Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the past 6 years 16 patients suffering from Paget's disease of bone have been treated and regularly followed up in our department. 10 of these patients have received etidronate (ethane-hydroxy-diphosphonate), 4 others have received synthetic human calcitonin and the last 2 have received both treatments, first successively then simultaneously. Under either therapy satisfactory clinical and biological results have been observed (diminution of pain and decreased levels of serum alkaline phosphatase and hydroxyprolinuria). Etidronate has been more efficient in reducing biological parameters, whereas calcitonin has produced a faster symptomatic response. On the basis of these observations the present principles for treatment of Paget's disease are discussed.
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PMID:[Treatment of Paget's disease of bone: diphosphonates or calcitonin?]. 678 79

Bone metastases can have a devastating effect on a patient's quality of life due to pain and pathologic fractures. Local external beam radiotherapy is very effective for patients with only a few involved areas. Systemic therapy consisting of chemotherapy and hormonal therapy is extremely useful until the patient becomes refractory to treatment. Systemic radionuclide therapy using Strontium-89 has been shown to be very valuable, specifically in patients with bone metastases from hormonally-resistant prostate cancer. Studies have shown a significant improvement in analgesic requirement, time to further radiotherapy, and a reduction in tumor markers with this treatment. The use of Strontium-89 in the treatment of other bone neoplasms and the use of other radionuclides, such as Rhenium-186 HEDP and Samarium-153 EDT-MP, are still investigational.
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PMID:Systemic radionuclide therapy of bone metastases with strontium-89. 816 90

A 12-year-old patient with a severe traumatic brain injury developed heterotopic ossification (HO) with rapidly decreasing range of motion in multiple joints despite intensive passive range of motion exercises and the use of nonsteroidal antiinflammatory drugs (NSAIDs). His alkaline phosphatase was markedly elevated. Etidronate, 20mg/kg/d was used to control the ossification. After 7 months of continual etidronate use, the patient developed periarticular pain with widened growth plates, suggesting a rachitic syndrome. Serum laboratory panel including calcium, phosphorous, alkaline phosphatase, and vitamin D were normal. After 3 months off etidronate, radiological studies showed growth plate calcification, though not before development of bilateral slipped femoral capital epiphyses. Further improvement and resolution of all complications occurred 5 months after discontinuation of etidronate. Rachitic syndromes secondary to didronel use in a clinical setting has not been previously reported. Other possible causes for a rachitic syndromes were not present. Alternate treatments for children with or at risk for HO should be considered.
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PMID:Rachitic syndrome after disodium etidronate therapy in an adolescent. 829 54

Bone pain is a common symptom in disseminated malignancy and may be difficult to manage effectively. Radiation is of proven benefit for pain palliation and there is growing interest in the therapeutic potential of bone-seeking radiopharmaceuticals. Clinical data relating to the use of phosphorus-32, strontium-89, samarium-153 EDTMP, rhenium-186 HEDP and tin-117m DTPA are reviewed in the context of the pathophysiology of metastatic bone pain. Possible mechanisms of action of palliative radiotherapy and, in particular, the theoretical role of early response genes are discussed. The application of Monte Carlo simulation to targeted radiotherapy for bone metastases may provide the basis for a clearer understanding of the microdosimetry and radiobiology of bone pain palliation and for reliable prediction of clinical response and toxicity.
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PMID:Cancer therapy using bone-seeking isotopes. 891 78

Prostate carcinoma is the most commonly associated with osseous metastases malignancy in males. The lesions, being usually of a mixed sclerotic/lytic variety and less often of the pure sclerotic type, need to be treated by a bone seeking radioactive element with an as low as possible radiobiological burden on the surrounding (peritumoral) tissues. Rhenium-186-HEDP was used to treat these osseous metastatic lesions due to its bone seeking kinetics attractive radiochemical properties. Of a total of 16 prostate cancer patients. 3 experiment loss of pain, 8 experienced obvious and 2 some improvement. No change was observed in 3 patients. Ten patients manifested a flare syndrome increasing pain approximately 2 to 6 days, after Re-186-HEDP i.v. application. Six patients showed a definite and 9 a slight decrease in platelet levels and absolute number of polymorphonuclear white blood cells, up to fourth week following treatment. One patient underwent a whole blood transfusion and in 2 peripheral neuropathy was observed lasting about 9 to 12 days. Re-186-HEDP appears to be a promising new metal ion complex for the palliation of painful bone metastases in prostate cancer. Compared to Sr-89 therapy, it shows a longer analgetic efficacy and has the advantage of emitting gamma rays, a fact which facilitates dosimetric calculations.
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PMID:Rhenium-186-HEDP palliative treatment in disseminated bone metastases due to prostate cancer. 917 22

