Biomaterial Database

Strontium-89 for symptomatic metastatic prostate cancer to bone: recommendations for hospice patients. 1996

K Schmeler, and K Bastin

In our institution, 4 mCi doses of the radiopharmaceutical strontium-89 (Sr89) have been given to 101 prostate cancer patients suffering from symptomatic bone metastases. Patients were prospectively analyzed for pain response, treatment-related hematologic toxicity, and survival. Pre-treatment clinical factors were correlated with outcome. Karnofsky Performance Scores (KPS) predicted for survival and pain response. Myelosuppression from the Sr89 treatment was minimal. Twenty-eight of the treated patients had a KPS of 60 or less. This group of patients had a median actuarial survival of 17.5 weeks, and collectively, met Hospice admission survival criteria. In a subset analysis of this group, patients with a KPS of 50 or less demonstrated a low pain response (40%) and average survival (12.5 weeks), both of which did not appear to justify the significant cost and risk of toxicity associated with Sr89 treatment. In these patients, opioids appeared to offer more cost-effective pain control. Patients with a pre-treatment KPS score of 60 had a mean survival of 20.5 weeks following Sr89 therapy, with 42 percent of patients experiencing a reduction in pain. We conclude that patients with a pretreatment KPS of 50 or less should not be treated with Sr89 and patients with a pretreatment KPS of 60 should be evaluated on a case-by-case basis to determine whether or not Sr89 represents the most reasonable treatment option for palliation of their bone pain.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D010147	Pain Measurement	Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.	Analgesia Tests,Analogue Pain Scale,Formalin Test,McGill Pain Questionnaire,Nociception Tests,Pain Assessment,Pain Intensity,Pain Severity,Tourniquet Pain Test,Visual Analogue Pain Scale,Analog Pain Scale,Assessment, Pain,McGill Pain Scale,Visual Analog Pain Scale,Analgesia Test,Analog Pain Scales,Analogue Pain Scales,Formalin Tests,Intensity, Pain,Measurement, Pain,Nociception Test,Pain Assessments,Pain Intensities,Pain Measurements,Pain Questionnaire, McGill,Pain Scale, Analog,Pain Scale, Analogue,Pain Scale, McGill,Pain Severities,Pain Test, Tourniquet,Questionnaire, McGill Pain,Scale, Analog Pain,Scale, Analogue Pain,Scale, McGill Pain,Severity, Pain,Test, Analgesia,Test, Formalin,Test, Nociception,Test, Tourniquet Pain,Tests, Nociception,Tourniquet Pain Tests
D010166	Palliative Care	Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)	Palliative Treatment,Palliative Supportive Care,Palliative Surgery,Palliative Therapy,Surgery, Palliative,Therapy, Palliative,Care, Palliative,Palliative Treatments,Supportive Care, Palliative,Treatment, Palliative,Treatments, Palliative
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D011471	Prostatic Neoplasms	Tumors or cancer of the PROSTATE.	Cancer of Prostate,Prostate Cancer,Cancer of the Prostate,Neoplasms, Prostate,Neoplasms, Prostatic,Prostate Neoplasms,Prostatic Cancer,Cancer, Prostate,Cancer, Prostatic,Cancers, Prostate,Cancers, Prostatic,Neoplasm, Prostate,Neoplasm, Prostatic,Prostate Cancers,Prostate Neoplasm,Prostatic Cancers,Prostatic Neoplasm
D001859	Bone Neoplasms	Tumors or cancer located in bone tissue or specific BONES.	Bone Cancer,Cancer of Bone,Cancer of the Bone,Neoplasms, Bone,Bone Neoplasm,Neoplasm, Bone
D003362	Cost-Benefit Analysis	A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes.	Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013326	Strontium Radioisotopes	Unstable isotopes of strontium that decay or disintegrate spontaneously emitting radiation. Sr 80-83, 85, and 89-95 are radioactive strontium isotopes.	Radioisotopes, Strontium
D016019	Survival Analysis	A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.	Analysis, Survival,Analyses, Survival,Survival Analyses