Pain Management in Bone Metastases
Scrafini, AN, Houston SJ, Resche I, et al
Palliation of Pain Associated with Metastatic Bone Cancer Using Samarium 153 Lexidronam: A Double Blind Placebo Controlled Clinical Trial
J Clin Oncol 16: 1574-1581, 1998
Bone metases are a common complication of solid malignant tumors and can cause severe morbidity. Significant bone pain occurs in nearly half of the patients with breast and prostate cancer who have bone metastases. Bone seeking agents that combine radionuclides with shorter half-life and lower energy particle emissions have been recently developed, and their various chelating agents can localize preferentiually to osteoblastic metastases after intravenous administration. One such agent that is attractive for use in the palliation of painful bony metastases is Samarium – 153 Lexidronam [ S 153 EDTMP]. The safety and efficacy of this agent in a single dose was studied in a placebo-controlled double-blind study.
118 patients with painful bone metastases secondary to a variety of primary malignancies received either S 153 EDTMP or placebo. Evaluations by patients and clinicians were used to assess pain relief as well as concurrent change in opiod analgesia.
Results showed significant pain relief in the S 153 EDTMP group in each of the 4 weeks in 62% to 72% of the patients, with marked or complete pain relief in 31% by 4 weeks and in 43% of the patients pain relief continued upto 16 weeks. Significant reduction of opiod analgesia was also observed in these patients. Mild but reversible bone marrow suppression was observed in those patients.