Rhenium-188 HEDP to treat painful bone metastases

Clin Nucl Med. 2001 Nov;26(11):919-22. doi: 10.1097/00003072-200111000-00006.


Purpose: Rhenium-188 hydroxyethylidine diphosphonate (HEDP) is a new and attractive radiopharmaceutical that localizes in skeletal metastases and emits beta particles that may be therapeutically beneficial. In this study, the therapeutic efficacy of Re-188 HEDP was investigated in an uncontrolled initial trial of 61 patients with different types of advanced cancer for the palliation of painful bone metastases.

Materials and methods: Sixty-one patients with painful bone metastases of lung, prostate, breast, renal, rhinopharyngeal, and bladder cancers were treated with 1.1 GBq (31 mCi) to 6.9 GBq (188 mCi) Re-188 HEDP. After treatment, the patients were followed at weekly intervals for the first 2 months and monthly thereafter for as long as 1 year. Hematologic function tests were also performed before and after treatment for 6 weeks. Pain responses were scored according to a three-point pain-rating scale as complete, significant, and minimal.

Results: Prompt and significant relief of bone pain occurred in 80% of patients overall. Of the specific tumor types, pain relief was achieved in 77% of patients with lung cancer, in 80% with prostate cancer, in 83% with breast cancer, in 100% with bladder cancer, in 50% with renal cancer, in 50% with rhinopharyngeal cancer, and in 87% of patients with other tumor types, with no severe side effects or hematopoietic toxicity.

Conclusion: This large clinical trial verified that Re-188 HEDP is a useful radiopharmaceutical agent to treat painful bone metastases from various tumor types.

MeSH terms

  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / radiotherapy*
  • Bone Neoplasms / secondary*
  • Etidronic Acid
  • Female
  • Follow-Up Studies
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Organometallic Compounds
  • Pain / etiology
  • Pain Management
  • Palliative Care
  • Platelet Count
  • Radionuclide Imaging
  • Radiopharmaceuticals / therapeutic use*
  • Rhenium


  • Organometallic Compounds
  • Radiopharmaceuticals
  • rhenium-186 HEDP
  • Rhenium
  • Etidronic Acid