one of the leading causes of activity ... Methods: We completed a retrospective review of patients who underwent diagnostic radionuclide bone ...

Abstract	Background: Back and low back pain have been reported as one of the leading causes of activity restriction. While degenerative changes in the spine are among the common causes of low back pain, zygapophyseal (facet) joint pain is seen as the most widely accepted cause of back pain. Standard imaging modalities may have low predictive value in detecting the source of back pain. Thanks to radionuclide bone scintigraphy, painful lesions can be distinguished from age-related changes, especially in patients with chronic low back pain. In this study, we aimed to retrospectively evaluate the clinical results of facet-induced low back pain, which was confirmed by bone scintigraphy, after facet injection treatment. Methods: We completed a retrospective review of patients who underwent diagnostic radionuclide bone scintigraphy imaging for low back pain at our institution from 2019 to 2021. Scintigraphy imaging was often performed in conjunction with traditional diagnostic imaging. The patients underwent injection at the levels that were decided by the referring physician on the basis of the clinical symptoms, the physical examination findings, and findings on existing radiologic images, with performance of bone scanning. Results: The patients consisted of 24 (47.1 %) males and 27 (52.9 %) females with a mean age of 44.03 ± 9.26 years (range 34-67 years) at initial symptom onset. In the bone scintigraphy, increased radioactive uptake was detected in the facet joints of the lumbar region in 33 of 51 (64.7 %) patients. Statistically significant improvement was found in VAS-ODI and SF-36 scorings in 30 patients (90.1 %) after injection in patients with increased radioactive uptake. Statistically significant improvement was found in VAS-ODI and SF-36 scorings in 12 (66.6 %) patients who had no pathological findings with imaging modalities and were injected according to physical examination. When the two groups were compared with each other, the success rate in the group with increased radioactive uptake was found to be statistically significantly higher (p < 0.01) CONCLUSIONS: Application of this technology may lead to more reliable diagnosis and treatment of painful facet arthropathy. Appropriate diagnostic tests and determination of spinal level localization will provide satisfactory results with correct patient selection.
MeSH term(s)	Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Low Back Pain/diagnostic imaging ; Low Back Pain/therapy ; Retrospective Studies ; Zygapophyseal Joint ; Back Pain/complications ; Radiopharmaceuticals ; Lumbar Vertebrae/diagnostic imaging
Chemical Substances	Radiopharmaceuticals
Language	English
Publishing date	2022-09-15
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2022.107440
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