Radionuclide Treatment in Metastasized Prostate Cancer

Painful osseous metastases are the major cause of cancer-related pain in metastasized prostate cancer. In hormone refractory prostate cancer multiple painful metastases can be treated with radionuclides. Initially, Strontium-89 was successfully used for pain palliation with pain relief in more than half the patients. More recently, radionuclides with shorter physical half-lives such as Rhenium and Samarium were shown to result in similar pain reduction rates, possibly lower myelosuppression incidences, and at least earlier recovery of hematological parameters allowing repetitive dosing. The low number of randomized trials on radionuclides in prostate cancer does prohibit proper selection based on efficacy and toxicity. Hence application is often dependent on local availability of the different radionuclides.