Javaid Irfan Ullah, Aleem Khan, Shehzad Afzal, Saeed Akhtar, Syed Ijaz, Hussain Shah.
Evaluation of radioactive phosphorus for bone pain.
Professional Med J Jan ;8(4):479-86.

OBJECTIVES: Our main objective was to assess the efficacy of phosphorus 32 in palliating bony pain patients with prostate cancer having metastatic bone disease. DATA SOURCES: Data was collected from the patients selected for the study. DESIGN OF STUDY: Study was designed to evaluate the palliative response of phosphorus 32 in patients with carcinoma of prostate metastatic to bone at Punjab Institute of Nuclear Medicine Faisalabad in collaboration with Allied Hospital Faisalabad. MATERIAL & METHODS: The study comprises of six patients having mean age (635 years SD) Patients were selected according to following criteria. Bony pain due to skeletal metastasises in patients with prostate cancer, active bone lesions on the bone scan done 1-2 week before the administration of P-32 complete blood count (CEC) done a week before, therapy was considered only if Hemoglobin was:> 11 gm/dl, WEC count was > 4000/ml and platelets were > 130,000/ml and liver and renal functions were normal (evaluated on LFT`s and serum creatinine). 5mCi (185 MBq) slow IV injection of sodium phosphate (P-32) was administered. Patients were retained in the hospital for one hour then sent to home after recording the vital signs with suitable precautions. Each patient was advised to report at nuclear medicine clinic at 4,8 and 12 weeks after the therapy. Patients were assessed pre-treatment and on each follow up visits by subjective response, tender sites, mobility and type and frequency of analgesics. RESULTS: One out of six patients showed complete response to radiotracer therapy. Four out of six patients showed partial response and one patient showed stable disease. Two out of six patients developed leukopenia. Two patients also developed thrombocytopenia of moderate degree. One patient developed anemia. Two patients developed cord compression. These two patients showed extensive` metastatic deposits in the spine. CONCLUSION: In this study P-32 was found to be effective and safer therapy for pain palliation in patients with skeletal metastasis due to prostatic cancer.

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