Pain Therapy with Radionuclides




The SAMARIUM THERAPY is an ambulatory treatment for bone metastases in malignant diseases.






Used media: 153-samarium (EDTMP)

What are the indications for the therapy?

Pain in osteoblastic bone metastases (e.g. Ca-prostate, breast CA)

What is the purpose of the therapy?

Improvement of the quality of life and the possible dose reduction of pain medication causing severe side effects 

How does the therapy work?

The treatment is an outpatient procedure and similar to a bone scintigraphy, i.e. the patient is injected a radioactive substance into a vein on the arm whereby  the dose depends on the body weight. The radioactive substance is absorbed by the bones, especially by the overactive bone metastases that are irradiated selectively. After about 2-3 hours a distribution scintigram is recorded, in which the enrichment of the bone metastases can be detected in the bone.

The onset of pain relief usually takes effect within a week and lasts for up to four months or longer. The treatment can be repeated. A significant reduction of pain is achieved in about 80% of all treated patients.

Are special preparations necessary?

No, it is not necessary to specially prepare for this procedure.  However, a prerequisite for the therapy is that the presence of multiple osteoblastic skeletal metastases is visible in the bone scan, and that blood test is negative in terms of platelets and leukocytes.

Does medication have to be discontinued prior to the exam?


Are there any side effects?

As a direct effect on the therapy, in the early stage of the treatment an increase in pain (flare phenomenon) is possible, this, however, can be considered as a favorable response to the therapy. The pain will subside spontaneously and respond well to pain medication.

Furthermore, a decrease in white blood cells and platelets is generally observed in the blood. The decrease reaches its maximum usually after five to six weeks and usually normalizes again to baseline values after eight weeks. Otherwise, the substance is generally well tolerated. Direct effects (such as dizziness, flushing, headache) and allergic reactions are extremely rare and for the most part very mild.

When is a treatment not recommended?

A strict contraindication merely applies to pregnant women or to persons who have a known intolerance to the drug.

In addition, the therapy should not be used concurrently with chemotherapy or external half-body irradiation.

How high is the radiation exposure?

Desired high radiation for bone metastases with only a small radiation exposure to healthy tissue.

Because of the short range of the predominant beta radiation (up to 3 mm), there is no great radiation exposure to members of the family.