Radiotoxicity after strontium-89 therapy for bone metastases using the micronucleus assay

The purpose of this study was to evaluate the degree of cytologic radiation damage to lymphocytes after 89Sr therapy using the cytokinesis-blocked micronucleus assay. The chromosomal damage to lymphocytes exposed to 89Sr in vivo should result in augmentation of the number of cells with micronucleus.

We studied eight patients with painful bone metastases, who were treated with 111 MBq89Sr. Isolated lymphocytes collected from the patients 1 wk after therapy were harvested and treated according to the cytokinesis-blocked method of Fenech and Morley. The number of micronuclei per 500 binucleated cells was scored by visual inspection. As controls, lymphocytes from the same patients before therapy were also studied. For three patients, serial blood samples were examined for a maximum of 2 mo after therapy. In an in vitro study, lymphocytes from five normal volunteers were exposed to doses varying from 0.25 to 1.0 Gy and studied with the same method.

The mean number (+/-s.d.) of micronuclei per 500 binucleated cells after treatment was significantly increased (p<0.05) as compared to control subjects (17.1+/-3.0 compared to 6.0+/-1.7). Thereafter, the number of micronuclei recovered gradually by 6 wk following therapy and, in one case, nearly to the baseline range in 2 mo. The number of micronuclei after 0.53+/-0.13 Gy of external irradiation was nearly equivalent to that after 89Sr therapy.

The relatively low frequency of lymphocyte micronuclei exposed to 89Sr in vivo supported the contention that short-term nonstochastic damage with 111 MBq89Sr in patients with painful bone metastases is minimal.