Manafi-Farid Reyhaneh, Masoumi Fardad, Divband Ghasemali, Saidi Bahare, Ataeinia Bahar, Hertel Fabian, Schweighofer-Zwink Gregor, Morgenroth Agnieszka, Beheshti Mohsen
Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran.
Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran.
J Clin Med. 2020 Aug 12;9(8):2622. doi: 10.3390/jcm9082622.
Bone metastasis develops in multiple malignancies with a wide range of incidence. The presence of multiple bone metastases, leading to a multitude of complications and poorer prognosis. The corresponding refractory bone pain is still a challenging issue managed through multidisciplinary approaches to enhance the quality of life. Radiopharmaceuticals are mainly used in the latest courses of the disease. Bone-pain palliation with easy-to-administer radionuclides offers advantages, including simultaneous treatment of multiple metastatic foci, the repeatability and also the combination with other therapies. Several β¯- and α-emitters as well as pharmaceuticals, from the very first [Sr]strontium-dichloride to recently introduced [Ra]radium-dichloride, are investigated to identify an optimum agent. In addition, the combination of bone-seeking radiopharmaceuticals with chemotherapy or radiotherapy has been employed to enhance the outcome. Radiopharmaceuticals demonstrate an acceptable response rate in pain relief. Nevertheless, survival benefits have been documented in only a limited number of studies. In this review, we provide an overview of bone-seeking radiopharmaceuticals used for bone-pain palliation, their effectiveness and toxicity, as well as the results of the combination with other therapies. Bone-pain palliation with radiopharmaceuticals has been employed for eight decades. However, there are still new aspects yet to be established.
骨转移在多种恶性肿瘤中均有发生，发病率范围广泛。多处骨转移的存在会导致多种并发症且预后较差。相应的难治性骨痛仍是一个具有挑战性的问题，需要通过多学科方法来处理，以提高生活质量。放射性药物主要用于疾病的晚期阶段。使用易于给药的放射性核素缓解骨痛具有诸多优势，包括可同时治疗多个转移灶、可重复性以及能与其他疗法联合使用。人们对多种β⁻发射体和α发射体以及药物进行了研究，从最初的[Sr]氯化锶到最近引入的[Ra]氯化镭，以确定最佳药物。此外，亲骨性放射性药物与化疗或放疗联合使用，以提高治疗效果。放射性药物在缓解疼痛方面显示出可接受的有效率。然而，仅有有限数量的研究记录了其对生存的益处。在本综述中，我们概述了用于缓解骨痛的亲骨性放射性药物、它们的有效性和毒性，以及与其他疗法联合使用的结果。使用放射性药物缓解骨痛已有八十年历史。然而，仍有一些新的方面有待确定。
