Palliative treatment of metastatic bone pain with radiopharmaceuticals: A perspective beyond Strontium-89 and Samarium-153

Francisco D.C. Guerra Liberal, Adriana Alexandre S. Tavares, João Manuel R.S. Tavares*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract / Description of output

Purpose: The present review article aims to provide an overview of the available radionuclides for palliative treatment of bone metastases beyond 89Sr and 153Sm. In addition, it aims to review and summarize the clinical outcomes associated with the palliative treatment of bone metastases using different radiopharmaceuticals. Materials and methods: A literature search was conducted on Science Direct and PubMed databases (1990 - 2015). The following search terms were combined in order to obtain relevant results: "bone", "metastases", "palliative", "care", "therapy", "treatment", "radiotherapy", "review", "radiopharmaceutical", "phosphorus-32", "strontium-89", "yttrium-90", "tin-117m", "samarium-153", "holmium-166", "thulium-170", "lutetium-177", "rhenium-186", "rhenium-188" and "radium-223". Studies were included if they provided information regarding the clinical outcomes. Results and conclusions: A comparative analysis of the measured therapeutic response of different radiopharmaceuticals, based on previously published data, suggests that there is a lack of substantial differences in palliative efficacy among radiopharmaceuticals. However, when the comparative analysis adds factors such as patient's life expectancy, radionuclides' physical characteristics (e.g. tissue penetration range and half-life) and health economics to guide the rational selection of a radiopharmaceutical for palliative treatment of bone metastases, 177Lu and 188Re-labeled radiopharmaceuticals appear to be the most suitable radiopharmaceuticals for treatment of small and medium/large size bone lesions, respectively.

Original languageEnglish
Pages (from-to)87-99
Number of pages13
JournalApplied radiation and isotopes
Volume110
Early online date6 Jan 2016
DOIs
Publication statusPublished - 1 Apr 2016

Keywords / Materials (for Non-textual outputs)

  • Alpha particles
  • Auger electrons
  • Beta particles
  • Bone metastases
  • Radiopharmaceutical
  • Systematic review

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