Clinical utility of strontium-89 chloride for the palliation of bone pain in metastatic prostate carcinoma

ABSTRACT

Metastatic bone disease is a major sequela of several malignancies, such as the prostate, breast, lung, kidney and thyroid. Bone pain is a common symptom in advancing malignancy and often determines the quality of life in the later stages of disease. Management of bone pain from metastasis remains palliative at present. With the improved cancer survival resulting from advances in cancer management, the population of patients seeking relief of bone pain has increased. Radiopharmaceutical therapy offers potential pain relief with minimal adverse effects. This is a case report on the clinical utility of strontium-89 chloride for the palliation of bone pain in metastatic prostate cancer. A 67-year-old male presented with bone pain due to disseminated bone metastases form prostate cancer, most intense in the lower back (Visual Analogue Scale pain score of 8). Strontium-89 chloride was administered intravenously at a dose of 148 MBq (4mCi). There was a transient, moderate, tolerable pain flare (Visual Analogue Scale pain score of 4) within the first week of treatment, which was relieved by oral opioid analgesics. He was pain-free thereafter (Visual Analogue Scale pain score of 0). Reversible bone marrow suppression was also observed a few weeks after the treatment.