Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0153690 (bone metastases)
 6,382 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bone metastases that develop in patients with advanced prostate cancer often cause deep, unremitting pain. Palliative options for the control of this pain include analgesic support, cytotoxic chemotherapy and external-beam radiotherapy. In addition to external irradiation, interest in intravenously injected radioisotopes that are preferentially localized to bone has been mounting. Metastron (an isotope of strontium) imitates the biodistribution of calcium in vivo and is avidly taken up into bony metastases where it has a biological half-life of just over 50 days. The biological half-life in undiseased bone is far shorter, approximately 14 days. Various studies have been conducted to evaluate the role of Metastron in metastatic prostate cancer. An optimum dose has yet to be finalized, but it is clear that the change of haematological toxicity becomes more significant at much larger doses. In the large, randomized Trans Canada study in which Metastron or placebo was given to patients as an adjunct to local field irradiation, those patients treated with Metastron had a significantly reduced intake of analgesics. Furthermore, progression of pain, as measured either by sites of new pain or by the requirement for further palliative radiotherapy, demonstrated statistically significant differences in favour of Metastron. There is thus increasing evidence of a useful role for Metastron in the treatment of prostate cancer metastatic to bone.
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PMID:Strontium-89 (Metastron) in the treatment of prostate cancer metastatic to bone. 753 65

A retrospective study was performed on the cost-effectiveness of treatment for advanced prostate cancer metastatic to bone. Patients (n = 29) recruited into the trans Canada trial at the Cross Cancer Institute, Edmonton and randomized to treatment with Metastron (strontium-89 chloride) (n = 14) or placebo (n = 15) after local field irradiation therapy for pain palliation were studied over their entire survival time. Estimates were made of the direct costs of treatment, i.e. drugs (analgesics and hormonal agents) and external radiotherapy, and the indirect costs (investigations, outpatient visits and inpatient days, either total or for tertiary care) based on records from the referring hospital, the cancer clinic and any hospitals to which the patients may subsequently have been referred. Meaningful differences were apparent between the two groups in direct costs with the group receiving Metastron showing a reduction over the entire survival time of Can$ 1,720/person compared with placebo; it should be noted that in this analysis neither the costs of the Metastron, nor of the initial radiotherapy, have been included. The Metastron group also showed a reduction in costs of hospitalization for tertiary care of Can$ 5,696/person, though the total cost of hospitalization was similar in the two groups. These results suggest that treatment with Metastron can bring about reductions in management costs for patients with advanced prostate cancer and, coupled with the findings of the Trans Canada trial on the improvement in quality of life for patients given Metastron, they add financial support to the clinical rationale for the use of Metastron for the palliative treatment of patients with bone metastases resulting from prostate cancer.
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PMID:A retrospective analysis of the cost effectiveness of treatment with Metastron in patients with prostate cancer metastatic to bone. 753 66

Bony metastasis is the most common cause of cancer pain. Strontium-89 (Sr-89), or Metastron, therapy has been shown to be effective for the palliation of pain due to skeletal metastases. By reducing opioid analgesics intake and restoring mobility, Sr-89 improves the patient's quality of life. Sr-89 is given conveniently as an outpatient procedure, and when necessary it can be repeated at 3-month intervals. Sr-89 is useful as an adjunct to local external beam radiation (EBR) because Sr-89 will target all skeletal metastases, including those not included in the EBR field. Because Sr-89 is a beta-emitting radionuclide with a long physical half-life (50.5 days), precautions should be taken by the caretaker(s) against Sr-89 contamination from the patient's blood or excretions, particularly if the patient is incontinent.
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PMID:Palliation of bone pain in patients with metastatic cancer using strontium-89 (Metastron). 754 83

Prostate cancer is one of the most common tumors in men. At presentation, 50% of patients have advanced disease and 25% have bone metastases. Hormonal palliation is the treatment of choice for metastatic bone pain, with a pain-free response rate of 75% for a period of 16-18 months. Second-line treatment with chemotherapy has a moderate and short-term effect. Once endocrine therapy and chemotherapy cease to be effective, radiotherapy is a good option for recurrent painful bone metastases. Diffuse painful metastases can be treated with half-body irradiation with a response rate of up to 70%, but there is considerable toxicity. Strontium-89 (Metastron) is a calcium analog radionuclide that is selectively absorbed at bone locations with increased osteoblastic activity. It is a pure beta-emitter with bone penetration of 0.8 cm, and it has been used in multiple trials with response rates of up to 80%. Results are reported with Metastron in 28 patients with diffuse painful bone metastases, in whom a response rate of 82% was seen.
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PMID:An overview of current clinical experience with strontium-89 (Metastron). 817 12

