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Tin-117m(4+)-DTPA for Palliation of Pain from Osseous Metastases: A Pilot Study

Medical Department, Brookhaven National Laboratory, Upton, New York
Department of Radiology, State University of New York at Stony Brook
Department of Nuclear Medicine, Department of Veterans Affairs Medical Center, Northport, New York

Correspondence: For correspondence or reprints contact: Harold L. Atkins, MD, Medical Department, Box 5000, Brookhaven National Laboratory, Upton, NY 11973-5000.

ABSTRACT

The physical and biological attributes ^117mSn(4+)-DTPA indicate that it should be an effective agent for palliative therapy of painful bony metastatic disease. The aim of this study was to evaluate whether or not thus agent could effectively reduce pain while sparing the hemopoietic marrow from adverse effects. Methods: Fifteen patients (10 males and 5 females) with painful bony metastases from various primary cancers were included in the study. Seven patients received 1.22 to 3.11 MBq/kg of ^117mSn intravenously (Group 1) and eight patients received 4.85 to 5.77 MBq/kg (Group 2). All but one were treated as outpatients and followed for a minimum of 2 mo. Results: In the first group, pain relief was nonassessable in four patients because of death or additional treatment of soft-tissue disease by another modality. One patient had no relief of pain, one had complete relief of pain and one had transient relief of pain. No myelotoxicity was observed. For Group 2, three patients achieved complete relief of pain, two good relief, two partial relief and one began to experience pain relief when he suffered a pathological fracture 2 mo post-treatment. None of these patients had myelotoxicity. Conclusion: Tin-117m(4+)-DTPA can reduce pain from metastatic disease to bone without inducing adverse reactions related to bone marrow. Further studies are needed to assess tolerance levels for the bone marrow and to evaluate response rates and duration of effect.

Key Words: tin-117m-DTPA • pain palliation • bone metastases

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