strontium-radioisotopes and Thyroid-Neoplasms

Therapeutic use of radionuclides includes 131I for thyroid cancer and hyperthyroid Graves' disease, 89SrCl3 for metastatic bone tumors, 131I-MIBG for malignant pheochromocytoma and neuroblastoma, and radioimmunotherapies. 131I is concentrated in 60-70% of metastases from differentiated thyroid cancer following total thyroidectomy. Radioiodine uptake in metastatic lesions is greater in younger patients than in older ones. Hypothyroidism is often mild or even absent in patients with a large amount of tumor tissue, indicating that thyroid hormones produced by highly differentiated tumors compensate partially or even completely for hypothyroidism following total thyroidectomy. Adequate uptake of 131I has been reported to be associated with significant reduction in the size and number of metastases, and with lower recurrence and higher survival rates. Other favorable factors for longer survival are younger age, well-differentiated histological type, small disease extent, and early discovery of metastases. Older patients with extensive metastases and/or bulky tumor masses in the bone have a poor prognosis. Therefore, it is important to discover metastases as early as possible, when patients are still young. Long-term follow-up with periodic thyroglobulin measurements and imaging studies is strongly recommended. In Japan, 131I treatment for Graves' disease is performed only in selected patients in whom antithyroid drugs cannot be used because of side effects or not effective, considering the high prevalence of permanent hypothyroidism. 89SrCl3 is useful for reducing pain due to bone metastases of malignant tumors. 131I-MIBG therapy is effective for improvement of QOL in some patients with metastatic malignant pheochromocytoma. Radioimmuno-therapy using anti-CD20 has been used successfully in clinical application in patients with malignant B cell lymphoma.

Topics: 3-Iodobenzylguanidine; Antineoplastic Agents; Bone Neoplasms; Clinical Trials as Topic; Graves Disease; Humans; Iodine Radioisotopes; Prognosis; Radiopharmaceuticals; Strontium Radioisotopes; Thyroid Neoplasms

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: 3-Iodobenzylguanidine; Antibodies, Monoclonal; Bone Neoplasms; Brachytherapy; Humans; Iodine Radioisotopes; Iodobenzenes; Neoplasms; Phosphorus Radioisotopes; Radioisotopes; Radiotherapy Dosage; Rhenium; Samarium; Strontium Radioisotopes; Thyroid Neoplasms

Topics: Antibodies, Monoclonal; Antigens, CD20; Bone Neoplasms; Brachytherapy; Contraindications; Humans; Lymphoma, B-Cell; Pain; Strontium Radioisotopes; Thyroid Neoplasms; Yttrium Radioisotopes

Topics: Antibodies, Monoclonal; Ascites; Bone Neoplasms; Chromium Compounds; Humans; Hyperthyroidism; Iodine Radioisotopes; Lymphoma, Non-Hodgkin; Organometallic Compounds; Organophosphorus Compounds; Pain; Patient Isolation; Phosphates; Pleural Effusion, Malignant; Polycythemia Vera; Radiation Protection; Radiopharmaceuticals; Sodium Iodide; Strontium Radioisotopes; Thrombocytopenia; Thyroid Neoplasms; Yttrium Radioisotopes

During 1994, 19 thyroid tumor-affected children and 17 healthy children from the Gomel region, one of the areas most polluted by the Chernobyl fallout, were analysed for (i) the presence of in their urine and (ii) chromosome aberrations (CA) in circulating lymphocytes. They were compared with 35 healthy children from Pisa, Italy. Tumor-affected children showed significantly (p<0.05) higher levels in their urine as compared to healthy controls from the Gomel region. No radioactivity was found in urine from the Pisa controls. CA frequency was significantly higher in tumor-affected children compared to the Gomel controls, but was not significantly different between Gomel and Pisa controls. However, dicentric chromosomes were found in a significantly (p<0.01) greater proportion in both affected and healthy Gomel children (3.4 and 1.3/1000 cells, respectively) as compared to the Pisa controls (0.4/1000 cells). Multiple regression analysis showed that the proportion of cells with acentric fragments, dicentric and ring chromosomes was significantly correlated (p<0.05) with the amount of excreted in their urine. These findings suggest that children from the Gomel region were still being exposed to radionuclides, which makes it possible to study a dose-effect relationship.

