Bone tumors

Strontium-89 chloride is a calcium analogue that rapidly clears from the blood and is taken up into bone mineral, particularly in areas of active osteogenesis, as weU as primary bone tumors and metastases. It is used for reHef of bone pain in patients having painful skeleton bone metastases. It is suppHed in an injectable solution. 

Lloyd RD, Taylor GN, Jee WSS, et al. 1999. Relative radiosensitivity of bone tumor induction among beagles as a function of age at injection of 239Pu or 226RA. Health Phys 76(l) 75-81. 

Radical polymerization of maleic anhydride and fullerene was used to obtain a new material, the photodynamic properties of which have been studied in vitro and in vivo. HeLa and bone tumor cell growth were inhibited by treatment with fullerene and light, so the polymer was tested on mice affected by bone tumor. After injection and irradiation, tumor size and weight were reduced and the mouse survival time was extended (Jiang and Li, 2007). The photodynamic properties of a supramolecular cucurbit[8]uril-fullerene complex have been studied by the same authors (Jiang and Li, 2006) who attributed HeLa cell death mainly to the damage of membrane phosphohpids and proteins. 

Heymann D, Qry B, Gouin F, et al. Bisphosphon-ates new therapeutic agents for the treatment of bone tumors. Trends Mol Med 2004 10 337-43. 

Fifteen cases of bone tumors resulting from intravenous Thorotrast injection have been reported (9 of which were osteosarcoma). The mean latency period was 26 years and the latency period and injected amount of Thorotrast were inversely related (Flarrist et al. 1979). The mean dose rate to bone was 16 rads/year (0.16 Gy/year) per 25 mL of injected Thorotrast (Van Kaick et al. 1983). 

Muller WA, Nenot JC, Daburon ML, et al. 1975. Metabolic and dosimeter studies after inhalation of Th-227 in rats with regard to the risk of lung and bone tumors. Radiation Env Biophysics 11 309-318. 

Anastrozole (Arimidex) [Antineoplastic/Nonsteroidal Aromatase Inhibitor] Uses Breast CA postmenopausal w/ met breast CA, adjuvant Rx postmenopausal early hormone-rec tor(+) breast CA Action Selective nonsteroidal aromatase inhibitor, X circ estradiol Dose 1 mg/d Caution [D, ] Contra PRO Disp Tabs SE D, HTN, flushing, t bone/tumor pain, HA, somnolence Interactions None noted EMS May cause vag bleeding during 1st few wks of Tx OD May cause NA, abd discomfort, and bloody stools symptomatic and supportive... 

Ewing s sarcoma is the second most common malignant bone tumor in children. The majority of patients have microscopic metastases at diagnosis the lung is the most common metastatic site. This sarcoma is a relatively rare disease with limited therapeutic options. The majority of patients are initially responsive to chemotherapy with vincristine, doxorubicin (Adriamycin), and cyclophosphamide. However, relapsed disease is usually extremely difficult to treat because of its resistance to chemotherapy (Zhou et al., 2001). 

Bone tumors, primarily osteogenic sarcomas, have appeared in the first group of German patients injected with radium-224 (see Section 2.2.4) (Spiess et al. 1989). A total of 56 sarcomas have been found the expected number is 0.2 to 0.3 (Spiess et al. 1989). The lowest total dose associated with a bone tumor was 6.4 pCi/kg (237 kBq/kg) given over two months (Mays and Spiess 1984). 

Gossner W. 1986. Pathology of radiation-induced bone tumors. Leuk Res 10 897-904. 

Raabe OG, Parks NJ Book SA. 1981b. Dose-response relationships for bone tumors in beagles exposed to 226Ra and °Sr. Health Phys 40 863-880. 

