[A multicenter study to determine the efficacy and safety of strontium (89Sr) chloride for palliation of painful bony metastases in cancer patients].

Masamichi Nishio, Muneaki Sano, Yoshio Tamaki, Hirofumi Fujii, Yasuo Shima, Hiroyuki Fujimoto, Atsushi Kubo, Kiyoshi Koizumi, Yutaka Tokuda, Shuji Adachi, Yoshimitsu Sumiyoshi, Toshihiro Hasegawa, Kenji Eguchi
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Abstract

Purpose: A multicenter study was conducted to evaluate the efficacy of strontium chloride (89SrCl2) for palliation of painful bony metastases using the Visual Analogue Scale (VAS), Brief Pain Inventory (BPI) and Functional Assessment for Cancer Therapy-General (FACT-G).

Methods: Ninety patients received a single injection of 2.0 MBq/kg and were classified as responders if VAS scores decreased without increased use of analgesics or if analgesic consumption decreased without an increase in the VAS.

Results: In the 69 subjects that could be evaluated, mean VAS values decreased significantly from 48.0 +/- 20.8 mm at baseline to 24.1 +/- 22.3 mm at last visit(Week 12) (p < 0.0001). VAS decreased more than 10 mm in 58.0% of these subjects, and analgesic consumption was reduced more than 10% in 39.1% of subjects. The response rates were 46.4% (95% confidence interval (CI) 34.3-58.8%) in the 69 subjects that could be evaluated and 43.3% (95% CI 32.9-54.2%) in all subjects. The scoring in BPI for interference in daily life improved together with improvement in its pain scores. Total FACT-G score showed significant improvement, as did its score in the subsection of physical well-being. Both platelets and leucocytes decreased by 22% at nadir (week 8), and such profiles of myelosuppression by 89SrCl2 were similar to those in the previous clinical studies.

Conclusion: These results suggest the clinical utility of 89SrCl2 for pain palliation, which leads to QOL improvement in patients with painful generalized bone metastases.

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[一项确定氯化锶(89Sr)缓解癌症患者骨转移疼痛的有效性和安全性的多中心研究]。
目的:采用视觉模拟量表(VAS)、简短疼痛量表(BPI)和肿瘤治疗功能评估量表(FACT-G)对氯化锶(89SrCl2)缓解疼痛性骨转移的疗效进行多中心研究。方法:90例患者接受单次注射2.0 MBq/kg,如果VAS评分下降而不增加镇痛药的使用,或者如果镇痛药消耗减少而不增加VAS,则被归类为反应者。结果:在69名可评估的受试者中,平均VAS值从基线时的48.0 +/- 20.8 mm显著下降到最后一次访问(第12周)时的24.1 +/- 22.3 mm (p < 0.0001)。其中58.0%的受试者VAS下降超过10 mm, 39.1%的受试者镇痛消耗减少超过10%。69名可评估受试者的有效率为46.4%(95%可信区间(CI) 34.3-58.8%),所有受试者的有效率为43.3% (95% CI 32.9-54.2%)。日常生活干扰的BPI评分随疼痛评分的提高而提高。总FACT-G得分显示出显著的改善,其在身体健康分项中的得分也是如此。血小板和白细胞在最低点(第8周)都下降了22%,89SrCl2的骨髓抑制情况与之前的临床研究相似。结论:提示89SrCl2对疼痛缓解的临床应用价值,可改善疼痛性骨转移患者的生活质量。
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[Abstracts of the 45th Autumn Meeting of the Japanese Radiological Society. October 29-31, 2009. Wakayama, Japan]. [Abstracts of the 68th Annual Meeting of the Japanese Radiological Society. April 16-19, 2009. Yokohama, Japan]. [The 44th Autumn Meeting of the Japanese Radiological Society. Fukushima, Japan. October 22-24, 2008. Abstracts]. [The 67th Annual Meeting of the Japanese Radiological Society. Yokohama, Japan. April 4-6, 2008. Abstracts]. [The 43rd autumn meeting of the Japan Radiological Society. Nagoya, Japan. October 25-27, 2007. Abstracts].
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