Topics: Adolescent; Cell Division; Cesium Radioisotopes; Child; Chromatids; Chromosome Aberrations; Chromosomes; Demography; Female; Humans; Italy; Lymphocytes; Male; Potassium Radioisotopes; Power Plants; Radioactive Hazard Release; Regression Analysis; Republic of Belarus; Sister Chromatid Exchange; Strontium Radioisotopes; Thyroid Gland; Thyroid Neoplasms; Ukraine

The bone-seeking radiopharmaceutical Sr-89 has been used as a palliative treatment for patients with bone pain caused by bone metastases. The authors report the results of nine patients (three with prostate cancer, four with breast cancer, one with thyroid cancer, and one with lung cancer) who underwent therapy with Sr-89 chloride for painful bone metastases, and evaluate Sr-89 imaging with bremsstrahlung. Two levels of dosage (1.5 and 2.2 MBq/kg) were used. Sr-89 imaging was performed in seven patients 1 week after injection. Abnormal uptake was seen in all and was consistent with the results of Tc-99m HMDP imaging. Six patients were assessed at 3 months and three patients toward the time they were terminal; 78% (seven of nine) derived some benefit. Two patients had a favorable clinical response and showed improvement on Tc-99m HMDP imaging.

Topics: Adult; Aged; Bone and Bones; Bone Neoplasms; Breast Neoplasms; Female; Follow-Up Studies; Humans; Lung Neoplasms; Male; Middle Aged; Pain; Palliative Care; Prostatic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Radiotherapy Dosage; Remission Induction; Strontium Radioisotopes; Technetium Tc 99m Medronate; Terminal Care; Thyroid Neoplasms

Topics: Analgesics, Non-Narcotic; Bone Neoplasms; Female; Humans; Iodine Radioisotopes; Isotopes; Male; Organometallic Compounds; Organophosphorus Compounds; Palliative Care; Pentetic Acid; Radioisotopes; Recombinant Proteins; Samarium; Strontium; Strontium Radioisotopes; Thyroid Neoplasms; Thyrotropin; Tin

The osteotropic radionuclides 89Sr and 32P are now mainly used in the treatment of bone metastases. This therapy is palliative and is mainly directed at alleviating pain. The indications, procedure, treatment result and side effects are described as discussed. Bone metastases of iodinophilous thyroid carcinomas represent a special case. These can be treated selectively with 131I. However, complete regression of the tumour by means of radioactive iodine is only rarely achieved in bone metastases. Nevertheless, the complaints and symptoms are definitely alleviated even with relatively small radiation doses, similar to the therapy employing strontium.

Topics: Adenocarcinoma; Bone Neoplasms; Female; Humans; Iodine Radioisotopes; Male; Prostatic Neoplasms; Rectal Neoplasms; Strontium Radioisotopes; Thyroid Neoplasms

Topics: Bone Neoplasms; Humans; Iodine Radioisotopes; Lung Neoplasms; Phosphorus Radioisotopes; Radionuclide Imaging; Strontium Radioisotopes; Technetium; Thyroid Neoplasms

Topics: Bone and Bones; Humans; Neoplasm Metastasis; Radionuclide Imaging; Strontium Radioisotopes; Technetium; Thyroid Neoplasms

Topics: Animals; Calcium Radioisotopes; Cesium Radioisotopes; Male; Neoplasms, Experimental; Radioisotopes; Rats; Strontium Radioisotopes; Thyroid Neoplasms; Time Factors

Data now available on the risks of radiation-induced fatal cancer and hereditary disease and radionuclide metabolism suggest that limits on the rates of intake of 90Sr, 226Ra and 239Pu at work, presently recommended by the International Commission on Radiological Protection, might be in need of considerable revision one with another and with the limit for uniform exposure of the whole body.

Topics: Body Burden; Breast Neoplasms; Carcinoma; Dose-Response Relationship, Radiation; Female; Genetic Diseases, Inborn; Humans; Leukemia; Lung Neoplasms; Male; Maximum Allowable Concentration; Neoplasms, Radiation-Induced; Nuclear Warfare; Occupational Medicine; Osteosarcoma; Paranasal Sinus Neoplasms; Plutonium; Radiation Injuries; Radiation Tolerance; Radium; Strontium Radioisotopes; Thyroid Neoplasms

Topics: Adenofibroma; Adenoma; Adrenal Gland Neoplasms; Animals; Cesium Isotopes; Female; Fibroma; Iodine Radioisotopes; Leukemia, Radiation-Induced; Lymphoma, Non-Hodgkin; Mammary Neoplasms, Experimental; Neoplasms, Experimental; Neoplasms, Radiation-Induced; Osteosarcoma; Parathyroid Neoplasms; Radioisotopes; Rats; Strontium Radioisotopes; Thyroid Neoplasms