Samarium-153 treatment of painful bone metastases
Radiotherapy for painful bone metastases is a palliative treatment modality for patients with advanced cancers. It is indicated for patients with strong pain related to bone metastases.
Painful bone metastases mostly occur in patients with prostate and breast cancer, less frequently in patients with bladder, ovarian, kidney, lung, colon cancer, as well as malignant myeloma.
Pain relief effect is usually observed 1-2 weeks after the radioisotope administration and is felt for 4-6 months. The therapy can be repeated every 6 months.
Treatment effects:
- pain reduction
- decrease in analgesic consumption
- improvement of life quality observed in 61-90% of patients depending on the cancer type and stage
As the therapy involves radiopharmaceutical usage, it is contraindicated in:
• pregnant and breastfeeding patients;
• patients with vertebral compressions;
• patients who underwent radiotherapy within the last 8 weeks;
• patients who underwent chemotherapy within the last 8 weeks;
• patients who can continue hormonal therapy.
Patient eligibility for the treatment:
Each patient must be assessed for eligibility before undergoing any isotopic treatment procedure. During the eligibility assessment visit, the nuclear medicine specialist interviews and examines the patient, as well as studies their available medical imaging records (e.g. CT, MRI or bone scintigraphy). As bone scintigraphy delivers invaluable diagnostic information, the patient must undergo this scan before the treatment, the maximum allowed time period between the bone scan and treatment being 3 months.
During the visit, the patient should provide the doctor with the important information on the previously administered systemic therapies (e.g. chemotherapy, radiotherapy, surgery) and pain treatment. The nuclear medicine specialist prescribes blood tests to be taken (blood cell counts with platelet counts, liver and kidney blood test results). Having analyzed their results and all the previously collected information, the doctor determines the individual radioactivity dose to be administered and schedules the patient for the treatment.
If you would like to schedule an appointment for the eligibility assessment, you can do it in person, by mail or by phone.
Patient preparation for the treatment:
- no special patient preparation is required
How is the treatment performed?
- • Upon their arrival to the clinic, the patient is examined by the nuclear medicine specialist. Then a vein catheter is inserted and the patient is invited to a separate room. 500 ml of intravenous fluids is given (5% glucose solution or isotonic saline if the patient has diabetes), followed by a slow IV injection of the radiopharmaceutical over 1-2 minutes, and more IV fluids. The patient stays in the clinic for about 6 hours.
What do I need to do after the treatment?
- due to the potential risk of transient myelosuppression, it is necessary to run a follow-up blood test 2 weeks after isotopic treatment and provide the doctor in charge with the results
- radiotherapy or chemotherapy cannot be administered for 8 weeks after the treatment