Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-07-2007 | Original Article

Radiopharmaceutical therapy of bone metastases with ⁸⁹SrCl₂, ¹⁸⁶Re-HEDP and ¹⁵³Sm-EDTMP: a dosimetric study using Monte Carlo simulation

Authors: L. Strigari, R. Sciuto, M. D’Andrea, R. Pasqualoni, M. Benassi, C. L. Maini

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2007

Abstract

Purpose

The aim of the paper is to calculate the dose to bone surface and bone volume using a Monte Carlo particle transport model and to give quantitative arguments for activity prescription.

Methods

This study simulates the dose delivery process to skeletal metastases by bone surface- and bone volume-seeking radiopharmaceuticals. Dose distributions for three radiopharmaceuticals, ¹⁸⁶Re-HEDP, ¹⁵³Sm-EDTMP and ⁸⁹SrCl₂, frequently used for pain palliation therapies, were calculated using the EGSnrc Monte Carlo code. The model simulates a cylindrical geometry with regions of different constant density compositions and radioactivity distribution consistent with known biodistribution features of the three radiopharmaceuticals: superficial for phosphonates (¹⁸⁶Re-HEDP and ¹⁵³Sm-EDTMP) and volumetric for ⁸⁹SrCl₂. After 3D dose distribution calculation, dose-volume histogram reduction was carried out using the “preferred Lyman” method, which yields effective uniform dose (D _eff) equivalent to the inhomogeneous dose distributions to the reference region (volume and surface).

Results

Our simulations showed that to obtain a delivered dose to bone surface equivalent to that obtained from ⁸⁹SrCl₂, the administered activities of ¹⁵³Sm-EDTMP and ¹⁸⁶Re-HEDP should be increased by 37% and 48%, respectively, in comparison with those usually administered.

Conclusion

These results prove theoretically the empirical results from clinical observations and show that improvement in bone pain palliation by means of radiopharmaceutical therapy should be expected for dose-guided prescription.

Twicross RG, Fairfield S. Pain in advanced cancer. Pain 1982;14:303–10.CrossRef

Coleman RE. Skeletal complications of malignancy. Cancer 1997;80:1588–94.PubMedCrossRef

Slatkin N. Cancer-related pain and its pharmacological management in the patient with bone metastasis. J Support Oncol 2006;4(2 Suppl 19):15–21.PubMed

Lewington VJ. Bone seeking radionuclides for therapy. J Nucl Med 2005;46:38S–47S.PubMed

Sciuto R, Festa A, Rea S, Pasqualoni R, Bergomi S, Petrilli G, et al. Effects of low-dose cisplatin on ⁸⁹Sr therapy for painful bone metastases from prostate cancer: a randomized clinical trial. J Nucl Med 2002;43:79–86.PubMed

Breen SL, Powe JE, Porter AT. Dose estimation in strontium-89 radiotherapy of metastatic prostatic carcinoma. J Nucl Med 1992;33:1316–23.PubMed

Laing AH, Ackery DM, Bayly RJ, Buchanan RB, Lewington VJ, McEwan AJ, et al. Strontium-89 therapy for pain palliation in prostatic skeletal malignancy. Br J Radiol 1991;64:816–22.PubMedCrossRef

De Klerk JMH, Zonnenmberg BA, van het Ship AD, van Dijk A, Han SH, Quirijnen JM, et al. Dose escalation study of Re-186 HEDP in patients with metastatic prostate cancer. Eur J Nucl Med 1994;21:1113–20.CrossRef

Maxon HR III, Deutsch EA, Thomas SR, Libson K, Lukes SJ, Williams CC et al. Re-186(Sn)-HEDP for treatment of multiple metastatic foci in bone: human biodistribution and dosimetric studies. Radiology 1988;166:501–7.PubMed

10.

Collins C, Eary JF, Donaldson G, Vernon C, Bush NE, Petersdorf S, et al. Samarium-153 EDTMP in bone metastases of hormone refractory prostate carcinoma: a phase I/II trial. J Nucl Med 1993;34:1839–44.PubMed

11.

Turner JH, Martindale AA, Sorby P, Hetherington EL, Fleay RF, Hoffman RF, et al. Samarium-153 EDTMP therapy of disseminated skeletal metastases. Eur J Nucl Med 1989;15:784–95.PubMedCrossRef

12.

Turner JH, Claringbold PG, Hetherington EL, Sorby P, Martindale AA. A phase I study of samarium–153 ethylenediaminetetramethylene phosphonate therapy for disseminated skeletal metastases. J Clin Oncol 1989;7(12):1926–31.PubMed

13.

Bouchet LG, Jokisch DW, Bolch WE. A three-dimensional transport model for determining absorbed fractions of energy for electrons within trabecular bone. J Nucl Med 1999;40:1947–66.PubMed

14.