Plicamycin [plick a MYE sin] (mithramycin) also exerts its cytotoxicity through restriction of DNA-directed RNA synthesis. Resistance is due to P-glycoprotein efflux. Plicamycin has a relative toxic specificity for osteoclasts preventing their resorption, and lowers plasma calcium concentration in hypercalcemic patients—especially those with bone tumors. Toxicities include hemorrhage as well as effects on the bone marrow, liver, and kidneys. 

Two carcinogenicity bioassays were conducted in rats (3-60x MRHD). Treatment resulted in a marked dose-related increase in the incidence of osteosarcoma, a rare mahgnant bone tumor, in both male and female rats. Osteosarcomas were observed at all doses and the incidence reached 40-50% in the high-dose groups. Teriparatide also caused a dose-related increase in osteoblastoma and osteoma in both sexes. Bone tumors in rats occurred in association with a large increase in bone mass and focal osteoblast hyperplasia Second 2-year study was carried out in order to determine the effect of treatment duration and animal age on the development of bone tumors. Female rats were treated for different periods between 2 and 26 months of age (at 3x to 20x MRHD based on body surface area). The... 

In male and female rats, teriparatide caused an increase in the incidence of osteosarcoma (a mahgnant bone tumor) that was dependent on dose and treatment duration. Effect was observed at systemic exposures to teriparatide ranging from 3 to 60 times the exposure in humans given a 20 meg dose. 

In an effort to improve the benefit-to-risk ratio of PTH in the context of the uncertain relevance of the findings in rodents, it was strongly recommended that participation in clinical studies be limited to adults with severe osteoporosis who have completed bone maturation. It was further advised that any case of osteosarcoma (or other bone tumor) be immediately reported and long-term follow-up be conducted for patients treated with PTH. Importantly, subjects in clinical trials of PTH and PTH analogues should be informed about the occurrence of osteosarcomas in rodents. 

Adverse reactions Hot flashes, mild nausea, anorexia, edema, headache, diarrhea Hot flashes, mild nausea, vaginal dryness, transient thrombocytopenia, bone/ tumor pain, thromboembolic events, hepatotoxicity, fluid retention Hot flashes, loss of libido, impotence, diarrhea, nausea, anorexia, gynecomastia, edema, rare hepatotoxicity Depression, hot flashes, nausea, weight gain, edema, gynecomastia... 

Delayed treatment with multiple doses of DTPA removes moderate amounts of plutonium from animals. Treatment of swine on five successive days two months after plutonium contamination removed 11—19% of the plutonium 9S). The body burden of rats was reduced to 60% of the controls by treatment with DTPA administered on day 6, 8 and 11 after the plutonium injection99). The largest decrease of plutonium was found in the soft tissues, but skeletal removal was more difficult, and the moderate amounts removed may not significantly reduce the number of bone tumors formed59 100 101). Further details on the use of DTPA in removing internally deposited plutonium may be gained from other reviews6 13 102 103). 

Genomic Applications of Other Markers of Interest in Soft Tissue and Bone Tumors... 

There are several other determinants that often figure into differential diagnosis in the sphere of soft tissue and bone tumor pathology. They include melanocyte-related markers such as melan-A (MART-1), tyrosinase, and neuroendocrine and... 

Park YK, Yang MH, Kim YW, et al. Osteocalcin expression in primary bone tumors In situ hybridization and immunohistochemical study. J Korean Med Sci. 1995 10 263-268. 

Serra M, Morini MC, Scotlandi K, et al. Evaluation of osteonectin as a diagnostic marker of osteogenic bone tumors. Hum Pathol. 1992 23 1326-1331. 

Bosse A, Vollmer E, Bocker W, et al. The impact of osteonectin for differential diagnosis of bone tumors An immunohistochemical approach. Pathol Res Pract. 1990 186 651-657. 

Ozdemirli M, Fanburg-Smith JG, Hartmann DP, et al. Precursor B-lymphoblastic lymphoma presenting as a solitary bone tumor and mimicking Ewing s sarcoma A report of four cases and review of the literature. Am J Surg Pathol. 1998 22 795-804. 

---