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177Lu-Edtmp for Metastatic Bone Pain Palliation: A Systematic Review and Meta-Analysis Publisher Pubmed



Askari E1 ; Harsini S2, 3 ; Vahidfar N4 ; Divband G5 ; Sadeghi R1
Authors
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Authors Affiliations
  1. 1. Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  2. 2. Association of Nuclear Medicine and Molecular Imaging (ANMMI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  3. 3. Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Behbahan Faculty of Medical Sciences, Behbahan, Iran

Source: Cancer Biotherapy and Radiopharmaceuticals Published:2021


Abstract

Purpose: Painful metastatic bone involvement is common in advanced stages of many cancers. Between available radionuclides for bone pain palliation, no consensus has been reached on lutetium ethylenediaminetetramethylene phosphonate (177Lu-EDTMP) administration in this milieu. The aim of this study is to evaluate the treatment efficacy, safety profile, and toxicities of 177Lu-EDTMP in patients with metastatic bone involvement, according to the published literature. Methods: A comprehensive literature search of PubMed/MEDLINE, Scopus, and Google Scholar databases was carried out to retrieve pertinent articles published until January 2019, concerning the clinical efficacy and safety of 177Lu-EDTMP for bone pain palliative purposes. Results: Eight studies (172 patients) were included. This analysis revealed statistically significant effect of 177Lu-EDTMP therapy on the visual analog score (4.84% (95% CI: 3.88-5.81; p < 0.001), bone palliative pain response (84%, 95% CI: 75%-90%; p < 0.001), and Karnofsky performance status (21%, 95% CI: 18%-24%; p < 0.001) overall (as well as in the high-dose and low-dose subgroups). Complete palliative pain response to treatment was observed in 32% (95% CI: 16%-53%) of patients receiving 177Lu-EDTMP. Anemia was found to be the most common hematologic toxicity imposed by this therapeutic approach (grade I/II anemia in 24% (95% CI: 14%-38%; p < 0.001) and grade III/IV anemia in 19% (95% CI: 12%-28%; p < 0.001)). Conclusions: 177Lu-EDTMP seems to have comparable efficacy and safety profile as that of the frequently administered radiopharmaceuticals for bone palliation. Therefore, this agent can be a good option for bone pain palliative purposes, in case of limited access to other bone palliative radiopharmaceuticals. © 2021, Mary Ann Liebert, Inc., publishers.
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3. An Impressive Approach in Nuclear Medicine: Theranostics, PET Clinics (2021)
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