Schmerztherapie mit Rhenium-186 HEDP bei multiplen Knochenmetastasen

Zusammenfassung

Ziel: Die effiziente, medikamentöse Behandlung von Patienten mit schmerzhaften, disseminierten Knochemmetastasen stellt ein therapeutisches Problem dar. Die systemische Radionuklidtherapie kommt als Alternative in Frage. In der vorliegenden Studie wurde die Effektivität von Rhenium-186 HEDP zur Schmerztherapie bei disseminierten Knochenmetastasen evaluiert. Methoden: 30 Patienten, die wegen schmerzhafter Knochenmetastasen analgetisch behandelt wurden, erhielten -teilweise mehrfach- Injektionen von jeweils 1295 MBq ¹⁸⁶Re HEDP zur Schmerzbehandlung. Ergebnisse: Bei 70% der Patienten ließ sich eine Schmerzreduktion erreichen. Die Dauer des Ansprechens auf die Therapie betrug im Mittel 4 Wochen (1 Wo-2,5 Mon). Die wesentlichen Nebenwirkungen bestanden in einem geringen Abfall der Thrombozyten (durchschnittl. 30000/ul) und einer kurzzeitigen Verstärkung der Schmerzsymptomatik (Flare-Effekt). Schlußfolgerung: Bei Patienten mit schmerzhaften, disseminierten Knochenmetastasen kann die Schmerztherapie mit Rhenium-186 HEDP komplementär zur medikamentösen Therapie eingesetzt werden.

Summary

Aim: Therapeutic means for patients with painful bony metastases are strongly limited. In these patients, a systemic therapy with isotopes can be helpful. The aim of this study was to evaluate the efficacy of rhenium-186 HEDP for pain palliation in patients with disseminated bone metastases. Methods: 30 patients taking analgesics because of bone pain received one or more injection of 1295 MBq ¹⁸⁶Re HEDP for pain palliation. Results: In 70% of the patients, therapy resulted in a significant reduction of pain. The average duration of pain relief was 4 weeks (1 week-2.5 months). The main side effects of therapy were a decrease of platelets (aver. 30000/ul) and an increase of pain for 1-2 days (flare-phenomenon). Conclusion: Therapy with rhenium-186 HEDP can be used complementarily to analgesic therapy in patients with painful, disseminated bone metastases.

Schlüsselwörter

Knochenmetastasen - ¹⁸⁶Re HEDP - Schmerzbehandlung

Keywords

Bone metastases - ¹⁸⁶Re HEDP - pain therapy

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