Bouchet LG, Bolch WE. A three-dimensional transport model for determining absorbed fractions of energy for electrons within cortical bone. J Nucl Med 1999;40:2115–24.PubMed

15.

Whitwell JR, Spiers FW. Calculated beta-ray dose factors for trabecular bone. Phys Med Biol 1976;21:16–38.PubMedCrossRef

16.

Beddoe AH. Measurements of the microscopic structure of cortical bone. Phys Med Biol 1977;22:298–308.PubMedCrossRef

17.

Bouchet LG, Bolch WE, Howell RW, Rao DV. S values for radionuclides localized within the skeleton. J Nucl Med. 2000;41:189–212.PubMed

18.

Jokisch DW, Patton PW, Inglis BA, Bouchet LG, Rajon DA, Rifkin J, et al. NMR microscopy of trabecular bone and its role in skeletal dosimetry. Health Phys 1998;75:584–96.PubMedCrossRef

19.

Nelson WR, Hirayama H, Rogers D. The EGS4 Code System. SLAC-265. Stanford, CA: Stanford Linear Accelerator Center; 1985.

20.

Kawrakow I. Accurate condensed history Monte Carlo simulation of electron transport. EGSnrc, the new EGS4 version. Med Phys 2000;27:485–98.PubMedCrossRef

21.

Kawrakow I, Rogers DWO. The EGSnrc Code System: Monte Carlo simulation of electron and photon transport. Technical Report PIRS-701. Ottawa, Canada: National Research Council of Canada; 2000.

22.

http://www.nndc.bnl.gov/nudat2/

23.

ICRU. Tissue substitutes in radiation dosimetry and measurement, ICRU Report 44. Bethesda, MD: ICRU; 1989.

24.

ICRU. Photon, electron, proton and neutron interaction data for body tissues, ICRU Report 46. Bethesda, MD:ICRU; 1992.

25.

Bartlett ML, Webb M, Durrant S, Morton AJ, Allison R, Macfarlane DJ. Dosimetry and toxicity of Quadramet for bone marrow ablation in multiple myeloma and other haematological malignancies. Eur J Nucl Med Mol Imaging 2002;29:1470–7.PubMedCrossRef

26.

Li L, Liang Z, Deng H, Kuang A, Tan T, Luo S. Samarium-153-EDTMP bone uptake rate and its relation to therapeutic effect. Chin Med J 2002;115(7):1096–8.PubMed

27.

Brenner W, Kampen WU, Kampen AM, Henze E. Skeletal uptake and soft-tissue retention of ¹⁸⁶Re-HEDP and ¹⁵³Sm-EDTMP in patients with metastatic bone disease. J Nucl Med 2001;42:230–6.PubMed

28.

Early JF, Collins C, Stabin M, Vernon C, Petersdorf S, Baker M, et al. Samarium-153 biodistribution and dosimetry estimation. J Nucl Med 1993;34:1031–6.

29.

Bayouth JE, Macey DJ, Kasi LP, Fossella FV. Dosimetry and toxicity of samarium–153-EDTMP for bone pain due to skeletal metastases. J Nucl Med 1994;35:63–9.PubMed

30.

Singh A, Holmes RA, Farhangi M, Volkert WA, Williams A, Stringham LM, et al. Human pharmacokinetic of samarium-153-EDTMP metastatic cancer. J Nucl Med 1989;30:1814–8.PubMed

31.

Harbert JC. Nuclear medicine therapy. New York: Thieme Medical; 1987; p 216–20.

32.

Blake GM, Zivanovic MA, Blaquiere RM, Fine DR, Mc Ewan AJ, Ackery DM. Strontium-89 therapy: measurement of absorbed dose to skeletal metastases. J Nucl Med 1988;29:549–57.PubMed

33.

Lyman JT. Complication probability as assessed from dose-volume histograms. Radiat Res 1985;104:S13–9.CrossRef

34.

Kutcher GJ, Burman C. Calculation of complication probability factors for nonuniform normal tissue irradiation: the effective volume method. Int J Radiat Oncol Biol Phys 1991;21:123–35.PubMed

35.

Lewington VJ, Mc Ewan AJ, Ackery DM, Bayly RJ, Keeling DH, Macleod PM, et al . A prospective randomized double-blind cross-over study to examine the efficacy of strontium-89 in pain palliation in patients with advanced prostate cancer metastatic to bone. Eur J Cancer 1991;27:954–8.PubMedCrossRef

36.

Pons F, Herranz R, Garcia A, Vidal-Sicart S, Conill C, Grau JJ, et al. Strontium-89 for palliation of pain from bone metastases in patients with prostate and breast cancer. Eur J Nucl Med 1997;24:1210–4.PubMedCrossRef

37.

