Palliative Radiation with a Radiolabeled Diphosphonate (Rhenium-186 Etidronate) in Patients with Hormone-Refractory Disseminated Prostate Carcinoma

Material and methods: The present study investigates the safety and efficacy of 2590 MBq rhenium-186 ( 186 Re) etidronate (i.e. twice the activity normally used) administered intravenously in 15 patients with disseminated prostatic carcinoma and bone pain. Results: Pain relief was observed in 11 of 14 evaluable patients (79%), 4 of whom became completely free from pain. Five of the responding patients also noted an improvement in daily activity and two found it possible to reduce or discontinue morphine medication. Pain relief occurred within one week in four patients, and within two weeks in eight of the responding patients. The mean duration of pain relief after the first course of 186 Re-etidronate was 6 weeks (range 4-10). The toxicity was mild (< grade 2), transient, and restricted to hematological toxicity. Conclusions: 186 Re-etidronate provided rapid pain-relief and had mild toxicity in most patients with disseminated hormone-refractory prostatic carcinoma, but doubling the activity did not markedly improve the efficacy.