Subject(s)
Humans , Female , Middle Aged , Carcinoma, Papillary , Thyroid Neoplasms , 3-Iodobenzylguanidine , Carcinoma, Papillary/diagnosis , Carcinoma, Papillary/surgery , Sjogren's Syndrome/complications , Thyroid Neoplasms/complications , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/surgery , ThyroidectomyABSTRACT
Background: Samarium153 EDTMP, a beta and gamma emitter, is used in the palliative therapy of painful bone metastases. Aim: To evaluate the analgesic effects and myelotoxicity of Samarium153 EDTMP in patients with prostate, breast and renal carcinoma. Patients and methods: Twenty patients with bone metastases (11 males), aged 65 years old as a mean, received a 1 to 2 mCi/kg intravenous dose of Samarium153 EDTMP, produced in Chile. Patients were followed thereafter during 4 to 40 weeks. Pain was assessed using a visual analogue scale. Results: Pain decreased from a score of 6.4 prior to treatment, to 2.7 at the fourth week of therapy and the effect lasted a mean of 12.5 weeks. Myelotoxicity was observed in 68percent of cases (WHO stage I in 21 percent, stage II in 37 percent, stage III in 11percent and no patients in stage IV). Platelets were the most affected series and neutrophils the least affected. Cell counts returned to normal between the sixth and eighth week. Seventy nine percent of patients decreased their basal analgesic therapy at the sixth week and 88percent did so at the eighth week. Forty one percent of these patients discontinued all analgesics. Conclusions: Samarium153 EDTMP is effective in the treatment of pain in patients with bone metastases and its myelotoxicity is low to moderate. It should be considered as a therapy for this type of pain, with the precaution of performing periodical bood counts
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Samarium/pharmacokinetics , Bone Neoplasms/drug therapy , Neoplasm Metastasis/drug therapy , Radioisotopes/pharmacokinetics , Pain/drug therapy , AnalgesiaABSTRACT
Introducida hace ya dos décadas atrás, la tomografía de emisión de fotón único SPECT, ha tenido su mayor auge en éste último decenio, empleándose con éxito en la evaluación del flujo sanguíneo cerebral (FSC), ya sea en forma global como regional de sus diferentes territorios, permitiendo así una mejor comprensión, tanto de su fisiología como los cambios que allí ocurren en diferentes entidades clínicas. Esta técnica se desarrolló a partir de la experiencia adquirida en el uso de la tomografía de emisión de positrones (PET), que utiliza radiofármacos de vida media ultracorta como el oxígeno 15, carbono 11, clucosa marcada con flúor 18 entre otros, con los cuales es posible el estudio del metabolismo cerebral. Dado su alto costo y complejidad, el PET está disponible en pocos centros a nivel muldial. Estos hechos, junto con una mayor disponibilidad de gammacámaras SPECT, condujeron a producción de trazadores de flujo cerebral que se pueden marcar con emisores de fotones simples, en la base que el FSC y el metabolismo se modifican paralelamente. Mientras los métodos de diagnósticos por imágenes como la tomografía axial computada (TAC) y la resonancia nuclear magnética (RNM) nos entregan esencialmente información de carácter morfológico, el SPECT proporciona información principalmente funcional