An overview of current clinical experience with strontium‐89 (Metastron®)

Prostate cancer is one of the most common tumors in men. At presentation, 50% of patients have advanced disease and 25% have bone metastases. Hormonal palliation is the treatment of choice for metastatic bone pain, with a pain‐free response rate of 75% for a period of 16‐18 months. Second‐line treatment with chemotherapy has a moderate and short‐term effect. Once endocrine therapy and chemotherapy cease to be effective, radiotherapy is a good option for recurrent painful bone metastases. Diffuse painful metastases can be treated with half‐body irradiation with a response rate of up to 70%, but there is considerable toxicity. Strontium‐89 (Metastron®) is a calcium analog radionuclide that is selectively absorbed at bone locations with increased osteoblastic activity. It is a pure beta‐emitter with bone penetration of 0.8 cm, and it has been used in multiple trials with response rates of up to 80%. Results are reported with Metastron in 28 patients with diffuse painful bone metastases, in whom a response rate of 82% was seen. © 1994 Wiley‐Liss, Inc.