Radiopharmaceuticals for palliative treatment of bone cancer pain

Bone pain is a common symptom of bone cancer, and bone cancer pain is much more severe than pain caused by other reasons. It is difficult for patients to bear it, and conventional analgesics are difficult to work. At present, the treatments for bone cancer mainly include surgery, external irradiation therapy, radionuclide therapy, hormone therapy, chemotherapy, and traditional Chinese medicine treatment, etc. These treatments have a certain analgesic effect. For patients with multiple bone metastases, systemic therapies such as chemotherapy, bisphosphonates, hormone therapy, hemi-body or local bone external irradiation, and radioactive drugs can be used for palliative treatment of metastatic bone pain.

Radiopharmaceutical therapy refers to the intravenous injection of radioactive drugs into the patient's body. The drugs can specifically accumulate in reactive bone sites and release high doses of radiation to metastatic sites to achieve the purpose of treatment and pain relief. Currently, the radioactive drugs that have passed the review for palliative treatment of bone pain include 89Sr, 153Sm, 186Re, 188Re, 117Sn, 32P, etc., with 89Sr and 153Sm being the most widely used. The advantages of radioactive drugs are that they are easy to inject, can treat multiple lesions of metastatic diseases, can target bone lesions, are expected to improve cure rates, and can be combined with other therapies such as chemotherapy and external irradiation to enhance efficacy.

Radioactive drugs are effective in relieving pain in bone cancer, but they have adverse reactions such as hematological toxicity in the early stages. Patients show varying degrees of thrombocytopenia, with mild symptoms being more common. Some patients also experience nausea and vomiting, which can be appropriately relieved by antiemetic drugs.