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Acta medica Lituanica

ISSN 1392-0138
ISSN 2029-4174 (online)

2008 m. Nr. 2

Efficiency of strontium-89 for the palliation of painful bone metastases in prostate cancer
Zenonas BARANAUSKAS, Eduardas ALEKNAVIČIUS, Arvydas BURNECKIS, Rita STEPONAVIČIENĖ

Background. To evaluate the efficiency of strontium-89 chloride for prostate cancer patients with multiple bone metastases, to determine factors that would allow predicting the sensitivity to the strontium-89 therapy.

Materials and methods. We retrospectively studied the data on all the patients referred to the Department of Radiotherapy of the Institute of Oncology, Vilnius University between 1999 and 2006 years with a histologically confirmed diagnosis of prostate cancer with multiple bone metastases. 113 patients received Sr-89, 91 patients were included in our study.

Results. During the years 1999–2006 deaths of 68 patients were recorded (74.7%). The median survival time (MST) of patients with bone metastases was 32 months. Arm A: MST 25 months. Gleason score 7.6 ± 1.0; PSA 75.7 ± 40.6 ng/ml; Hb 106.6 ± 13.8 g/l, ALP 1695 ± 1194.0; VAS pain score 8.5 ± 0.8; the number of lesions detected by bone scintigraphy 14.4 ± 3.0; days from the beginning of treatment 828.5 ± 756.7; days after the treatment 108.3 ± 75.9; ECOG performance status 3. Arm B: MST 42 months. Gleason score 7.1 ± 1.1; PSA 59.5 ± 40.0 ng/ml; Hb 123.6 ± 16.4 g/l, ALP 548 ± 442.0; VAS pain score 8.2 ± 0.7; the number of lesions detected by bone scintigraphy 8.2 ± 2.4; days from the beginning of treatment 1076.8.5 ± 1166.8; days after the treatment 537.0.3 ± 428.4; ECOG performance status 2.

Conclusion. Sr-89 appears to be effective in palliating bone pain from metastatic prostate cancer in 69.2% patients. Average pain improvement was in 36.2% cases, whereas 33.0 % cases were pain-free. Duration of response ranged from 3.2 to 6.7 months. While selecting patients for Sr-89 treatment it is important to pay attention to the fact whether they meet the following criteria: ECOG performance status < 2; HB > 120 g/l; ALP < 500 U/l; the number of lesions detected by bone scintigraphy < 8; the treatment starts as early as possible after the bone metastases are detected.

Keywords: strontium chloride-89, prostate cancer, bone metastases, pain

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