BASELINE AND POS 153Sm-EDTMP THERAPY BONE SCAN

            Male 81 y/o with Prostate Carcinoma and bone metastasis, complaining of low back pain under treatment with Zometa, Lupron and Estramustina and analgesics. Pain increased in recent weeks and so an adjuvant therapy with Samarium was requested for pain palliation. Liver and Renal function exams were normal. At the BCC there was anemia of 10 g Hb, and normal platelets and leucocytes count. On the left, posterior whole body scan with multiple metastasis, the bigger in the sacrum. A dose of 1 mCi/kg was given on april 4th, obtaining next day a whole body EDTMP scan, similar to the one with MDP. The clincal course demonstrated a significant pain alleviation, which lasted for 3 months. A second dose was schedulled, taking the MDP bone scan on august 19th, 2011. Note decrease of osteoblastic uptake in many of the lesions.

            Paes F et al discussed the value of this therapy, whose summarized results are in the table above, showing pain relief in 62% to 84% of cases.

References:

Paes, Fabio M. and Serafini, Aldo N. Systemic Metabolic Radiopharmaceutical Therapy in the Treatment of Metastatic Bone Pain. Semin Nucl Med 40:89-104 © 2010