Radiopharmaceuticals for Palliation of Bone Pain in Patients with Castration-resistant Prostate Cancer Metastatic to Bone: A Systematic Review

Joyce M van Dodewaard-de Jong; Daniela E Oprea-Lager; Lotty Hooft; John M H de Klerk; Haiko J Bloemendal; Henk M W Verheul; Otto S Hoekstra; Alfons J M van den Eertwegh

doi:10.1016/j.eururo.2015.09.005

Radiopharmaceuticals for Palliation of Bone Pain in Patients with Castration-resistant Prostate Cancer Metastatic to Bone: A Systematic Review

Joyce M van Dodewaard-de Jong, Daniela E Oprea-Lager, Lotty Hooft, John M H de Klerk, Haiko J Bloemendal, Henk M W Verheul, Otto S Hoekstra, Alfons J M van den Eertwegh

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

CONTEXT: The majority of patients with castration-resistant prostate cancer develop bone metastatic disease. It is often challenging to optimally palliate malignant bone pain. In case of multifocal pain due to diffuse osteoblastic metastases, treatment with bone-seeking radiopharmaceuticals can be considered.

OBJECTIVE: This systematic review evaluates the efficacy of different bone-seeking radiopharmaceuticals for palliation of malignant bone pain from prostate cancer.

EVIDENCE ACQUISITION: The PubMed (Medline) and Embase databases were searched for publications on 89-strontium-chloride ((89)Sr), 153-samarium-EDTMP ((153)Sm), 186-rhenium-HEDP ((186)Re), 188-rhenium-HEDP ((188)Re), and 223-radium-chloride ((223)Ra). Randomised controlled trials and prospective cohort studies were included. Metastatic bone pain had to be registered as outcome measure for prostate cancer patients separately.

EVIDENCE SYNTHESIS: This review included 36 articles of which 13 randomised trials and 23 prospective studies. Of all trials, 10 studies used (89)Sr, 7 (153)Sm, 12 (186)Re, 2 (188)Re, and 2 (223)Ra; three reported on a combination of different radionuclides. Only a few trials contained a blinding procedure and several studies contained incomplete follow-up or lack of intention-to-treat analysis. It was not possible to calculate a pooled estimate of pain response to treatment with any of the radionuclides because different definitions of pain response were used.

CONCLUSIONS: Overall, pain response percentages greater than 50-60% were seen with each radionuclide. Haematological toxicity was reported in 26 of the 36 studies and more than half of these trials stated no grade 3/4 leukopenia or thrombocytopenia occurred.

PATIENT SUMMARY: In this report we reviewed the efficacy of bone-seeking radionuclides for treating bone pain from metastatic prostate cancer. Overall, treatment with bone-seeking radionuclides resulted in pain responses greater than 50-60%.

Original language	English
Pages (from-to)	416-426
Journal	European Urology
Volume	70
Issue number	3
DOIs	https://doi.org/10.1016/j.eururo.2015.09.005
Publication status	Published - Sept 2016

Keywords

Bone metastases
Bone pain
Bone seeking
radiopharmaceutical
Prostate cancer

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Jong, J. M. V. D., Oprea-Lager, D. E., Hooft, L., de Klerk, J. M. H., Bloemendal, H. J., Verheul, H. M. W., Hoekstra, O. S., & van den Eertwegh, A. J. M. (2016). Radiopharmaceuticals for Palliation of Bone Pain in Patients with Castration-resistant Prostate Cancer Metastatic to Bone: A Systematic Review. European Urology, 70(3), 416-426. https://doi.org/10.1016/j.eururo.2015.09.005

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title = "Radiopharmaceuticals for Palliation of Bone Pain in Patients with Castration-resistant Prostate Cancer Metastatic to Bone: A Systematic Review",

abstract = "CONTEXT: The majority of patients with castration-resistant prostate cancer develop bone metastatic disease. It is often challenging to optimally palliate malignant bone pain. In case of multifocal pain due to diffuse osteoblastic metastases, treatment with bone-seeking radiopharmaceuticals can be considered.OBJECTIVE: This systematic review evaluates the efficacy of different bone-seeking radiopharmaceuticals for palliation of malignant bone pain from prostate cancer.EVIDENCE ACQUISITION: The PubMed (Medline) and Embase databases were searched for publications on 89-strontium-chloride ((89)Sr), 153-samarium-EDTMP ((153)Sm), 186-rhenium-HEDP ((186)Re), 188-rhenium-HEDP ((188)Re), and 223-radium-chloride ((223)Ra). Randomised controlled trials and prospective cohort studies were included. Metastatic bone pain had to be registered as outcome measure for prostate cancer patients separately.EVIDENCE SYNTHESIS: This review included 36 articles of which 13 randomised trials and 23 prospective studies. Of all trials, 10 studies used (89)Sr, 7 (153)Sm, 12 (186)Re, 2 (188)Re, and 2 (223)Ra; three reported on a combination of different radionuclides. Only a few trials contained a blinding procedure and several studies contained incomplete follow-up or lack of intention-to-treat analysis. It was not possible to calculate a pooled estimate of pain response to treatment with any of the radionuclides because different definitions of pain response were used.CONCLUSIONS: Overall, pain response percentages greater than 50-60% were seen with each radionuclide. Haematological toxicity was reported in 26 of the 36 studies and more than half of these trials stated no grade 3/4 leukopenia or thrombocytopenia occurred.PATIENT SUMMARY: In this report we reviewed the efficacy of bone-seeking radionuclides for treating bone pain from metastatic prostate cancer. Overall, treatment with bone-seeking radionuclides resulted in pain responses greater than 50-60%.",

keywords = "Bone metastases, Bone pain, Bone seeking, radiopharmaceutical, Prostate cancer",

author = "Jong, {Joyce M van Dodewaard-de} and Oprea-Lager, {Daniela E} and Lotty Hooft and {de Klerk}, {John M H} and Bloemendal, {Haiko J} and Verheul, {Henk M W} and Hoekstra, {Otto S} and {van den Eertwegh}, {Alfons J M}",

year = "2016",

month = sep,

doi = "10.1016/j.eururo.2015.09.005",

language = "English",

volume = "70",

pages = "416--426",

journal = "European Urology",

issn = "0302-2838",

publisher = "Elsevier",

number = "3",

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TY - JOUR

T1 - Radiopharmaceuticals for Palliation of Bone Pain in Patients with Castration-resistant Prostate Cancer Metastatic to Bone

