Abstract
1405
Objectives After ineffective bisphosphonate therapy the 2nd choice for bone pain palliation is the Y-90-EDTMP therapy. After successful single (only one) treatment in 191 patients - with good painkilling effect and without any severe side effect - our question was if we could reach these nice results with repeated therapy. We analyzed: 1) the degree of painkilling effect, 2) the duration of effectiveness of repeated treatment and the summed, longest effectiveness, 3) if there is any “cumulative” side effect and 4) if there is any relationship between the number or severity of bone lesions and the long term effectiveness.
Methods 24 patients received repeated pain palliation therapy: 12 of them 2 times, 7 - 3 times and 5 - 4-6 times. We analyzed each therapeutic cycle for 1) the degree of pain palliation on a 10-degree pain-scale, 2) the duration of effectiveness of one treatment and the summed painkilling interval of them. 3) We measured the number of thrombocytes and leucocytes (as the marker of myelosuppression) in every 2-3 weeks. 4) The severity and the number of bone lesions were also analyzed at the start and the end of each cycle with a 1-3 scale.
Results 1) The severity of bone pain - measured on pain-scale - decreased with 3-9 (on average 5) degrees. 2) The mean duration of pain palliation of one cycle was longer than 5 months and the longest summed painkilling effect was more than 2 years (in 3 cases). 3) We could not find any “cumulative” side effect according to the number of thrombocytes and leukocytes - they normalized until the 12th week spontaneously. 4) There was no relationship between the number and/or severity of bone lesions at the beginning of the therapeutic cycle and the change of them during the treatments.
Conclusions We experienced longer painkilling effect without any severe cumulative side effect - independently of the number of treatment cycles. We could not find any relationship between the duration, effectiveness and the bone lesions. As a summary, our results with repeated therapy proved to be similar or even more impressive then the single treatment with Y-90-EDTMP.