1.Strontium-89 for bone metastases from prostate cancer: an update.
Wei-wei ZHAO ; Peng XIE ; Hou-fu DENG
National Journal of Andrology 2010;16(3):269-272
Strontium-89 (Sr-89) is a pure emitter with maximum beta energy of 1.46 MeV, average beta energy of 0.58 MeV, and a physical half-life of 50.5 days. It is rapidly taken up by bone and preferentially retained at the sites of osseous metastases. Its biological half-life is >50 days at the metastatic sites, but about 14 days only in the normal bone. The dose of its absorption in the tumor-bearing bone ranges from 21 +/- 4 to 231 +/- 56 cGy/MBq, 2-25 times higher than in the normal bone. Strontium-89 therapy is an effective palliative treatment of bone metastases from prostate cancer, with analgesic effectiveness in 80%.
Bone Neoplasms
;
radiotherapy
;
secondary
;
Humans
;
Male
;
Neoplasm Metastasis
;
Prostatic Neoplasms
;
pathology
;
radiotherapy
;
Strontium Radioisotopes
;
therapeutic use
2.Management consideration in nonpulmonary visceral metastatic seminoma of testis.
Dong Soo PARK ; Debra M PROW ; Robert J AMATO ; Christopher J LOGOTHETIS
Journal of Korean Medical Science 1999;14(4):431-437
To develop a more appropriate therapeutic strategy for treatment of nonpulmonary visceral metastatic testicular seminoma based on the International Germ Cell Consensus Classification, we reviewed the medical records of patients with nonpulmonary visceral metastatic testicular seminoma who were treated over a 20-year period. Only 15 (2.2%) of the 686 cases of testicular seminoma were nonpulmonary visceral metastatic seminoma. The median age of patients was 38 years (range, 22-53 years). Ten (67%) of the patients had an initial diagnosis of supradiaphragmatic or visceral metastatic disease. In addition to nonpulmonary visceral metastasis, all patients had lymph node metastasis as well, the majority of which involved the retroperitoneal lymph nodes. The median and mean progression-free survival durations after chemotherapy for advanced disease were 19 months and 63.7 months, respectively. Six patients (40%) survived, five relapsed after radiation therapy and four died of chemorefractory disease not dependent on the specific regimen. Although the number of cases reviewed in this study was small, we conclude that the choice of chemotherapeutic regimen among the current treatments for nonpulmonary visceral metastatic seminoma of testis primary does not present a different outcome. Therefore, multimodality therapies using new strategies or new agents are well indicated.
Adult
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Antineoplastic Agents, Combined/administration & dosage*
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Bone Neoplasms/secondary
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Bone Neoplasms/radiotherapy
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Bone Neoplasms/drug therapy
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Combined Modality Therapy
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Human
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Lung Neoplasms/secondary
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Lung Neoplasms/radiotherapy
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Lung Neoplasms/drug therapy
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Lymphatic Metastasis
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Male
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Middle Age
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Retroperitoneal Neoplasms/secondary*
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Retroperitoneal Neoplasms/radiotherapy
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Retroperitoneal Neoplasms/drug therapy*
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Retrospective Studies
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Seminoma/secondary*
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Seminoma/radiotherapy
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Seminoma/drug therapy*
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Testicular Neoplasms/pathology*
3.A Case of Low Grade Osteosarcoma Developing in the Middle Skull Base after Radiotherapy of Adenoid Cystic Carcinoma in the Posterior Nasal Cavity.
Jaehoon JUNG ; Sue Jean MUN ; Dong Hun SHIN ; Hwan Jung ROH
Korean Journal of Otolaryngology - Head and Neck Surgery 2015;58(2):147-152
Adenoid cystic carcinoma arises rarely in the nasal cavity and paranasal sinus. Treatment strategy showing the best survival rate includes surgical excision and adjuvant radiotherapy. There were a few case reports of radiation-induced osteosarcoma from adenoid cystic carcinoma overseas but not in Korea. We experienced a case of radiation-induced low-grade osteosarcoma in the middle skull base including sphenoid bone, which had arisen after 10 years of radiotherapy of adenoid cystic carcinoma. Authors present this case with serial imaging findings and literature review.
