Efficacy and toxicity of 153samarium-EDTMP in painful breast cancer bone metastases

The aim of this study was to assess the usefulness of (153)samarium-ethylene-diamino-tetramethylene phosphonic acid ((153)Sm-EDTMP, a beta and gamma emitter) treatment in the palliation of painful bone metastases from breast cancer.

43 women (aged 41-79, mean 60 years) with bone-disseminated breast cancer and bone pain refractory to opioid analgesics received (153)Sm-EDTMP. Karnofsky performance status, pain score (numeric rating scale), analgesic score (World Health Organisation) and blood count were evaluated before treatment and 1 and 3 months after the treatment.

Significant pain relief was observed in 51 and 42% of the patients, mild relief in 30 and 30%, and no effect in 19 and 28% of the patients 1 and 3 months after administration, respectively. Mild and transient bone marrow suppression was observed as a side effect of (153)Sm-EDTMP treatment. None of the patients showed grade 4 haematological toxicity and only 1 patient showed grade 3 (National Cancer Institute common toxicity criteria). The majority of patients had grade 1 or 2 haematological toxicity.

(153)Sm-EDTMP treatment is effective and safe in bone pain palliation in breast cancer. 3 months after administering (153)Sm-EDTMP, pain relief to varying degrees was observed in 72% of patients.The haematological toxicity after (153)Sm-EDTMP treatment was mild and transient.