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Evaluation of Toxicity and Efficacy of ¹⁸⁶Re-Hydroxyethylidene Diphosphonate in Patients with Painful Bone Metastases of Prostate or Breast Cancer

Department of Nuclear Medicine, Henri Mondor Hospital, Créteil; and Departments of Nuclear Medicine, Breast Disease, and Oncology-Urology, Centre Oscar-Lambret, Lille, France

Twenty-eight patients (12 men with prostate cancer, 16 women with breast cancer) were included in a phase II trial to evaluate the efficacy of ¹⁸⁶Re-hydroxyethylidene diphosphonate (HEDP) on pain from bone metastasis and the toxicity of this agent. Methods: After intravenous administration of 1295 MBq ¹⁸⁶Re-HEDP, the efficacy was evaluated by means of a daily log. Results: We observed an objective response in 67% of prostate cancer patients and in 36% of breast cancer patients. The mean duration of response was 45 d for prostate cancer patients and 24 d for breast cancer patients. No major adverse effects were observed. Marrow toxicity did not exceed grade 2 for white blood cells and grade 3 for platelets using National Cancer Institute criteria. Conclusion: ¹⁸⁶Re-HEDP provides safe symptomatic relief of pain in prostate cancer patients. The benefit of this treatment is less clear in breast cancer patients. Further studies should be conducted to evaluate treatment by ¹⁸⁶Re-HEDP at an earlier stage of the disease.

Key Words: bone metastasis • prostate carcinoma • breast carcinoma • radionuclide-targeted radiotherapy • ¹⁸⁶Re

Received Oct. 19, 1999; revision accepted Feb. 16, 2000.

For correspondence or reprint requests contact: Charles Sulman, MD, Department of Nuclear Medicine, Centre Oscar-Lambret, 1 rue Frederic Combemale, 59000 Lille, France.

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