Carcinoma, Adenoid Cystic*
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Korea
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Nasal Cavity*
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Neoplasms, Radiation-Induced
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Osteosarcoma*
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Radiotherapy*
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Radiotherapy, Adjuvant
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Skull Base*
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Sphenoid Bone
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Survival Rate
4.Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction.
Re Mee DOH ; Sungtae KIM ; Ki Chang KEUM ; Jun Won KIM ; June Sung SHIM ; Han Sung JUNG ; Kyeong Mee PARK ; Moon Kyu CHUNG
The Journal of Advanced Prosthodontics 2016;8(5):363-371
PURPOSE: On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS: Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS: The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION: Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.
Bone Density
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Head and Neck Neoplasms
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Humans
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Molar
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Osseointegration
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Pilot Projects*
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Prostheses and Implants
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Radiotherapy
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Rats, Sprague-Dawley
5.Strontium-89: a desirable therapeutic for bone metastases of prostate cancer.
Yu-Bo MA ; Wei-Li YAN ; Ji-Can DAI ; Feng XU ; Qi YUAN ; He-Hai SHI
National Journal of Andrology 2008;14(9):819-822
OBJECTIVETo evaluate the efficacy of strontium-89 (89Sr) in the treatment of painful bone metastases of prostate cancer.
METHODSA total of 116 patients with painful bone metastases of prostate cancer received bilateral orchiectomy and incretion, followed by intravenous injection of 89Sr at the dose of 1.48-2.22 MBq (40-60 microCi)/kg. The clinical effects were evaluated by follow-up analysis.
RESULTSAfter the 89Sr treatment, appetite and sleep were evidently improved in 33.6% and 56.0% of the patients respectively, the applied dose of anodyne reduced in 61.2%, pain alleviated in 83.6%, with an absolute palliation rate of 24.1%. Pain relief started at 3-21 (10.2 +/- 6.5) days and lasted 3-12 (5.3 +/- 2.2) months. Flare ache occurred in 31.9% of the patients. Compared with pre-treatment, the mean score on Karnofsky's performance status (KPS) was 20.0% higher, and the WBC count decreased to 3.0-3.9 x 10(6)/L in 18.1% of the patients. Whole body bone scintigraphy of 53 followed-up patients showed that 39 (73.6%) of them exhibited an obvious decrease in the number of metastases, 10 (18.9% remained in a stabilized state and only 4 (7.5% deteriorated.
CONCLUSION89Sr, capable of inhibiting bone metastasis, palliating pain and improving the quality of life with few adverse effects, can be used as a desirable therapeutic for painful bone metastases of prostate cancer.
Aged ; Aged, 80 and over ; Bone Neoplasms ; radiotherapy ; secondary ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pain, Intractable ; radiotherapy ; Prostatic Neoplasms ; pathology ; Strontium Radioisotopes ; therapeutic use ; Treatment Outcome
6.Preliminary application of strontium-89 for the treatment of bone metastases from prostate cancer.
