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CASE REPORT
Year : 2013  |  Volume : 2  |  Issue : 4  |  Page : 239-242

Samarium-153-ethylene diamine tetramethylene phosphonate (EDTMP) therapy in the management of refractory bone pain in a patient with carcinoma prostate and diffuse bone metastasis


1 Department of Nuclear Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
2 Department of Radiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
3 Department of Urology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

Correspondence Address:
T Kalawat
Additional Professor and Head, Department of Nuclear Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati
India
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Source of Support: None, Conflict of Interest: None


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Samarium-153-ethylene diamine tetramethylene phosphonate (samarium-153 EDTMP) is a novel systemic radiopharmaceutical, used for treatment of bone pain due to metastatic disease. We report a patient with carcinoma prostate, diffuse metastatic bone disease with severe back pain that was refractory to analgesics and morphine. He was also found to be anaemic (haemoglobin 8.1 g/dL). Inspite of anaemia and diffuse metastatic bone disease being relative contraindications for the use samarium-153-EDTMP, because of its potential for causing radiation induced myelotoxicity, the patient was treated with this modality and showed a remarkable response in pain control within a few days. He developed mild radiation induced myelotoxicity, which was subsequently managed with blood transfusion and supportive care. The present case highlights the utility of samarium-153 EDTMP therapy in patients with intractable pain due to diffuse metastatic bone disease.


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