Improvement of quality of life in patients with bone pain in advanced cancer: reinforcing the role of radionuclide therapy for bone pain palliation

Context: Patients with multiple bone pains due to metastatic cancer in bones presenting in the clinic are very challenging for all oncologists. Along with conventional medical and interventional techniques, the option of radioisotopes for bone pain palliation especially in the multiple bone pain setting is not very popular. Aims: We describe our initial clinical experience with Sm-153 EDTMP in a tertiary care centre set in a hilly state and briefly review the potential of radioisotope methods for bone pain palliation in such a setting. Settings and Design: Initial patients treated with Sm-153 EDTMP (1mg/kg) over first 6 months of the current year were included in the study. Methods and Material: Clinical assessment, haematological assessment and assessment of quality of life with a mini questionnaire was done at baseline and at 6-12 weeks after Sm-153 EDTMP. Statistical analysis used: Data from questionnaires was entered in excel for import to SPSS. Means were compared using paired t test while proportions were compared using chi square test for proportions. Results: Of the 26 patients included in the study 19(73%) showed subjective improvement in pain. Statistically significant improvement in quality of life was observed within 6-12 weeks. Quality of life improved in all the patients who experienced pain relief. None of the patients developed severe haematological toxicity. Conclusions: In the availability of a Nuclear Medicine department, Sm-153EDTMP can be used in a well selected group of patients for utilization for bone pain relief even in the setting of peripheral, smaller cities located away from metropolitan cities. Advantages include long duration of effect, ease of administration, low toxicity and repeatability of doses. It can have a positive impact in quality of life of patients with advanced cancer.