Comparative analysis of 11 different radioisotopes for palliative treatment of bone metastases by computational methods - Abstract

PURPOSE: Throughout the years, the palliative treatment of bone metastases using bone seeking radiotracers has been part of the therapeutic resources used in oncology, but the choice of which bone seeking agent to use is not consensual across sites and limited data are available comparing the characteristics of each radioisotope.

Computational simulation is a simple and practical method to study and to compare a variety of radioisotopes for different medical applications, including the palliative treatment of bone metastases. This study aims to evaluate and compare 11 different radioisotopes currently in use or under research for the palliative treatment of bone metastases using computational methods.

METHODS: Computational models were used to estimate the percentage of deoxyribonucleic acid (DNA) damage (fast Monte Carlo damage algorithm), the probability of correct DNA repair (Monte Carlo excision repair algorithm), and the radiation-induced cellular effects (virtual cell radiobiology algorithm) post-irradiation with selected particles emitted by phosphorus-32 (32P), strontium-89 (89Sr), yttrium-90 (90Y ), tin-117 (117mSn), samarium-153 (153Sm), holmium-166 (166Ho), thulium-170 (170Tm), lutetium-177 (177Lu), rhenium-186 (186Re), rhenium-188 (188Re), and radium-223 (223Ra).

RESULTS: 223Ra alpha particles, 177Lu beta minus particles, and 170Tm beta minus particles induced the highest cell death of all investigated particles and radioisotopes. The cell survival fraction measured post-irradiation with beta minus particles emitted by 89Sr and 153Sm, two of the most frequently used radionuclides in the palliative treatment of bone metastases in clinical routine practice, was higher than 177Lu beta minus particles and 223Ra alpha particles.

CONCLUSIONS: 223Ra and 177Lu hold the highest potential for palliative treatment of bone metastases of all radioisotopes compared in this study. Data reported here may prompt future in vitro and in vivo experiments comparing different radionuclides for palliative treatment of bone metastases, raise the need for the careful rethinking of the current widespread clinical use of 89Sr and 153Sm, and perhaps strengthen the use of 223Ra and 177Lu in the palliative treatment of bone metastases.

Written by:
Guerra Liberal FD, Tavares AA, Tavares JM.   Are you the author?
Instituto de Engenharia Mecânica e Gestão Industrial, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias s/n, Porto 4200-465, Portugal.

Reference: Med Phys. 2014 Nov;41(11):114101.
doi: 10.1118/1.4897240


PubMed Abstract
PMID: 25370676