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American Journal of Hospice and Palliative Medicine®, Vol. 21, No. 4, 303-313 (2004)
DOI: 10.1177/104990910402100415

Radiopharmaceuticals for palliation of painful osseous metastases

Howard Smith, MD

Division of Pain Management, Department of Anesthesiology, Albany Medical College, Albany, New York

Annu Navani, MD

Division of Pain Management, Department of Anesthesia, Stanford University School of Medicine, Stanford, California

Scott M. Fishman, MD

Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, University of California, Davis, Sacramento, California

Bone metastases represent the most common etiology of pain for patients with advanced cancer. In the United States, the most common treatment for pain caused by bone metastases in late-stage cancer cases is external beam radiotherapy in conjunction with opioids. An alternative or adjuvant to external radiotherapy is intravenous radiopharmaceutical treatment. This review explores the pros and cons of different radiopharmaceutical options, their advantages over traditional external beam radiotherapy, and the conditions for optimal efficacy.

Key Words: cancer pain treatment • bisphosphonates • osseous metastases • radiopharmaceuticals • strontium-89 chloride 89Sr • hypercalcemia • phosphurous-32 • 32P • orthophosphate • rhenium-186 hydroxyethlidene • 186Re-HEDP • samarium-153 lexidronam • 153Sm-EDTMP • 117mSn-DTPA


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