• Anneyuko I Saito, Tatsuya Inoue, Makiko Kinoshita, Takahiro Kosaka, and Taira Mitsuhashi.
• Department of Radiation Oncology, Faculty of Medicine, Juntendo University, Tokyo, Japan. anyusaike@yahoo.co.jp.
• Ir J Med Sci. 2023 Apr 1; 192 (2): 569574569-574.

BackgroundRe-irradiation of a previously irradiated site must be done with careful consideration to minimize dose to organs at risk.AimsTo evaluate pain response and safety of Sr-89 administration for painful bone metastases after prior irradiation.MethodsWe retrospectively reviewed patients with Sr-89 injection for painful bone metastasis in a previously irradiated site. All patients were seen in follow-up at 1, 2, 3, and 4 months after injection and every 6 months thereafter. Pain control, toxicity, and pain progression-free survival were analyzed. Correlation of pain relapse with the following characteristics was analyzed: gender, age, primary tumor, tumor pathology, baseline performance status, and baseline verbal rating scale.ResultsAmong 25 patients analyzed (10 male, 15 female), median age was 68 (range, 50-81) years. Primary tumor sites included lung (n = 11), breast (n = 3), uterine cervix (n = 3), prostate (n = 3), and others (n = 5). Median follow-up was 25 (range, 1-76) months. Pain relief was observed in 24 patients (96.0%). One- and 2-year pain progression-free survival rates in these patients were 54.5% and 48.4%, respectively. Median time to pain progression was 5 (range, 2-16) months. Statistically significantly lower pain progression-free survival was observed in patients with osteolytic bone metastases (p < 0.01). No grade 3 or worse adverse events were observed.ConclusionSr-89 injection showed pain relief in most of our patients with painful bone metastases in a previously irradiated site and caused no grade 3 or worse adverse events. Sr-89 is an option for patients with a painful bone metastasis in a previously irradiated site.© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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