Faculty Collaboration Database

Adverse events in the long-term follow-up of patients treated with samarium Sm 153 lexidronam for osseous metastases. Int J Radiat Oncol Biol Phys 2011 Oct 01;81(2):506-10

Date

10/05/2010

Pubmed ID

20888141

DOI

10.1016/j.ijrobp.2010.05.066

Scopus ID

2-s2.0-80052805510 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

PURPOSE: To investigate adverse events after samarium Sm 153 lexidronam and the effect of pre- and post-samarium Sm 153 lexidronam external beam radiation therapy (EBRT) and/or chemotherapy on myelosuppression in patients who received samarium Sm 153 lexidronam for osseous metastases.

METHODS AND MATERIALS: We performed a single-institution retrospective review of 139 patients treated with samarium Sm 153 lexidronam between November 1997 and February 2008. New-onset adverse events after samarium Sm 153 lexidronam were reported. The effect of samarium Sm 153 lexidronam on platelet and peripheral white blood cell counts and the duration of myelosuppression after samarium Sm 153 lexidronam plus EBRT and/or chemotherapy were calculated. Differences in the prevalence of adverse events among patients with varying treatment histories were evaluated with the Pearson chi-square test.

RESULTS: Hematologic follow-up was available for 103 patients. Chemotherapy and/or EBRT had no effect on the magnitude or duration of myelosuppression. The most common nonhematologic adverse events were acute lower extremity edema (n = 27) and acute and transient neuropathy (n = 29). Patients treated with chemotherapy after samarium Sm 153 lexidronam had a higher prevalence of lower extremity edema (9 of 18 [50%]) than those who were not treated with chemotherapy after samarium Sm 153 lexidronam (18 of 85 [21.2%]) (p = 0.01, chi-square test). No adverse events were correlated with EBRT.

CONCLUSIONS: Our observation of new-onset, acute and transient edema and neuropathy after samarium Sm 153 lexidronam and of a relationship between edema and post-samarium Sm 153 lexidronam chemotherapy suggests the need for re-examination of patients in past series or for a prospective investigation with nonhematologic adverse events as a primary endpoint.

Author List

Paravati AJ, Russo AL, Aitken C

Author

Candice A. Johnstone MD, MPH Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Blood Platelets
Bone Marrow
Bone Marrow Diseases
Bone Neoplasms
Combined Modality Therapy
Edema
Female
Follow-Up Studies
Humans
Leg
Leukocytes
Male
Middle Aged
Organometallic Compounds
Organophosphorus Compounds
Peripheral Nervous System Diseases
Retrospective Studies