PMID: 8949010Jan 1, 1996Paper

Strontium-89 for symptomatic metastatic prostate cancer to bone: recommendations for hospice patients

The Hospice Journal
K Schmeler, K Bastin

Abstract

In our institution, 4 mCi doses of the radiopharmaceutical strontium-89 (Sr89) have been given to 101 prostate cancer patients suffering from symptomatic bone metastases. Patients were prospectively analyzed for pain response, treatment-related hematologic toxicity, and survival. Pre-treatment clinical factors were correlated with outcome. Karnofsky Performance Scores (KPS) predicted for survival and pain response. Myelosuppression from the Sr89 treatment was minimal. Twenty-eight of the treated patients had a KPS of 60 or less. This group of patients had a median actuarial survival of 17.5 weeks, and collectively, met Hospice admission survival criteria. In a subset analysis of this group, patients with a KPS of 50 or less demonstrated a low pain response (40%) and average survival (12.5 weeks), both of which did not appear to justify the significant cost and risk of toxicity associated with Sr89 treatment. In these patients, opioids appeared to offer more cost-effective pain control. Patients with a pre-treatment KPS score of 60 had a mean survival of 20.5 weeks following Sr89 therapy, with 42 percent of patients experiencing a reduction in pain. We conclude that patients with a pretreatment KPS of 50 or less should not be tr...Continue Reading

Citations

Jun 14, 2000·Cancer Biotherapy & Radiopharmaceuticals·A J McEwan
Aug 19, 2004·The American Journal of Hospice & Palliative Care·Howard SmithScott M Fishman
Jul 24, 2013·International Journal of Clinical Oncology·Sadamoto ZendaTetsuo Akimoto
Dec 6, 2005·The American Journal of Hospice & Palliative Care·Knut LiepeJörg Kotzerke
Sep 22, 2000·Current Review of Pain·C Ripamonti, F Fulfaro
Mar 2, 2005·The American Journal of Hospice & Palliative Care·Gary M ReisfieldGeorge R Wilson
Jul 14, 2007·Cancer Biotherapy & Radiopharmaceuticals·David Murray, Alexander J McEwan
Jul 29, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·S SchmidC Rothermundt

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