Systemic Radiotherapy of Bone Metastases With Radionuclides

Murray, Iain; Du, Yong

doi:10.1016/j.clon.2020.11.028

Cited by 16 publications

(9 citation statements)

References 68 publications

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“…This leads to the induction of potentially cytotoxic DNA double-strand breaks in cells with a relatively short 100-micrometer distance while sparing surrounding normal tissue [10]. These physical characteristics generally result in a lower risk of myelosuppression than beta-emitting radioisotopes, such as strontium-89 or samarium-153 [11]. Radium-223 is approved for use in mCRPC based on a randomized phase III trial, which demonstrated improved overall survival and symptomatic control [4]; however, its effect in non-prostate cancer bone metastases is unclear, and to our knowledge, there are no published reports on its use in extraneural metastatic medulloblastoma.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Extraneural Metastatic Medulloblastoma in an Adult Presenting With a Superscan and Treated With Radium-223

Mou¹,

Cruz-Lim²

2023

Cureus

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A 32-year-old man with medulloblastoma was initially treated with subtotal resection and craniospinal irradiation. He developed recurrent metastatic disease three years later with extensive bone-only metastases. Biopsy of the bone lesions confirmed metastatic medulloblastoma and restaging investigations demonstrated a superscan with no evidence of recurrence in the craniospinal axis. Extraneural metastatic medulloblastoma is rare, and the presentation with diffuse bone-only metastases with a superscan on imaging is unique. The patient had diffusely painful bone metastases requiring multiple hospitalizations for poor pain control. He declined chemotherapy and was treated with radium-223, an alpha particle emitting radionuclide therapy typically used in metastatic castrate-resistant prostate cancer. The patient received three out of a planned six cycles of radium-223 before it was discontinued due to myelosuppression requiring multiple blood transfusions, and restaging demonstrated local recurrence in the posterior fossa. This is the first report to our knowledge describing the use of radium-223 in a patient with extraneural boneonly metastatic medulloblastoma. Further research into the effect of radium-223 in patients with diffuse bone-only metastases from non-prostate cancer primary tumors is warranted.

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Section: Discussionmentioning

confidence: 99%

Recurrent Extraneural Metastatic Medulloblastoma in an Adult Presenting With a Superscan and Treated With Radium-223

Mou¹,

Cruz-Lim²

2023

Cureus

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“…Bone is a particularly common site for metastases and a major cause of morbidity and mortality in patients [8,29]. The application of radionuclides in the treatments of bone metastases has been well established in oncology owing to their high speci city to the bone tissues affected by primary cancers [17].…”

Section: Discussionmentioning

confidence: 99%

“…However, for patients with widespread systemic metastases, extensive external irradiation often leads to serious adverse events [15]. The curative application of radiolabeled tracer has a theoretical advantage, that is, radiation can be delivered to tumor more speci cally than EBRT, so as to avoid unnecessary radiation to non-affected tissues [16,17]. Furthermore, radionuclide targeted therapy not only relieves pain in patients, but also it decreases or delays the occurrence of skeletal-related events (SREs) [10].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Bone-Targeting Radioisotopes in Patients with Bone Metastases: A Meta-Analysis

Ye¹,

Fan²,

Shen³

2021

Preprint

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Background: Radionuclides such as Strontium-89, Samarium-153, and Radium-223 are commonly used for the treatment of bone metastases (BM) and they have shown efficacy in previous studies. The aim of this meta-analysis is to compare the curative performance of different types of radionuclides in patients with BM, and to provide evidence for further future research and clinical practice.Methods: The electronic databases of PubMed, Web of Science, Embase, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure (CNKI) were searched. Studies using radionuclides therapy to cure patients were included. Pooled overall response rate, occurrence rates of common adverse events, hazard ratio (HR), and their respective 95% confidence interval (CIs) were calculated.Results: A total of 28 articles with 33 studies patients were identified for inclusion in this meta-analysis. The types of radionuclides used in the studies contained 89Sr, 153Sm, 223Ra, 186Re, and 188Re. The overall response rate was 72% [66%, 77%]. The respective overall response rates of 89Sr, 153Sm, and 223Ra were 72% [64%, 79%], 80% [75%, 84%], and 54% [32%, 75%]. In the survival analysis, the pooled HR was 0.85 [0.67, 1.08]. The pooled occurrence rate of leucocyte hematological toxicity of any grade was 5% [2%, 8%]. The pooled occurrence rate of thrombocytopenia of any grade was 7% [5%, 8%]. With regard to anemia, the pooled occurrence rate of any grade was 15% [11%, 19%].Conclusion: The results of this meta-analysis indicate that radionuclides therapy is efficacious in patients, type of radionuclides and history of patients should be considered to prevent potential adverse events.

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“…Such as 153Sm-EDTMP (ethylene diamine tetramethylene phosphonic acid) has high cancerous properties and bone affinity. It has been used to treat bone metastases and relieve bone pain, and can also be used to treat primary bone cancer.153Sm produces beta particles, which are often coupled with ethyleneenetetramethylphosphate, integrated into the bone cavity and irradiated on the prostate cancer cells implanted in the bone, which can provide rapid pain relief with a half-life of 1.9 days, but does not affect the patient's OS when used alone [85].…”

Section: Samarium-153 153 Smmentioning

confidence: 99%

Research Progression in the Mechanism of Bone Metastasis and Bone-Targeted Drugs in Prostate Cancer

Ahmad

2024

ann urol oncol

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Prostate cancer is a particularly slow growing cancer, the early stage of the disease is not easy to detect, the some major clinical manifestations include low back pain, urgent and frequent urination, urinary pain, and other urethral symptoms. These symptoms are often experienced after surgical resection or drug castration treatment. Early-stage, prostate cancer is curable, and with disease progression many clinical symptoms become worse with high probability of metastasis. Bone is the most common site of advanced metastasis of prostate cancer. Bone metastasis is a continuous and complex pathological process regulated by tumor cells and bone microenvironment, in which epithelial-mesenchymal transformation, homing and dormancy, reactivation, and proliferation of tumor cells are closely related to its occurrence and development. Several cytokines such as Receptor activator of NF-κB ligand (RANK-L) is overexpressed in bone microenvironment and prostate cancer. RANKL, chemokine family, and integrins are involved in bone metastasis of prostate cancer through complex interaction mechanisms. A variety of bone-targeting drugs such as bisphosphonates, RANKL inhibitors (denosumab) and radiotherapy drugs (radium-223, strontium-89, samarium-153), tyrosine kinase inhibitors, integrin-targeted drugs, etc. are approved for the prevention and treatment of skeletal related events caused by bone metastasis in prostate cancer patients. In this review, the biological mechanism of bone metastasis in prostate cancer and the research progress of bone-targeting drugs are reviewed.

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Systemic Radiotherapy of Bone Metastases With Radionuclides

Cited by 16 publications

References 68 publications

Recurrent Extraneural Metastatic Medulloblastoma in an Adult Presenting With a Superscan and Treated With Radium-223

Recurrent Extraneural Metastatic Medulloblastoma in an Adult Presenting With a Superscan and Treated With Radium-223

Efficacy and Safety of Bone-Targeting Radioisotopes in Patients with Bone Metastases: A Meta-Analysis

Research Progression in the Mechanism of Bone Metastasis and Bone-Targeted Drugs in Prostate Cancer

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