T2 - A Systematic Review

AU - Jong, Joyce M van Dodewaard-de

AU - Oprea-Lager, Daniela E

AU - Hooft, Lotty

AU - de Klerk, John M H

AU - Bloemendal, Haiko J

AU - Verheul, Henk M W

AU - Hoekstra, Otto S

AU - van den Eertwegh, Alfons J M

PY - 2016/9

Y1 - 2016/9

N2 - CONTEXT: The majority of patients with castration-resistant prostate cancer develop bone metastatic disease. It is often challenging to optimally palliate malignant bone pain. In case of multifocal pain due to diffuse osteoblastic metastases, treatment with bone-seeking radiopharmaceuticals can be considered.OBJECTIVE: This systematic review evaluates the efficacy of different bone-seeking radiopharmaceuticals for palliation of malignant bone pain from prostate cancer.EVIDENCE ACQUISITION: The PubMed (Medline) and Embase databases were searched for publications on 89-strontium-chloride ((89)Sr), 153-samarium-EDTMP ((153)Sm), 186-rhenium-HEDP ((186)Re), 188-rhenium-HEDP ((188)Re), and 223-radium-chloride ((223)Ra). Randomised controlled trials and prospective cohort studies were included. Metastatic bone pain had to be registered as outcome measure for prostate cancer patients separately.EVIDENCE SYNTHESIS: This review included 36 articles of which 13 randomised trials and 23 prospective studies. Of all trials, 10 studies used (89)Sr, 7 (153)Sm, 12 (186)Re, 2 (188)Re, and 2 (223)Ra; three reported on a combination of different radionuclides. Only a few trials contained a blinding procedure and several studies contained incomplete follow-up or lack of intention-to-treat analysis. It was not possible to calculate a pooled estimate of pain response to treatment with any of the radionuclides because different definitions of pain response were used.CONCLUSIONS: Overall, pain response percentages greater than 50-60% were seen with each radionuclide. Haematological toxicity was reported in 26 of the 36 studies and more than half of these trials stated no grade 3/4 leukopenia or thrombocytopenia occurred.PATIENT SUMMARY: In this report we reviewed the efficacy of bone-seeking radionuclides for treating bone pain from metastatic prostate cancer. Overall, treatment with bone-seeking radionuclides resulted in pain responses greater than 50-60%.

AB - CONTEXT: The majority of patients with castration-resistant prostate cancer develop bone metastatic disease. It is often challenging to optimally palliate malignant bone pain. In case of multifocal pain due to diffuse osteoblastic metastases, treatment with bone-seeking radiopharmaceuticals can be considered.OBJECTIVE: This systematic review evaluates the efficacy of different bone-seeking radiopharmaceuticals for palliation of malignant bone pain from prostate cancer.EVIDENCE ACQUISITION: The PubMed (Medline) and Embase databases were searched for publications on 89-strontium-chloride ((89)Sr), 153-samarium-EDTMP ((153)Sm), 186-rhenium-HEDP ((186)Re), 188-rhenium-HEDP ((188)Re), and 223-radium-chloride ((223)Ra). Randomised controlled trials and prospective cohort studies were included. Metastatic bone pain had to be registered as outcome measure for prostate cancer patients separately.EVIDENCE SYNTHESIS: This review included 36 articles of which 13 randomised trials and 23 prospective studies. Of all trials, 10 studies used (89)Sr, 7 (153)Sm, 12 (186)Re, 2 (188)Re, and 2 (223)Ra; three reported on a combination of different radionuclides. Only a few trials contained a blinding procedure and several studies contained incomplete follow-up or lack of intention-to-treat analysis. It was not possible to calculate a pooled estimate of pain response to treatment with any of the radionuclides because different definitions of pain response were used.CONCLUSIONS: Overall, pain response percentages greater than 50-60% were seen with each radionuclide. Haematological toxicity was reported in 26 of the 36 studies and more than half of these trials stated no grade 3/4 leukopenia or thrombocytopenia occurred.PATIENT SUMMARY: In this report we reviewed the efficacy of bone-seeking radionuclides for treating bone pain from metastatic prostate cancer. Overall, treatment with bone-seeking radionuclides resulted in pain responses greater than 50-60%.

KW - Bone metastases

KW - Bone pain

KW - Bone seeking

KW - radiopharmaceutical

KW - Prostate cancer

U2 - 10.1016/j.eururo.2015.09.005

DO - 10.1016/j.eururo.2015.09.005

M3 - Article

C2 - 26391636

SN - 0302-2838

VL - 70

SP - 416

EP - 426

JO - European Urology

JF - European Urology

IS - 3

ER -

Radiopharmaceuticals for Palliation of Bone Pain in Patients with Castration-resistant Prostate Cancer Metastatic to Bone: A Systematic Review

Abstract

Keywords

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