Sciuto R, Tofani A, Festa A, Giannarelli D, Pasqualoni R, Maini CL. Short- and long-term effects of ¹⁸⁶ Re-1,1-hydroxyethylidene diphosphonate in the treatment of painful bone metastases. J Nucl Med 2000;41:647–54.PubMed

38.

Resche I, Chatal JF, Pecking A, Ell P, Duchesne G, Rubens R, et al. A dose-controlled study of 153-Sm-ethylenediaminetetramethylenephosphonate (EDTMP) in the treatment of patients with painful bone metastases. Eur J Cancer 1997;33:1583–91.PubMedCrossRef

39.

Serafini AN, Houston SJ, Resche I, Quick DP, Grund FM, Ell PJ, et al. Palliation of pain associated with metastatic bone cancer using samarium-153 lexidronam: a double-blind placebo-controlled clinical trial. J Clin Oncol 1998;16:1574–81.PubMed

40.

Sciuto R, Festa A, Tofani A, Pasqualoni R, Semprebene A, Cucchi R, et al. Platinum compounds as radiosensitizers in strontium-89 metabolic radiotherapy. Clin Ter 1998;149:43–7.PubMed

41.

Tu SM, Millikan RE, Mengistu B, Delpassand ES, Amato RJ, Pagliaro LC, et al. Bone-targeted therapy for advanced androgen-independent carcinoma of the prostate: a randomized phase II trial. Lancet 2001;357:336–41.PubMedCrossRef

42.

Porter AT, McEwan AJ. Strontium-89 as an adjuvant to external beam radiation improves pain relief and delays disease progression in advanced prostate cancer. A randomized controlled trial. Semin Oncol 1993;20:38–43.PubMed

43.

Storto G, Klain M, Paone G, Liuzzi R, Molino L, Marinelli A, et al. Combined therapy of Sr-89 and zoledronic acid in patients with painful bone metastases. Bone 2006;39:35–41.PubMedCrossRef

44.

Serafini AN. Therapy of metastatic bone pain. J Nucl Med 2001;42:895–906.PubMed

45.

Sciuto R, Festa A, Pasqualoni R, Semprebene A, Rea S, Bergomi S, et al. Metastatic bone pain palliation with 89-Sr and 186-Re-HEDP in breast cancer patients. Breast Cancer Res Treat 2001;66:101–9.PubMedCrossRef

46.

Maini CL, Sciuto R, Romano L, Bergomi S. Radionuclide therapy with bone seeking radionuclides in palliation of painful bone metastases. J Exp Clin Cancer Res 2003;22:71–4.PubMed

47.

Samaratunga RC, Thomas SR, Hinnefeld JD, Von Kuster LC, Hyams DM, Moulton JS, et al. A Monte Carlo simulation model for radiation dose to metastatic skeletal tumor from rhenium-186(Sn)-HEDP. J Nucl Med 1995;36(2):336–50.PubMed

48.

Alberts AS, Smit BJ, Louw WK, van Rensburg AJ, van Beek A, Kritzinger V, et al. Dose response relationship and multiple dose efficacy and toxicity of samarium-153-EDTMP in metastatic cancer to bone. Radiother Oncol 1997;43:175–9.PubMedCrossRef

Title: Radiopharmaceutical therapy of bone metastases with 89SrCl2, 186Re-HEDP and 153Sm-EDTMP: a dosimetric study using Monte Carlo simulation
Authors: L. Strigari
R. Sciuto
M. D’Andrea
R. Pasqualoni
M. Benassi
C. L. Maini
Publication date: 01-07-2007
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2007
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-006-0302-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Radiopharmaceutical therapy of bone metastases with ⁸⁹SrCl₂, ¹⁸⁶Re-HEDP and ¹⁵³Sm-EDTMP: a dosimetric study using Monte Carlo simulation

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2007

Jeroen J. Bax, Christopher M. Kramer, Thomas H. Marwick, William Wijns (eds) Cardiovascular imaging: a handbook for clinical practice

E.L. Mazzaferri, C. Harmer, U.K. Mallick, P. Kendall-Taylor (eds): Practical management of thyroid cancer: a multidisciplinary approach

Synthesis and in vivo evaluation of a novel 5-HT1A receptor agonist radioligand [O-methyl-11C]2-(4-(4-(2-methoxyphenyl)piperazin-1-yl)butyl)-4-methyl-1,2,4-triazine-3,5(2H,4H)dione in nonhuman primates

Bone and marrow imaging: do we know what we seeand do we see what we want to know?

19th international IRIST congress 18 to 21 June 2008 Krakow, Poland

M. Chinol, G. Paganelli (eds): Radionuclide peptide cancer therapy