strontium-radioisotopes and Neuroblastoma

Internal radiation therapy selectively targets beta- or alpha-emitting radionuclides to the area of the tumor tissue, and is therefore capable of treating disease regardless of the location and number of foci. The biological effect of internal radiation therapy is thought to be different from that of conventional external beam radiation. Thyroid cancer: The local recurrence and metastatic lesions from differentiated thyroid cancers can be controlled with 131I administration. Even though the patient does not have macroscopic disease, 131I is also utilized for thyroid remnant ablation in locally advanced cases. Recently, the maximum tolerable dose can be calculated based on the dosimetry of each patient, and safely administered. The therapeutic effect of this method is superior to the fixed dose method. 131I-MIBG: 131I-MIBG is taken up by sympathetic neurons as well as a group of tumors originating in the neural crest, especially phecromocytomas and neuroblastomas. The various symptoms caused by the hypersecretions of hormone-producing tumors can be improved. Pain palliation of bone metastases: Pain palliation using 89Sr is a very promising option in treating patients with painful bone metastases. The pain palliation mechanism of 89Sr is different from other drugs; therefore, complimentary usage is reasonable. The symptomatical improvement can last for several months, thus helping to maintain the quality of life of the patient.

Topics: 3-Iodobenzylguanidine; Bone Neoplasms; Humans; Iodine Radioisotopes; Neuroblastoma; Pain; Palliative Care; Strontium Radioisotopes; Thyroid Neoplasms; Thyroidectomy

Topics: Bone Neoplasms; Child; Humans; Male; Neuroblastoma; Pain; Palliative Care; Strontium Radioisotopes

We report two cases of children with metastatic bone disease who received strontium-89 intravenously. An 11-year-old boy with stage IV neuroblastoma received 50 microCi/kg of strontium-89. He had a good response, and his pain abated to the point that he could be taken off IV Dilaudid and was discharged from the hospital. A 7-year-old girl with the diagnosis of squamous cell carcinoma of the lung disclosed minimal increased uptake on a bone scan. Following the strontium-89 therapy, she did not have any significant improvement in pain, probably due to the minimal osteoblastic activity evidenced by the minimal abnormalities on the bone scan. Until this report there has been no reported case of using strontium-89 in the treatment of children with metastatic disease.

Topics: Analgesics, Opioid; Bone Neoplasms; Carcinoma, Squamous Cell; Child; Cranial Irradiation; Fatal Outcome; Female; Humans; Hydromorphone; Injections, Intravenous; Lung Neoplasms; Male; Neoplasm Staging; Neuroblastoma; Osteoblasts; Pain; Palliative Care; Patient Discharge; Remission Induction; Spinal Cord; Strontium Radioisotopes

Topics: Child; Diagnosis, Differential; Female; Humans; Laminectomy; Lumbar Vertebrae; Myelography; Neuroblastoma; Radionuclide Imaging; Spinal Diseases; Spinal Neoplasms; Strontium Radioisotopes