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Year : 2018  |  Volume : 17  |  Issue : 4  |  Page : 228-235

Clinical utility of 188Rhenium-hydroxyethylidene-1,1-diphosphonate as a bone pain palliative in multiple malignancies

1 Department of Nuclear Medicine and PET/CT, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
2 Division of Radiopharmaceuticals, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
3 Department of Radiation Oncology, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India
4 Radiation Medicine Centre, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India

Correspondence Address:
Ajit S Shinto
Department of Nuclear Medicine, Kovai Medical Center and Hospital Limited, Coimbatore - 641 014, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wjnm.WJNM_68_17

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188Rhenium-hydroxyethylidene-1,1-diphosphonate (188Re-HEDP) is a clinically established radiopharmaceutical for bone pain palliation of patients with metastatic bone cancer. Herein, the effectiveness of 188Re-HEDP for the palliation of painful bone metastases was investigated in an uncontrolled initial trial in 48 patients with different types of advanced cancers. A group of 48 patients with painful bone metastases of lung, prostate, breast, renal, and bladder cancer was treated with 2.96–4.44 GBq of 188Re-HEDP. The overall response rate in this group of patients was 89.5%, and their mean visual analog scale score showed a reduction from 9.1 to 5.3 (P < 0.003) after 1 week posttherapy. The patients did not report serious adverse effects either during intravenous administration or within 24 h postadministration of 188Re-HEDP. Flare reaction was observed in 54.2% of patients between day 1 and day 3. There was no correlation between flare reaction and response to therapy (P < 0.05). Although bone marrow suppression was observed in patients receiving higher doses of 188Re-HEDP, it did not result in any significant clinical problems. The present study confirmed the clinical utility and cost-effectiveness of 188Re-HEDP for palliation of painful bone metastases from various types of cancer in developing countries.

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