Role of radionuclide therapy as adjuvant to palliative external beamradiotherapy for painful multiple skeletal metastasis

摘要

Purpose: Aim of this study was to evaluate the palliative efficacy of localized external radiotherapyrncombined with systemic radionuclide therapy in patients who had multiple painful osseous metastases ofrndifferent primary origins. 33 patients with painful multiple bone metastases from different primarily originsrnwere eligible for this trial. Initially, local external radiotherapy was delivered to the most symptomatic region inrnall patients, followed by either Re186HEDP or Sm153EDTMP. The patients' mean age was 58.8 (min 35- max 82).rnThe performance status was assessed acording to ECOG scale. Before treatment, at the end of the radiotherapyrnand after the 4 weeks of systemic radionuclide therapy, analgesic intake and pain status were recorded by thernRTOG scoring system. In addition, the EORTC QLQ C30 (vesion 3.0 Turkish) questionnaire was performed tornevaluate the quality of life at the start of treatment, at the end of the radiotherapy and after the 4 weeks ofrnsystemic radionuclide therapy. Improved performances of 33.3% for post radiation therapy and 50% for postrnradionuclide therapy in the ECOG scale were observed. Statistically significant correlations were found betweenrnthe primary origins and decreased pain and analgesic intake (p< 0.05), but no differences were observed on thernself assesment quality of life questionnaire. Toxicity was acceptable. Overall median survival was 17 months,rnand progression free survival was 10 months. Patients with breast and prostate tumors had a higher overall andrnprogression free survival than those with other primary tumors (p=0.0062, p=0.0080). The results of this studyrndemonstrate that; both Re186HEDP and Sm153EDTMP are effective and safe in bone pain palliation as anrnadjuvant to local field radiation therapy of breast and prostate cancer patients, who also continued to receivernchemotherapy and/or hormontherapy. This combined treatment may be an alternative to half body irradiation forrnmultiple painful skeletal metastasis .