Repeated bone-targeted therapy for hormone-refractory prostate carcinoma: Randomized phase II trial with the new, high-energy radiopharmaceutical rhenium-188 hydroxyethylidenediphosphonate

被引:108
作者
Palmedo, H
Manka-Waluch, A
Albers, P
Schmidt-Wolf, IGH
Reinhardt, M
Ezziddin, S
Joe, A
Roedel, R
Fimmers, R
Knapp, FF
Guhlke, S
Biersack, HJ
机构
[1] Univ Bonn, Dept Nucl Med, D-53127 Bonn, Germany
[2] Univ Bonn, Dept Urol, D-53127 Bonn, Germany
[3] Univ Bonn, Dept Internal Med Oncol, D-53127 Bonn, Germany
[4] Univ Bonn, Dept Biostat, D-53127 Bonn, Germany
[5] Oak Ridge Natl Lab, Nucl Med Grp, Oak Ridge, TN USA
关键词
D O I
10.1200/JCO.2003.12.060
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: We investigated the effect of repeated bone-targeted therapy with rhenium-188 hydroxyethylidene-diphosphonate (HEDP) in patients with progressive, hormone-resistant prostate carcinoma and bone pain. The aim of this study was to determine the pain palliation and the antitumor effect of rhenium-188 HEDP treatments. Patients and Methods: Sixty-four patients were randomly assigned to one of two groups for radionuclide therapy with rhenium-188 HEDP; patients of group A received a single injection, patients of group B received two injections (interval, 8 weeks). After therapy, patients were followed-up by assessment of pain palliation and clinical outcome until death. Results: In both groups, toxicity was low, with moderate thrombopenia and leukopenia (maximum common toxicity criteria grade of 2). The effectiveness of rhenium-188 HEDP for pain palliation was better in the repeated treatment group (group B), with a response rate and time of response of 92% and 5.66 months, respectively (P = .006 and P = .001). In group B, 11 (39%) of 28 patients had a prostate-specific antigen decrease of more than 50% for at least 8 weeks, compared with two (7%) of 30 patients in the sing le-injection group (group A). The median times to progression of group A and group B were 2.3 months (range, 0 to 12.2 months) and 7.0 months (range, 0 to 24.1 months), respectively (P = .0013), and the median overall survival times were 7.0 months (range, 1.3 to 36.7 months) and 12.7 months (range, 4.1 to 32.2 months), respectively (P = .043). Conclusion: Compared with single-injection therapy, repeated bone-targeted therapy with rhenium-188 HEDP administered to patients with advanced progressive hormone-refractory prostate carcinoma enhanced pain palliation and improved progression-free and overall survival. Larger studies are justified to further evaluate the use of rhenium-188 HEDP.
引用
收藏
页码:2869 / 2875
页数:7
相关论文
共 38 条
[1]  
BLAKE GM, 1988, J NUCL MED, V29, P549
[2]   SR-89 THERAPY - STRONTIUM KINETICS IN DISSEMINATED CARCINOMA OF THE PROSTATE [J].
BLAKE, GM ;
ZIVANOVIC, MA ;
MCEWAN, AJ ;
ACKERY, DM .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE, 1986, 12 (09) :447-454
[3]   A multicentre observational study of radionuclide therapy in patients with painful bone metastases of prostate cancer [J].
Dafermou, A ;
Colamussi, P ;
Giganti, M ;
Cittanti, C ;
Bestagno, M ;
Piffanelli, A .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE, 2001, 28 (07) :788-798
[4]  
DONALDSON G, 1992, SCI COMPUT AUTOMATIO, V1, P45
[5]  
EARY JF, 1993, J NUCL MED, V34, P1031
[6]   Studies of the structure and composition of rhenium-1,1-hydroxyethylidenediphosphonate (HEDP) analogues of the radiotherapeutic agent (ReHEDP)-Re-186 [J].
Elder, RC ;
Yuan, J ;
Helmer, B ;
Pipes, D ;
Deutsch, K ;
Deutsch, E .
INORGANIC CHEMISTRY, 1997, 36 (14) :3055-3063
[7]  
Epstein JI, 1996, CANCER, V78, P350, DOI 10.1002/(SICI)1097-0142(19960715)78:2<350::AID-CNCR26>3.0.CO
[8]  
2-U
[9]   THE TREATMENT OF CANCER PAIN [J].
FOLEY, KM .
NEW ENGLAND JOURNAL OF MEDICINE, 1985, 313 (02) :84-95
[10]   PREDICTION OF PROGNOSIS FOR PROSTATIC ADENOCARCINOMA BY COMBINED HISTOLOGICAL GRADING AND CLINICAL STAGING [J].
GLEASON, DF ;
MELLINGE.GT .
JOURNAL OF UROLOGY, 1974, 111 (01) :58-64