Radiopharmaceuticals for Palliation of Painful Osseous Metastases

Abstract

Bone pain secondary to metastases may develop in more than half of patients with metastatic cancer. The treatment of metastatic osseous pain usually begins with oral analgesics following the WHO-ladder followed by external beam radiotherapy, ablative nerve blocks and implantable devices. Despite aggressive interventions, pain control seems challenging in this population. Treatment strategies including bisphosphonates, mitoxantrone and hormonal therapy have recently come into light. In some cases of osseous metastasis, radiopharmaceuticals may prove to be beneficial as an additional non-invasive therapy. This discussion will review different radiopharmaceutical agents available today including Strontium-89 chloride, Phosphorus-32 orthophosphate and Samarium-153 lexidronam and their clinical considerations.