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Targeted Palliative Radionuclide Therapy for Metastatic Bone Pain Publisher



Manafifarid R1 ; Masoumi F2 ; Divband G3 ; Saidi B1 ; Ataeinia B4 ; Hertel F5 ; Schweighoferzwink G6 ; Morgenroth A5 ; Beheshti M5, 6
Authors
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Authors Affiliations
  1. 1. Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, 1411713135, Iran
  2. 2. Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, 1411713135, Iran
  3. 3. Department of Nuclear Medicine, Jam Hospital, Tehran, 1588657915, Iran
  4. 4. Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital—Charlestown HealyhCare Center, Boston, 02129, MA, United States
  5. 5. Department of Nuclear Medicine, University Hospital, RWTH University, Aachen, 52074, Germany
  6. 6. Department of Nuclear Medicine and Endocrinology, Paracelsus Medical University, Salzburg, 5020, Austria

Source: Journal of Clinical Medicine Published:2020


Abstract

Bone metastasis develops in multiple malignancies with a wide range of incidence. The presence of multiple bone metastases, leading to a multitude of complications and poorer prognosis. The corresponding refractory bone pain is still a challenging issue managed through multidisciplinary approaches to enhance the quality of life. Radiopharmaceuticals are mainly used in the latest courses of the disease. Bone-pain palliation with easy-to-administer radionuclides offers advantages, including simultaneous treatment of multiple metastatic foci, the repeatability and also the combination with other therapies. Several β¯-and α-emitters as well as pharmaceuticals, from the very first [89Sr]strontium-dichloride to recently introduced [223Ra]radium-dichloride, are investigated to identify an optimum agent. In addition, the combination of bone-seeking radiopharmaceuticals with chemotherapy or radiotherapy has been employed to enhance the outcome. Radiopharmaceuticals demonstrate an acceptable response rate in pain relief. Nevertheless, survival benefits have been documented in only a limited number of studies. In this review, we provide an overview of bone-seeking radiopharmaceuticals used for bone-pain palliation, their effectiveness and toxicity, as well as the results of the combination with other therapies. Bone-pain palliation with radiopharmaceuticals has been employed for eight decades. However, there are still new aspects yet to be established. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.