The efficacy and toxicity of treatment with 1400 +/- 100 MBq of Re-186-HEDP were evaluated in women with osseous metastatic breast cancer. The follow-up period was fourteen weeks. The efficacy of treatment was assessed by a) a pain and performance questionnaire that patients were asked to complete daily and b) a CT scan comparison of a randomly preselected osseous lesion before and 30 weeks after Re-186-HEDP i.v. application. The response to treatment was also evaluated by using the Kamofsky Index. Two out of fourteen women (14%) experienced loss of pain, 6 experienced obvious and 2 some improvement. No change was observed in 4 patients. Five patients manifested a flare response to treatment, with increase in pain within the first, 4 to 5 days after Re-186-HEDP administration. Five patients showed a decrease in platelet levels and absolute number of polymorphonuclear blood transfusion; no neurologic side effects were observed. Re-186-HEDP appears to be a useful new radiopharmaceutical for pain palliation induced by osseous metastases due to breast cancer. Compared to Sr-89 chloride efficacy, it provides longer-lasting analgesia, and when needed it can be reinjected with less risk due to its improved physico- and radiochemical properties.
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PMID:Palliative therapy using rhenium-186-HEDP in painful breast osseous metastases. 917 32

A common complication in patients with breast or prostate cancer is bone metastases causing pain. New radionuclide therapy methods have recently been proposed for palliation, including 186Re-hydroxyethylidene diphosphonate (186Re-HEDP). This paper reports on the local development of 186Re-HEDP and the biodistribution studied in animals for eventual use in patients. Adult dose was computed assuming a 70 kg standard man. The 186Re was labelled to HEDP using standard techniques. The biodistribution in five Chacma baboons (Papio ursinus) was studied. Doses ranging from 39.4 to 44.9 MBq kg(-1) (mean 43.6 +/- 2.8 MBq kg[-1]) were administered, corresponding to an adult human dose of 2960 MBq (80 mCi). Whole-body images of the animals were obtained with a dual-headed scintillation camera on an hourly basis for 6 h post-injection and then daily for 3 days. The bone, soft tissue, kidneys and urinary bladder were considered source organs and data from these organs were used in a compartmental model to obtain the mean residence times of the radionuclide in the different source organs. Radiation dose estimates for 186Re-HEDP were subsequently obtained with the MIRDOSE 3 program. The estimated absorbed radiation doses to some of the organs (expressed in mGy MBq[-l]) were as follows: bone surface 1.69; kidneys 0.09; liver 0.04; ovaries 0.04; red marrow 0.75; total body 0.12; urinary bladder wall 0.43. 186Re-HEDP yielded an effective dose of 0.17 mSv MBq(-1). The radiation dose delivered to the bone marrow in this study did not cause any detrimental effect to the baboons, indicating that locally produced 186Re-HEDP is suitable for clinical use.
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PMID:Radiation dose estimates of 186Re-hydroxyethylidene diphosphonate for palliation of metastatic osseous lesions: an animal model study. 925 33

The aim of this study was to evaluate the efficacy of rhenium-186 hydroxyethyledine diphosphonate (Re-186 HEDP) for pain relief in patients with disseminated bone metastases primarily from prostate or breast cancer. Up to now, 44 patients taking analgesics were entered in this study and received one or more injections of 1295 MBq of Re-186 HEDP. An analgesic effect of more than 20%, evaluated by using a verbal rating scale (VRS) and a visual analogous scale (VAS), was defined as significant and could be achieved in 60% of these patients. Duration of clinical response averaged 1-4 months (median 5.5 weeks). Side effects such as a moderate decrease of platelets or an increase of pain for 1-2 days (flare-up effect) were observed. Radioactive treatment with Re-186 HEDP appears to be a useful compound for the palliation of painful skeletal metastases and improvement of the remaining quality of life.
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PMID:Rhenium-186 HEDP: palliative radionuclide therapy of painful bone metastases. Preliminary results. 940 4

Systemic administration of strontium-89 is an important option for pain relief in advanced prostate carcinoma with multiple osseous metastases. Recently, rhenium-186-HEDP was introduced as a new substance which has important advantages (shorter physical half-life, scintigraphic imaging, dose distribution). The myelosuppressive effect can be estimated more accurately in advance, so that adverse effects can be reduced and the treatment can be repeated after a shorter period of time and more often. Our study comprises 15 treatments with rhenium-186-HEDP in advanced prostate cancer patients using the 1.4- to 2-fold standard dose. The response rate, estimated as reduction in pain and increase in patient mobility, was 87% with no major myelosuppressive effects. The mean duration of pain relief was 4-6 weeks. All four patients with repeated therapy were also responding to the second treatment. Radionuclide therapy for painful osseous metastases with rhenium-186-HEDP appears to be an effective and, even at higher doses, safe procedure.
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PMID:[Palliative treatment for pain in osseous metastasized prostatic carcinoma with osteotropic rhenium-186 hydroxyethylidene diphosphonate (HEDP)]. 948 90

Therapeutic means for patients with disseminated painful bone metastases in breast cancer are strongly limited. There is a big need of an effective and well tolerated therapy. The aim of this study was to evaluate the efficacy of rhenium-186 HEDP for pain palliation in patients with bone metastases in breast cancer. 17 patients with painful bone metastases taking analgesics received one or more injections of 1295 MB9 rhenium-186 HEDP. In 59% of the patients the therapy resulted in a significant reduction of pain. The duration of pain relief partially hold on up to nine weeks. The main side effects of therapy were a short decrease of platelets and leucocytes and an increase of pain for 1-2 days. As conclusion we found out that therapy with rhenium-186 HEDP can be used complementarily to analgesic therapy and radiation in patients with painful disseminated bone metastases in breast cancer.
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PMID:[Pain therapy in multiple bone metastases in breast carcinoma with rhenium 186 HEDP]. 953 13


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