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Curr Oncol Rep. 2003 May;5(3):258-62.

Radioisotopic treatment of bone pain from metastatic prostate cancer.

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  • 1Department of Hematology/Oncology, Louisiana State University School of Medicine, Room 459, 533 Bolivar, New Orleans, LA 70112, USA.


Hormone-refractory prostate cancer patients with painful bony metastatic lesions are potential candidates for bone-seeking radiopharmaceutical therapies. After careful assessment of symptoms and localization of pain, a bone scan is the single most useful imaging modality for the clinician to assess patients for the presence and distribution of osteoblastic lesions. Increased uptake (compatible with bony metastases) on a conventional bone scan is currently a prerequisite for treating patients with a bone-targeted therapeutic isotope. Determining whether metastatic bony involvement is focal or diffuse is also important in the clinical decision-making process. Patients with multifocal metastatic disease are excellent candidates for systemic therapies, whereas patients with unifocal metastatic disease may be more appropriate candidates for focal therapies such as external-beam radiation. Patients who are poorly tolerant of narcotics should be actively considered for alternative treatments such as systemic radiopharmaceuticals. Contraindications to administration of current bone-seeking radioisotopes include substantial degrees of renal insufficiency or bone marrow suppression.

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