Effects of Low-Dose Cisplatin on 89Sr Therapy for Painful Bone Metastases from Prostate Cancer: A Randomized Clinical Trial

Journal of Nuclear Medicine

Anna Festa¹  Serenella Bergomi¹  Carlo L. Maini¹  Rosella Pasqualoni¹  Rosa Sciuto¹  Sandra Rea¹  Germana Petrilli¹ 

[1] Nuclear Medicine Department, Regina Elena Cancer Institute, Rome, Italy Nuclear Medicine Department, Regina Elena Cancer Institute, Rome, Italy Nuclear Medicine Department, Regina Elena Cancer Institute, Rome, Italy

关键词: strontium;    cisplatin;    pain palliation;    prostate cancer;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

This study evaluated the effects of low-dose cisplatin plus 89Sr versus 89Sr alone in the treatment of painful bone metastases from prostate cancer, addressing both pain palliation and cytostatic effects. Methods: Seventy patients with metastatic hormone-refractory prostate cancer were randomized into 2 groups: One group (arm A) received 148 MBq 89Sr plus 50 mg/m2 cisplatin, and the other group (arm B) received 148 MBq 89Sr plus placebo. After treatment, the patients were followed up until death to evaluate the outcome variables: grade and duration of pain palliation, onset of new painful sites, changes in bone disease, global survival, serum prostate-specific antigen and alkaline phosphatase changes, and hematologic toxicity. Results: Overall pain relief occurred in 91% of patients in arm A and 63% of patients in arm B (P < 0.01), with a median duration of 120 d in arm A and 60 d in arm B (P = 0.002). New painful sites on previously asymptomatic bone metastases appeared in 14% of patients in arm A and in 30% of patients in arm B (P = 0.18). The median survival without new painful sites was 4 mo in arm A and 2 mo in arm B (P = 0.04). Bone disease progression was observed in 27% of patients in arm A and in 64% of patients in arm B (P = 0.01). Median global survival after therapy was 9 mo in arm A and 6 mo in arm B (P = 0.30). Transient and moderate hematologic toxicity, as determined by World Health Organization criteria, was apparent in both arms without significant differences. Conclusion: The addition of a low dose of cisplatin enhances the effect of a standard dose of 89Sr without significant side effects, producing a significant improvement in pain palliation and a cytostatic effect on bone disease.

【 授权许可】

Unknown