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
Abstract
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.