technetium-tc-99m-medronate and Pain--Intractable

Rhenium-186 (tin) hydroxyethylidene diphosphonate (HEDP) is a new radiopharmaceutical that simultaneously localizes in multiple skeletal metastases in patients with advanced cancer. A single intravenous administration of 30-35 mCi (1110-1295 MBq) is associated with a prompt, significant relief of osseous pain in about 80% of such patients. The efficacy of this new compound was evaluated further by utilizing a double-blind crossover comparison with 99mTc-methylene diphosphonate (MDP) as a radioactive placebo. The new rhenium compound resulted in a significantly (p less than 0.05) greater decrease in pain than did treatment with the radioactive placebo. Rhenium-186(Sn)HEDP appears to be a useful new compound for the palliation of painful skeletal metastases.

Topics: Aged; Bone Neoplasms; Double-Blind Method; Etidronic Acid; Female; Humans; Male; Organometallic Compounds; Pain, Intractable; Palliative Care; Prostatic Neoplasms; Radioisotopes; Rhenium; Technetium Tc 99m Medronate

Topics: Adolescent; Biopsy; Bone Neoplasms; Chronic Disease; Diagnosis, Differential; Genetic Testing; Humans; In Situ Hybridization, Fluorescence; Joint Diseases; Knee Joint; Male; Pain, Intractable; Positron-Emission Tomography; Sarcoma, Ewing; Technetium Tc 99m Medronate; Thigh; Tomography, X-Ray Computed

Topics: Aged; Bone and Bones; Bone Neoplasms; Humans; Male; Pain, Intractable; Palliative Care; Prostatic Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Strontium Radioisotopes; Technetium Tc 99m Medronate

A 27-year-old woman with progressive diaphyseal dysplasia (Camurati-Engelmann disease) received pamidronate and corticosteroid therapy for bone pain. During therapy, disease activity was assessed serially using bone scintigraphy with Tc-99m HMDP. With pamidronate administration, the bone pain became worse and diaphyseal uptake of Tc-99m HMDP increased, whereas corticosteroid administration improved the bone pain and reduced the diaphyseal uptake. In this case, pamidronate and corticosteroid produced different effects. Bone scintigraphy allowed an objective assessment of the response to these treatments, accurately reflecting clinical symptoms.

Topics: Administration, Oral; Adult; Camurati-Engelmann Syndrome; Diphosphonates; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Pain Measurement; Pain, Intractable; Pamidronate; Prednisolone; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Medronate

Strontium-89 chloride is widely available in the U.S. and Europe for patients afflicted by bone metastasis associated with pain. 89Sr is a pure beta-emitter and it is thought to be difficult to estimate its distribution externally. We tried to image the distribution of 89Sr uptake with bremsstrahlung from beta-minus decay of 89Sr by using Nal scintillation camera. Pronounced 89Sr depositions in the bone metastatic sites were imaged in the energy windows from 50 keV to 150 keV bremsstrahlung. The distribution of these depositions corresponded to 99mTc-HMDP image may be suspected to the effectiveness of this therapy. The identification of 89Sr distribution might be useful in evaluating the bone marrow radiation dose too.

Topics: Aged; Bone and Bones; Bone Neoplasms; Female; Gamma Cameras; Humans; Male; Middle Aged; Pain, Intractable; Radionuclide Imaging; Radiotherapy, High-Energy; Scattering, Radiation; Scintillation Counting; Strontium Radioisotopes; Technetium Tc 99m Medronate

Two hundred and two patients with bone pain from metastatic cancer were treated with 40 microCi/kg of Sr-89. Patients were followed with pain diaries, records of medication taken, sleep patterns, serial bone scans and a Karnofsky Index. One hundred and thirty-seven patients with adequate followup survived at least 3 months, including 100 with prostate and 28 with breast carcinoma. Eighty of the 100 patients with prostate cancer responded, and 25 of the 28 breast cancer patients improved. Ten patients with prostate cancer and five with breast cancer became pain free. Little hematologic depression was noted. Sr-89 kinetic studies showed that strontium taken up in osteoblastic areas remained for 100 days. The tumor-to-marrow absorbed dose ratio was 10:1.

Topics: Bone Neoplasms; Breast Neoplasms; Female; Humans; Male; Pain, Intractable; Palliative Care; Prostatic Neoplasms; Radionuclide Imaging; Strontium Radioisotopes; Technetium Tc 99m Medronate