Reviews

Radiopharmaceuticals: When and How to Use Them to Treat Metastatic Bone Pain

Bone pain due to skeletal metastases constitutes the most common type of cancer-related pain. The management of bone pain remains challenging and is not standardized. In patients with multifocal osteoblastic metastases, systemic radiopharmaceuticals should be the preferred adjunctive therapy for pain palliation. The lack of general knowledge about radiopharmaceuticals, their clinical utility and safety profiles, constitutes the major cause for their underutilization. Our goal is to review the indications, selection criteria, efficacy, and toxicities of two approved radiopharmaceuticals for bone pain palliation: strontium-89 and samarium-153. Finally, a brief review of the data on combination therapy with bisphosphonates or chemotherapy is included.



 

Bone pain due to skeletal metastases constitutes the most common type of cancer-related pain. The management of bone pain remains challenging and is not standardized. In patients with multifocal osteoblastic metastases, systemic radiopharmaceuticals should be the preferred adjunctive therapy for pain palliation. The lack of general knowledge about radiopharmaceuticals, their clinical utility and safety profiles, constitutes the major cause for their underutilization. Our goal is to review the indications, selection criteria, efficacy, and toxicities of two approved radiopharmaceuticals for bone pain palliation: strontium-89 and samarium-153. Finally, a brief review of the data on combination therapy with bisphosphonates or chemotherapy is included.

Conflicts of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Fabio M. Paes MD
,
, Vinicius Ernani MD, Peter Hosein MD, Aldo N. Serafini MD
Received 8 March 2011; Accepted 16 June 2011. Available online 3 November 2011.


Correspondence to: Fabio M. Paes, MD, Department of Radiology, University of Miami/Jackson Memorial Medical Center, 1611 N.W. 12th Avenue, West Wing #279, Miami, FL 33136; telephone: (305) 585-7878; fax: (305) 585-5743

Vitae

Dr. Paes and Serafini are from the Department of Radiology, University of Miami/Jackson Memorial Medical Center, Sylvester Comprehensive Cancer Center, Miami, FL.

Dr. Ernani and Hosein are from the Division of Hematology Oncology, University of Miami/Jackson Memorial Medical Center, Sylvester Comprehensive Cancer Center, Miami, FL.


The Journal of Supportive Oncology
Volume 9, Issue 6, November-December 2011, Pages 197-205

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