Author/Authors :
بيگي، داوود نويسنده Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran Beiki, Davood , تاجيك ، مريم نويسنده , , حداد، پيمان نويسنده , , فلاحي، بابك نويسنده موسسه تحقيقات پزشكي هسته اي-بيمارستان دكتر شريعتي-دانشگاه علوم پزشكي تهران Fallahi, B. , عارف پور، اميرمحمد نويسنده , , ميرزايي ، حميدرضا نويسنده , , فرد اصفهاني، ارمغان نويسنده دانشگاه علوم پزشكي تهران,مركز تحقيقات پزشكي هسته اي، بيمارستان دكتر شريعي , , امامي اردكاني، عليرضا نويسنده بيمارستان دكتر شريعتي Emami-Ardakani, Alireza , افتخاري ، محمد 1329 نويسنده پزشکي ,
Abstract :
Introduction: Bone metastases are the most common cause of cancer-related pain in various primary malignant tumors,
most often, breast and prostate. 188Re-hydroxyethylidene diphosphonate (188Re-HEDP) is a new and less expensive bone
seeking radiopharmaceutical with favorable physical characteristics of the radionuclide such as short half life of 16.9h,
maximal B energy of 2.1 MeV with a 15% ?-component of 155 keV and easily available from an in-house 188W/188Re
generator. The aim of this study is to evaluate the therapeutic efficacy and safety profile of bone palliative therapy following
administration of 188Re-HEDP.
Methods: Twenty patients with painful metastatic bone lesions secondary to breast, prostate, multiple myeloma, ampulla of
vater and lung cancers received 1 mCi/kg of 188Re-HEDP. Four hours after treatment, post-therapy scintigraphy was
performed. All patients were interviewed using a standard set of questions (visual analogue scale: VAS) concerning their
pain relief before, and after therapy at weekly intervals for the first month and every 2 weeks for the following 4 months.
The general condition of the patients was also evaluated by Karnofsky-index and ECOG (Eastern Cooperative Oncology
Group) performance status. Hematologic profiles were recorded before treatment and every two weeks up to 8 weeks after
treatment.
Results: Overall pain relief was found in 68.8% of patients. Decreased from 8.37±2.12 to 5.68±2.98 at VAS was observed 4
weeks after treatment. The osteoblastic lesions (breast and prostate) showed rather similar response to the treatment. Mean
platelet counts decreased in 6th week and returned to baseline level in 8th week. One patient showed grade III leukopenia
without any serious complication.
Conclusion: 188Re-HEDP is an effective radiopharmaceutical for metastatic bone pain palliation therapy. Side effects
include mild and transient thrombocytopenia and leucopenia and no life threatening side effect is observed.
