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Updated: Mar 5, 2026
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Models of Bone Metastasis
Published on: September 4, 2012
43.3K
WITHDRAWN: Radioisotopes for metastatic bone pain
Marta Roqué I Figuls1, Maria José Martinez-Zapata1, Martin Scott-Brown2
1Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Sant Antoni Maria Claret 171, Edifici Casa de Convalescència, Barcelona, Catalunya, Spain, 08041.
The Cochrane Database of Systematic Reviews
|March 24, 2017
Summary
Radioisotopes offer some pain relief for bone metastases but can cause severe side effects like leucocytopenia and thrombocytopenia. Further research is needed to confirm benefits and safety profiles.
Area of Science:
- Oncology
- Radiopharmaceuticals
- Pain Management
Background:
- Bone metastases cause significant pain, fractures, and other complications.
- Current treatments include analgesia, radiotherapy, surgery, chemotherapy, hormone therapy, radioisotopes, and bisphosphonates.
Purpose of the Study:
- To evaluate the efficacy and safety of radioisotopes for managing metastatic bone pain.
- To assess the impact of radioisotopes on reducing complications and improving survival in patients with bone metastases.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) from MEDLINE, EMBASE, CENTRAL, and PaPaS Trials Register up to October 2010.
- Included studies compared radioisotope treatment with placebo or other radioisotopes for metastatic bone pain.
- Risk of bias, data extraction, and statistical analysis using random-effects and intention-to-treat (ITT) models were performed.
Main Results:
- Radioisotopes showed a small benefit in complete pain relief (NNT=5) and complete/partial relief (NNT=4) in the short to medium term.
- No conclusive evidence was found for reduced analgesic use compared to placebo.
- Significant adverse effects included leucocytopenia and thrombocytopenia (NNH=13).
Conclusions:
- Radioisotopes may offer pain reduction for bone metastases without increasing analgesic use, but severe adverse effects are common.
- Limited data exists for comparing different radioisotopes (e.g., Strontium-89, Samarium-153) and their dosages.
- Further evidence is needed to fully understand the efficacy and safety of radioisotopes in this patient population.