This retrospective study evaluated the toxicity and efficacy of strontium-89 chloride (Metastron, Amersham) in 94 patients with painful bone metastases of prostate cancer (117 injections of 150 MBq) and compared the efficacy of treatment in patients with moderate and extensive bone involvement. The predictive value of flare response with regard to analgesic response was also studied. High-grade leukothrombopenias were observed after only 5% of injections. An improvement in quality of life was obtained in 65% of cases, a decrease in pain in 78% (31% complete response) and a reduction of analgesics in 60%. Efficacy was significantly better for pain decrease (P=0.005) and reduction of analgesics (P=0.018), and response was significantly longer (P<0.0035) in patients with moderate than in patients with extensive bone involvement. The flare response observed in 23% of cases was not predictive of pain response (P=0.919) or reduction of analgesics (P=0.353). A second dose prolonged analgesia in three-quarters of cases without any apparent increase in toxicity. These results confirm the benefit of 89Sr chloride for the treatment of metastatic bone pain and suggest that internal radiotherapy should be started earlier. A bone scan could be proposed at the time of hormonal escape resulting in bone pain, and internal radiotherapy could be initiated when several metastatic foci exist, even if only one is painful. In this way, pain-free follow-up could be prolonged, and the transition to other therapeutic approaches, particularly opioids, delayed.
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PMID:Treatment of bone metastases of prostate cancer with strontium-89 chloride: efficacy in relation to the degree of bone involvement. 1108 37

An analysis of prospectively collected data from 75 patients with bone metastases secondary to prostate cancer who were treated with strontium-89 injection in a single centre over a 10-year period, is presented. The surrogate role of markers of disease progression (haemoglobin and prostate specific (PSA) antigen levels; number of bone scan-positive sites), symptomatic factors (analgesic intake; number of painful bone sites) and history of prior external radiotherapy, were analysed to determine whether any parameters had a predictive effect on the success of strontium-89 treatment. The success of strontium-89 injection was determined by calculating the change in number of sites of bone pain (pain sites) and analgesic intake. The outcome was classed as successful in 42 (56.0%) patients, unsuccessful in 13 (17.3%) and unchanged in 20 (26.7%). Proportionately more of the patients who had 'superscans' on bone scintigraphy at baseline had an unsuccessful outcome after a strontium-89 injection (5/7; 71.4%); for those with fewer bone scan-positive sites the majority had successful outcomes. Patients with a successful outcome had a significantly better survival rate after strontium-89 injection. Multivariate analysis showed haemoglobin level, PSA level and outcome after strontium-89 treatment to be significant independent prognostic variables; no change/unsuccessful outcome, a high PSA level prior to treatment, and a low haemoglobin level were associated with poor survival. It is suggested that early treatment with strontium-89 (Metastron) in patients with fewer bone metastases is more likely to be successful, with a longer time before further therapy required.
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PMID:Predictors of response to strontium-89 (Metastron) in skeletal metastases from prostate cancer: report of a single centre's 10-year experience. 1152 99

We evaluated possibilities of bone scintigraphy with 99mTc-methylendiphosphonate (99mTc-MDP) and magnetic resonance imaging (MRI) in follow-up and prediction of effect in patients with extensive bone metastatic disease treated with betha-emitter 89SrCl2. 24 patients with prostate cancer and extensive metastatic involvement of skeleton were referred for the study. 89SrCl2 was injected as single injection of 150 MBq (4 mCi), in eighteen from Amersham plc., England, as Metastron, in six--from Medradiopreparat, Russia). In all patients bone scintigraphy with 99mTc-MDP and MRI study of metastatic regions were performed before and in 3 months after 89SrCl2 injection. Patients treated with Metsatron were also studied in 6 months after injection. Quantitative analysis of data comprised count and anatomic dimensions of metastatic areas and calculation of indices [metastasis/intact bone] both for scintillation count of 99mTc-MDP bone scans and signal intensity of T1-weighted MRI scan. Henceforth, we conclude the data of bone scanning with 99mTc-MDP and of MRI give evidencies for significant regress of bone metastases in patients treated with 89SrCl2 besides symptomatic suppression of pain syndrome. 99mTc-MDP bone scanning is also of predictive value for the prognosis of therapeutic effect of systemic radiotherapy with 89SrCl2 in prostate cancer.
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PMID:[Radiologic follow-up and prognosis of efficiency of systemic Sr-89 Cl-2 therapy of bone metastases in prostate cancer]. 1271 12