Weiwei ZHAO ; Houfu DENG ; Peng JIE ; Chun QING ; Xiying ZHANG
Journal of Biomedical Engineering 2010;27(6):1251-1254
Bone metastases are a major problem in the clinical management of patients with prostate cancer. Despite the use of analgesic for the relief of such pain, the outcomes are not often satisfactory. Strontium-89 (89Sr) is a pure beta-emitting radioisotope to be avidly concentrated in the areas of high osteoblastic activity. The aim of this study was to evaluate the efficacy of 89Sr in the therapy for bone metastases of prostate carcinoma. 116 patients received intravenous injection of 89Sr at the dose of 3mCi (111MBq). All patients underwent physical examination and Karnofsky's Performance Score (KPS) evaluation before and after administration; the analgesic effects were evaluated by scores of pain. The complete response (CR) was defined as scores of pain > 75%; no response (NR) was defined as scores of pain < 25% the remaining was partial response (PR). The changes of bone metastases were screened by CT, MRI and 99mTc-MDP bone scintigraphy according to the standards of WHO. After the treatment with 89Sr, the total response rate was 80.2%. In the 116 cases, 21 cases (18.1%) displayed complete response and 72 cases (62.1%) displayed partial response, but 23 cases (19.2%) showed no response. The mean score on Karnfsky's performance status (KPS) was 20.0% higher. About 1/3 cases exhibited an obvious decrease in the number of metastases, and some foci disappeared. Thirteen cases (12%) showed a greater decrease in prostate-specific antigen (PSA) value. 89Sr chloride is an effective and safe therapy of the bone metastases from prostate cancer.
Adult
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Aged
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Aged, 80 and over
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Bone Neoplasms
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radiotherapy
;
secondary
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Humans
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Male
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Middle Aged
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Prostatic Neoplasms
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pathology
;
radiotherapy
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Strontium Radioisotopes
;
therapeutic use
7.Postirradiation sarcoma of the sphenoid bone--a case report.
Wan-Yee TEO ; Henry K K TAN ; Boon-Cher GOH ; Thomas C PUTTI
Annals of the Academy of Medicine, Singapore 2006;35(2):104-107
INTRODUCTIONThe development of secondary tumours as a result of radiation therapy is a rare but serious complication.
CLINICAL PICTUREThis is a case report of a 45-year-old Chinese male who developed postirradiation sarcoma of the sphenoid bone in less than 5 years after radiation therapy for Stage T3N1M0 nasopharyngeal carcinoma.
DISCUSSIONIn the literature, the only case of postirradiation osteosarcoma of the sphenoid bone was after radiation therapy for craniopharyngioma. There was no previously reported case of postirradiation sarcoma of the sphenoid bone after radiation therapy for nasopharyngeal carcinoma.
CONCLUSIONThis is the first case of postirradiation malignant fibrous histiocytoma of the sphenoid to be reported. Of about 3000 patients treated with radiotherapy for nasopharyngeal carcinoma over a 10-year period in Singapore, only 1 patient developed postirradiation tumour of the sphenoid bone.
Bone Neoplasms ; etiology ; secondary ; Fatal Outcome ; Histiocytoma, Malignant Fibrous ; etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; radiotherapy ; Neoplasms, Radiation-Induced ; etiology ; Sphenoid Bone ; pathology ; Spinal Neoplasms ; radiotherapy ; secondary
8.Radium-223 for the treatment of bone metastasis of prostate cancer.
Xiao-Feng XU ; Zhi-Feng WEI ; Zheng-Yu ZHANG
National Journal of Andrology 2017;23(1):78-81
Over 80% of the patients with prostate cancer (PCa) develop bone metastasis, which seriously affects the patients' quality of life and remains a major cause of morbidity. Radium-223 (Ra-223), a newly approved agent targeting bone metastasis of PCa, can improve the quality of life and prolong the overall survival of the PCa patients with bone metastasis. This article presents an overview of the clinical trials recently published on the management of bone metastasis of PCa with Ra-223.
Bone Neoplasms
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radiotherapy
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secondary
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Clinical Trials as Topic
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Humans
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Male
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Prostatic Neoplasms
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pathology
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Quality of Life
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Radioisotopes
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Radium
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therapeutic use
9.Association between salivary α-amylase activity and pain relief scale scores in cancer patients with bone metastases treated with radiotherapy.
