Radiofármacos en el tratamiento del dolor por metástasis óseas

Enrique García

Resumen

En el trabajo se revisa el estado actual de la utilización de radiofármacos en el tratamiento del dolor provocado por metástasis óseas con énfasis en las dosis utilizadas, la efectividad y seguridad de los productos existentes en el mercado y en desarrollo. Se constata la conveniencia de su uso rutinario, en el caso de múltiples metástasis, ya que los resultados son adecuados y los riesgos aceptables. Se examinan las dosis, los efectos adversos y se indica la importancia de los costos y relacionado con ello, la disponibilidad de los radionúclidos de partida. Se hace referencia, tanto al estado de la práctica en países desarrollados como en países de menores recursos. Se reseña la experiencia cubana y las perspectivas de la utilización en el país.

Palabras clave

radiofármacos, terapia, metástasis, esqueleto, dolor, dosis de radiación

Texto completo:

PDF Epub HTML

Referencias

CAPOCACCIA R, COLONNA M, CORAZZIARI I, et. al. Measuring cancer prevalence in Europe: the EUROPREVAL Project. Annals of Oncology. 2002; 13(6): 831- 839.

POLEDNAK AP. Estimating the prevalence of cancer in the United States. Cancer. 1997; 80(1): 136-41.

MERCADANTE S. Malignant bone pain: pathophysiology and treatment. Pain. 1997; 69(1-2): 1-18.

ROODMAN GD. Mechanisms of Bone Metastasis. N. Engl. J. Med. 2004; 350(16):1655-64.

JANJAN N. Bone metastases: approaches to management. Semin Oncol. 2001; 28(4 Suppl 11): 28-34.

DIEL IJ. What do patients with metastatic bone pain need?. Eur J Cancer Suppl. 2006; 4(8): 1- 3.

FINLAY IG, MASON MD, SHELLEY M. Radioisotopes for the palliation of metastatic bone cancer: a systematic review. Lancet Oncol. 2005; 6(6): 392-400.

ENRIQUE O, ZHONGYUN P, PARMA EP, et. al. Efficacy and toxicity of 153Sm-EDTMP in the palliative treatment of painful bone metastases. World. J. Nucl. Med. 2002; 1(1): 21-27.

FETTICH J, PADHY A, NAIR N, et. al. Comparative clinical efficacy and safety of 32P and 89Sr in the palliative treatment of metastatic Bone Pain: results of an IAEA coordinated research project. World. J. Nucl. Med. 2003; 2(3): 226-231.

CHAKRABORTY S, DAS T, UNNI PR, et. al. 177Lu labelled polyaminopshonates as potential agents for bone pain palliation. Nucl. Med. Communications. 2002; 23: 67-74.

LIEPE K, KROPP J, RUNGE R, KOTZERKE J. Therapeutic efficiency of rhenium-188-HEDP in human prostate cancer skeletal metastases. British J Cancer. 2003; 89(4): 625-629

LEONDI AH, SOUVATZOGLOU MA, RAPTI AS, et. al. Palliative treatment of painful disseminated bone metastases with 186 Rhenium-HEDP in patients with lung cancer. Q J Nucl Med. 2004; 48(3): 211-9.

BISHAYEE A, RAO DV, SRIVASTAVA C, et. al. Marrow-sparing effects of 117mSn (4+) diethylenetriaminepentaacetic acid for radionuclide therapy of bone cancer. J. Nucl. Med. 2000; 41(3): 2043-2050.

NILSSON S, FRANZEN L, PARKER C, et. al. Alfa-emitting Radium-223: two years follow up from a randomized phase II study in patients with bone metastases from hormone refractory prostate cancer. Eur J Cancer Suppl. 2009; 7(2): 411.

SERAFINI AN. Systemic metabolic radiotherapy with samarium-153 EDTMP for the treatment of painful bone metastasis. Q J Nucl Med 2001; 45(1): 91-9.

HENK G. VAN DER POEL. Radionuclide Treatment in Metastasized Prostate Cancer. EAU - EBU Update Series. 2007; 5(3): 113-125.

HAN SH, de KLERK JMN, TAN S, et. al. The Placorhen Study: a double-blind, placebo controlled, randomized radionuclide study with 186Re-etidronate in hormono-resistant prostate cancer patients with painful bone metastases. J. Nucl. Med. 2002; 43(9): 1150-1156.

FRIEDELL HL, STORAASLI JP. The use of radioactive phosphorus in the treatment of carcinoma of the breast with widespread metastases to the bone. Am J Roentgenol Radium Ther. 1950; 64(4):559-75.

SEVILLA A, SALGADO L, FONSECA AT, VIEIRA MR. Is early 89Sr-Therapy useful in prostate cancer patient with bone metastasis?. World. J. Nucl. Med. 2002; 1(Suppl 2): 276.

FERRETTI G., POVOLATO M., BISSSOLI S. 89SrCl and 153Sm-EDTMP radiometabolic treatment of metastatic bone pain (MBP) in prostate cancer (PC): our experience. Alasbimn Journal. 2002; 5 (17). Special Issue: World Congress of Nuclear Medicine.

NAIR N. Relative efficacy of 32P and 89Sr in palliation in skeletal metastases. J. Nucl. Med. 1999; 40(2): 256-261.

SINZINGER H, WEISS K, GRANEGGER S, HAJEK C. Repeated low-dose vs. single higt-dose 153Sm-EDTMP treatment. Advantages and disadvantages . Alasbimn Journal. 2002; 5(17). Special Issue: World Congress of Nuclear Medicine.

SRIVASTAVA SC, ATKINS HL, KRISHNAMURTHY GT, et. al. Treatment of metastatic bone pain with tin-117m stannic diethylenetriamine pentaacetic acid: a phase I/II clinical stud. Clin. Cancer Res. 1998; 4(1): 61-68.

SILBERSTEIN EB, BUSCOMBE JR, MC.EWANS A, TAYLOR AT. Society of nuclear medicine procedure guideline for palliative treatment of painful bone metastases. Society of nuclear medicine procedure. Guidelines manual. 2003. p. 145-153.

COOK GJR. Skeletal metastases: what is the future role for nuclear medicine?. Eur J Nucl Med Mol Imaging. 2009; 36(11):1803-1806.doi: 10.1007/S00259-009-1240-8.

PORTILLA I, ALSINA S de la C. OLIVA JP, et. al. P-32 en el tratamiento de las metástasis óseas por carcinoma prostático. Rev Cubana Oncol. 2000; 16(1): 44 -7.