Aiming to evaluate efficiency of 89SrCl (Metastron) in patients with metastatic lesion of the skeleton in prostate cancer we have performed a follow-up scintigraphy of the skeleton with 99mTc-methylendiphosphonate (MDP) and MRI with quantitative study of metastatic foci. 12 patients with prostate cancer (on the average 11 +/- 6 bone metastases were examined using scintigraphy of the skeleton with 99mTc-MDP and MRI study in T1, T2 and proton density modes. Investigations were performed before injected as a single dose of 150 MBq (4 mCi). At all the stages there was made a quantitative study of foci of pathological uptake of 99mTc-MDP compromising numbers of foci, focus parameters, intensity of 99mTc-MDP accumulation in the pathological part relatively the contralateral region as well as quantification of MRI signals from metastatic areas in signal intensity units. In 3 month 4 patients with extensive metastatic skeletal lesion (> 12) showed a considerable decrease of number of foci of pathological 99mTc-MDP uptake (on average to 6 +/- 3). In the remained metastatic foci there was noted a decrease of dimensions and 99mTc-MDP uptake intensity at an average by 29.8 +/- 15%, improvement in T1 intensity by 113 +/- 55.6 units. In 2 patients who initially presented a "superscan" pattern on 99mTc-MDP bone scintigraphy the 89SrCl treatment converted this of low intensity had demonstrated their complete regression. Results of radiologic follow-up of bone metastases in prostate cancer using MRI and bone scintigraphy with 99mTc-MDP argue that systemic radiotherapy with 89SrCl induces significant regress of metastatic process that involves all volume of the metastases.
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PMID:[Radiologic diagnosis of bone metastases recurrence in patients with prostate cancer treated strontium-89]. 1271 23

Background. The aim of this study was to evaluate the effectivness of connected therapy using strontium 89 or Sm153 (osteoblastic component) and bisphosphonate therapy (osteolytic component) in the group of breast cancer patients with multiple osteoblastic-osteolytic (mixt) bone metastases. <br /> Material and methods. The study included 16 patients with breast cancer and multiple bone painful metastases detected by scintigraphy and by radiogram or CT or MRI (the type of metastases). Each patient received a standard dose of strontium 89 (Metastron) or samarium 153 (Quadramet) combined with intravenous infusion of pamidronate (Aredia) or zoledronate (Zometa). The bisphosphonate therapy was repeated every month. For assessment of therapy effectivness; pain relief (VAS scale), a reduction in analgesic requirements and motor activity (ECOG and Karnofsky scale) were evaluated. The group of 10 patients treated with bisphosphonate only in the same time was observed. <br /> Results. We conclude that connected palliative therapy using strontium 89 and bisphosphonates is effective (66-75% "good" and "moderate" response rate) and safe for bone pain palliation in patients with multiple osteoblastic-osteolytic bone metastases from breast cancer. We have observed that the analgesic requirments decreased to 30% of dose on average. The motor activity of the points evaluated according to ECOG scale increased from 3 to 2 and from 50 to 60 to Karnofsky scale. <br /> Conclusions. The results of treatment in the group with radioisotope and bisphosphonate were better than in the group treated with bisphosphonates or radioisotope only.
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PMID:Preliminary results of combined application of radioisotopes and biphosphonates in the management of pain associated with osteoblastic-osteolytic bone metastases of breast cancer. 1803 12

Background. The aim of this study was to evaluate the effectivness of strontium 89 (Metastron) therapy in the group of prostate cancer patients with multiple bone metastases. <br /> Material and methods. The study included 70 patients (aged 53-84) with prostate cancer and multiple bone painful metastases detected by scintigraphy and by radiogram character of metastases (osteoblastic - 55 patients, osteolytic-osteoblastic - 15 patients). Before strontium 89 therapy 34 out 70 patients have been performed local irradiation to the back bone as prevention of spinal cord compression. For assessment of therapy effectivness; pain relief (VAS scale), a reduction in analgesic requirements and motor activity (ECOG and Karnofsky scale) were evaluated. <br /> Results. We conclude that palliative therapy using strontium 89 is effective (88% "good" and "moderate" response rate) and safe for bone pain palliation in patients with multiple prostate cancer bone metastases; it also improves the quality of life. We have observed that the analgesic requirments decreased to 50% of dose on average. The motor activity of the points evaluated according to ECOG scale and Karnofsky scale was much better (p < 0,05).
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PMID:The effectivness of strontium 89 in palliative therapy of painful prostate cancer bone metastases. 1803 33


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