Hong LIU ; Wen-yan DONG ; Jian-bo WANG ; Tao WANG ; Peng HU ; Shu-fang WEI ; Lin YE ; Qing-wei WANG
Chinese Medical Journal 2013;126(23):4444-4447
BACKGROUNDSubjective assessment tools such as visual analog scales (VAS) or pain scores are commonly used to evaluate the intensity of chronic cancer-induced pain. However, their value is limited in some cases. We measured changes in VAS pain scores and salivary α-amylase (sAA) concentrations in cancer patients receiving radiotherapy for bone metastases to ascertain the correlation between these measures.
METHODSWe enrolled 30 patients with bone metastases attending a single institution from June 2010 to March 2011. All patients with cancer-induced bone pain received radiation therapy (RT) at the same dose (30 Gy) and fractionation (3 Gy/fraction, 5 days/week) for palliative pain relief. We assessed heart rate (HR), systolic and diastolic blood pressures (DBP/SBP) and VAS pain scores before (d0) and after five (d5) and ten fractions (d10) of irradiation. sAA and salivary cortisol (SC) concentrations were measured using a portable analyzer and automated chemiluminescence analyzer, respectively.
RESULTSRadiotherapy markedly decreased VAS scores from (82.93 ± 9.29) to (31.43 ± 16.73) mm (P < 0.001) and sAA concentrations from (109.40 ± 26.38) to (36.03 ± 19.40) U/ml (P <0.001). Moreover, there was a significant correlation between these two indices (P <0.01, r = 0.541). HR decreased by 6.5% after radiotherapy, but did not correlate with VAS scores (P >0.05). SC concentrations and BP did not change significantly during the study (P >0.05).
CONCLUSIONSThe significant correlation between sAA concentrations and VAS pain scores identified in these preliminary results suggests that this biomarker may be a valuable, noninvasive and sensitive index for the objective assessment of pain intensity in patients with cancer-induced bone pain.
Aged ; Bone Neoplasms ; enzymology ; radiotherapy ; secondary ; Female ; Humans ; Male ; Middle Aged ; Pain ; enzymology ; radiotherapy ; Pain Management ; Pain Measurement ; Salivary alpha-Amylases ; metabolism ; Treatment Outcome
10.Clinical observation on treatment of multiple bone metastatic tumor of mammary cancer by combination therapy of 89Sr and Chinese herbal medicine.
Feng LIU ; Shu-hua LIU ; Zhi-gang REN
Chinese Journal of Integrated Traditional and Western Medicine 2003;23(4):265-267
OBJECTIVETo compare the clinical curative effects between 89Sr and its combination with the Guliu recipe (GLR, a Chinese herbal medicine) in treating multiple bone metastatic tumor of mammary cancer (MBM-MC).
METHODSBy adopting the random sampling and grouping method, 89Sr alone (Sr) and 89Sr combined with CHM (Sr-GLR) were used in treating 86 and 40 patients with MBM-MC respectively. The efficacy of therapy were appraised according to the degree of ostalgia relieving and quality of life (QOF) in patients, and the effect of treatment on focal bone metabolism and bone marrow hematopoietic function were compared.
RESULTSThe effective rate of Sr and Sr-GLR in relieving ostalgia was 83.72% and 95.00%, respectively (P > 0.05), the QOF improving and stabilizing rate of them 80.23% and 95.00% (P < 0.05), the effective rate on focal bone metabolism 59.30% and 52.50% (P > 0.05) and their hemo-toxicity 28.00% and 30.00% (P > 0.05).
CONCLUSIONSr-GLR is a combination therapy in treating MBM-MC with good effect, it could raise the patient's QOF, enhance the ostalgia relieving effect without increasing the hemo-toxicity of treatment.
Adult ; Aged ; Bone Neoplasms ; drug therapy ; radiotherapy ; secondary ; Breast Neoplasms ; drug therapy ; pathology ; radiotherapy ; Carcinoma, Ductal, Breast ; drug therapy ; radiotherapy ; secondary ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Phytotherapy ; Quality of Life ; Strontium Radioisotopes ; therapeutic use