Other Radiopharmaceuticals For The Pain Of Osteoblastic Metastases

The other radiopharmaceuticals listed in the table have shown efficacy in one or more clinical studies but have not been made available to practicing nuclear medicine physicians after early trials, usually because of economic and/or regulatory issues. Re-188 etidronate has been given to patients but little clinical data is available. As it has the highest dose rate of any of these radiotracers, it remains of interest. Yttrium (Y)-90 citrate has the most energetic beta emission of the materials listed but only limited clinical data have come forth. Sn-117m is of particular interest because its emissions, low-energy electrons, have very short path lengths and would be predicted to cause the least myelosuppression. This limited marrow toxicity has been confirmed in several studies, with a response rate in the range published for the other radiopharmaceuticals discussed. Sr-85 emits extremely low energy conversion electrons and 10-15 keV X-rays and has been described as yielding 75 to 80% patient responses, with pain relief less likely in patients with poorer performance status, similar to the findings in some, but not all of the Sr-89 studies noted before.

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