Myelotoxicity after 153Samarium-EDTMP Treatment
for Painful Bone Metastases
Doležal J.1, Vižďa J.1, Čermáková E.2
1Oddelění nukleární medicíny Fakultní nemocnice, Hradec Králové, přednosta MUDr. Ing. Jaroslav Vižďa 2Oddělení výpočetní techniky Lékařská fakulty UK, Hradec Králové, vedoucí prof. MUDr. Pravoslav Stránský, CSc. |
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Summary:
Aim: The breast cancer and the prostate cancer are considered as the most frequently occurred
metastatic tumors in bones. The bone pain appears in majority of patients with metastases. One
possibility how to reduce or to remove this pain is the administration of the radiotherapy to the
place of metastases. The present medicine disposes of two ways how to administer radiotherapy
in the place of metastases: externally irradiation (loco-regional or half-body) or intravenous administration
of bone-seeking therapeutic radiopharmaceuticals. Material and Method: We introduced
intravenous administration of 153Samarium-EDTMP in 57 patients (30 prostate cancer, 23
breast cancer, 4 renal cell carcinoma). Mean applied activity was 40 MBq per kg of patient’s body
weight. Results: After 153Sm-EDTMP administration we observed pain relief of various degree in
75 % of patients for three months. 1 and 3 months after 153Samarium-EDTMP administration the
following haematologic parameters changes were seen: a) 7 % reduction in red cell count in one
month after administration, 15 % reduction after three months. b) 43 % reduction in leukocyte
count in one month after administration, 24 % reduction after three months. c) 50 % reduction in
platelet count in one month after administration, 23 % reduction after three months. In all three
haematological profiles (red cells, leukocytes, platelets) we detected reduction of values after
treatment with 153Samarium-EDTMP. This reduction culminates one month after administration
and in three months leukocytes and platelets count was getting better. Conclusion: Myelosuppression
was mild and temporary. No patients had grade 4 hematological toxicity and only three
patients (5 %) had grade 3 hematological toxicity (National Cancer Institute Common Toxicity
Criteria).
Key words:
Myelotoxicity - Bone metastases - 153Samarium-EDTMP
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