|
|
Radiopharmaceuticals
Several radiopharmaceuticals have been used therapeutically. Iodine-131, used for the treatment of multiple bone metastases from thyroid cancer, results in bone scan evidence of response in 53 percent of patients.307 Phosphorus-32-orthophosphate has provided partial or complete relief of pain in about 80 percent of patients with bone metastases from breast and prostate carcinoma.422 In an analysis of 18 published studies, strontium-89 was found to provide partial to complete pain relief for 65 percent.421 For example, Silberstein and Williams (1985)423 reported a palliative response of 51 percent of patients, and Robinson, Spicer, Preston, et al. (1987) 394 reported 80 to 89 percent palliative response. In these studies, analgesic use and activities of daily living were used as measures of palliation. Myelosuppression, manifested by approximately a 30 to 50 percent decline in leukocyte and platelet levels within 4 to 6 weeks, generally occurs in patients with either extensive disease or pretreatment peripheral cytopenia.285 Rhenium-186 and samarium-153 phosphonate chelates have demonstrated 65 to 80 percent efficacy in international clinical trials, with FDA approval pending.306; 470 These B-emitting radiopharmaceuticals, which require only a single intravenous injection, are used to relieve pain from widespread, osteoblastic skeletal metastasis visualized with bone scintigraphy. If pain recurs, 50 percent of patients will respond to a second administration.
Go to the Non Pharmacologic Treatment of Pain in HIV Menu
Go to the Pain & HIV/AIDS Menu
Go to the HIVpositive.us Main Menu
74