PALLIATIVE TREATMENT OF PAINFUL OSSEOUS M ETASTASES IN PROSTATE CARCINOMA WITH THE OSTEOTROPIC BETA-EMITTER RHENIUM-186-HEDP

Systemic administration of strontium-89 is an important option for pai n relief in advanced prostate carcinoma with multiple osseous metastas es. Recently, rhenium-186-HEDP was introduced as a new substance which has important advantages (shorter physical half-life, scintigraphic i maging, dose distribution). The myelosuppressive effect can be estimat ed more accurately in advance, so that adverse effects can be reduced and the treatment can be repeated after a shorter period of time and m ore often. Our study comprises 15 treatments with rhenium-186-HEDP in advanced prostate cancer patients using the 1.4- to 2-fold standard do se. The response rate, estimated as reduction in pain and increase in patient mobility, was 87% with no major myelosuppressive effects. The mean duration of pain relief was 4-6 weeks. All four patients with rep eated therapy were also responding to the second treatment. Radionucli de therapy for painful osseous metastases with rhenium-186-HEDP appear s to be an effective and, even at higher doses, safe procedure.