Pengobatan kanker dengan radioisotop, baik untuk terapi maupun paliatif, sudah sering dilakukan. Hal ini sudah banyak digunakan di daerah-daerah dengan angka prevalensi kanker tinggi, misalnya penggunaan radioiodine (I-131) untuk kanker tiroid deferensiasi baik dan Strontium(Sr)-89 serta Samarium(Sm)-153 untuk mengontrol rasa nyeri pada tulang yang terkena metastasis keganasan kanker. Sm-153 EDTMP mempunyai efek yang baik untuk mengobati pasien dengan metastasis ke tulang. Hampir semua pasien merasakan adanya penurunan rasa nyeri tulang dalam 24 jam sampai 3 hari setelah pemberian Sm-153 EDTMP. Sangat sedikit efek samping yang dilaporkan, di antaranya adanya sakit kepala ringan yang muncul dalam 24 jam setelah suntikan intravena Sm-153 EDTMP. Makalah ini akan membahas dan mengevaluasi efek terapeutik dan paliatif dari Sm-153 EDTMP pada pasien dengan keganasan yang bermetastasis ke tulang.Kata kunci: metastasis tulang, nyeri tulang, Sm-153 EDTMP

Colorectal cancer (CRC) is the fourth most common cancer in worldwide. In the last 10 years, the mortality rate of CRC decreased by more than 20% and 5-year survival remains approximately 60% due to the rising developments in diagnostic techniques and optimization of surgical, neoadjuvant and palliative therapies. We reported a case of 80-year-old woman with diarrhea, blood in the stool and weight loss for a year. The patient was diagnosed with colonic polyp eight years ago. In double-contrast barium enema (DCBE) showed filling defects in sigmoid with pedunculated form. Optical colonoscopy demonstrated tumor in sigmoid. Computed tomography (CT) abdomen showed circumferential thickening and luminal narrowing of sigmoid colon with stranding of the serosa and mesenteric fat as well as enlarge pericolic nodes without distant metastasis. Based on American Joint Committee on Cancer criteria the stage was T3N1M0. From histopathological diagnosis, the tumor was well differentiated adenocarcinoma. We concluded as unresectable adenocarcinoma colorectal. Patient received transcatheter arterial chemoinfusion (TACI) with oxaliplatin and bevacizunab in three courses every 2 months. After first TACI, symptoms and patient's performance status improved without systemic side effects. Arteriography imaging showed decrease in tumor staining after third TACI. CT evaluation showed a significant decrease of tumor size, without nodal and distant metastasis.In this case, TACI treatment with oxaliplatin and bevacizumab in unresectable adenocarcinoma colorectaldemonstrated improvement of patient's performance status, partial response, decrease stage and symptoms, without systemic side effects. It is proven that TACI treatment may be an effective palliative therapy for unresectable colorectal cancer. Further studies should be performed to verify these findings.We reported a case of a woman with unresectable adenocarcinoma colorectal showed good results after received TACI treatment.

BNCT is an alternate therapy for treating cancer. The principle of BNCT involves a neutron boron uptake and a fission reaction that produce alpha particles and Li ions with a high level of linear energy transfer in the tissue. It is effective in killing tumor cells. To administer boron in the tumor cells, a boron delivery agent is needed. Thus far, there are a variety of boron delivery agents that have been developed. To date, just two main boron-based drugs, BPA and BSH, have been used for clinical studies. Many other boron delivery agents have been evaluated in vivo and in vitro but have not been evaluated clinically. Therefore, the other boron delivery agents have not been used in BNCT clinical studies.

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