{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T01:25:42Z","timestamp":1784769942119,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2009,3,31]],"date-time":"2009-03-31T00:00:00Z","timestamp":1238457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2009,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Samarium\u2010153 ethylenediaminetetramethylene phosphonic acid (<jats:sup>153<\/jats:sup>Sm\u2010EDTMP) has been used to treat patients with high\u2010risk osteosarcoma. The purpose of the current study was to determine the maximally tolerated dose of <jats:sup>153<\/jats:sup>Sm\u2010EDTMP that permits hematopoietic recovery within 6 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Patients with recurrent or refractory osteosarcoma with bone metastases were enrolled in this study. Subjects were treated with increasing doses of <jats:sup>153<\/jats:sup>Sm\u2010EDTMP, beginning with 1.0 millicuries (mCi)\/kg and followed initially with 40% increment dose level escalations, using a continual reassessment method for dose escalation and de\u2010escalation with a target dose\u2013limiting toxicity (DLT) rate of 30%. Complete blood counts were monitored weekly, and the primary DLT was defined as failure to achieve an absolute neutrophil count &gt;750\/mm<jats:sup>3<\/jats:sup> and a platelet count &gt;75,000\/mm<jats:sup>3<\/jats:sup> within 6 weeks of treatment. In addition to assessing toxicity, dosimetry measurements were made to estimate the radiation dose delivered to target lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>The maximally tolerated dose of <jats:sup>153<\/jats:sup>Sm\u2010EDTMP was 44.8 megabecquerel (MBq)\/kg (1.21 mCi\/kg). DLTs were confined to hematologic toxicities, particularly delayed platelet recovery in 2 patients treated at a dose of 51.8 MBq\/kg (1.4 mCi\/kg). Grade 2 and 3 pulmonary toxicity (graded according to the National Cancer Institute Common Toxicity Criteria [version 3.0]) as reported in 2 patients (at administered activities of 44.8 MBq\/kg and 51.8 MBq\/kg) was attributable to progressive pulmonary disease. No other significant nonhematologic toxicities were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Patients with osteosarcoma who have previously been heavily treated with chemotherapy can be safely administered <jats:sup>153<\/jats:sup>Sm\u2010EDTMP with rapid hematologic recovery. The data from the current study support the development of a future trial to assess the efficacy of combining targeted radiotherapy with cytotoxic chemotherapy as a treatment option for patients with high\u2010risk osteosarcoma. Cancer 2009. \u00a9 2009 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.24286","type":"journal-article","created":{"date-parts":[[2009,3,31]],"date-time":"2009-03-31T16:32:35Z","timestamp":1238517155000},"page":"2514-2522","source":"Crossref","is-referenced-by-count":49,"title":["Dose\u2010finding study of <sup>153<\/sup>Sm\u2010EDTMP in patients with poor\u2010prognosis osteosarcoma"],"prefix":"10.1002","volume":"115","author":[{"given":"David M.","family":"Loeb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Garrett\u2010Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Hobbs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Prideaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Sgouros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ori","family":"Shokek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Moody D.","family":"Wharam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy","family":"Scott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy L.","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,5,20]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198606193142502"},{"key":"e_1_2_6_3_2","first-page":"813","article-title":"Massive preoperative irradiation in the treatment of osteogenic sarcoma in children; a preliminary report","volume":"72","author":"Francis KC","year":"1954","journal-title":"Am J Roentgenol Radium Ther Nucl Med."},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197208)30:2<393::AID-CNCR2820300215>3.0.CO;2-2"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800510405"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.4065\/78.2.147"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1586\/14737140.7.11.1517"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.20.1.189"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-05-0628"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780141102"},{"key":"e_1_2_6_11_2","first-page":"1023","article-title":"OLINDA\/EXM: the second\u2010generation personal computer software for internal dose assessment in nuclear medicine","volume":"46","author":"Stabin MG","year":"2005","journal-title":"J Nucl Med."},{"key":"e_1_2_6_12_2","first-page":"37S","article-title":"MIRD pamphlet no. 16: techniques for quantitative radiopharmaceutical biodistribution data acquisition and analysis for use in human radiation dose estimates","volume":"40","author":"Siegel JA","year":"1999","journal-title":"J Nucl Med."},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.2307\/2531628"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1191\/1740774506cn134oa"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.24286","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.24286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T11:12:03Z","timestamp":1760267523000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.24286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,5,20]]},"references-count":13,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2009,6]]}},"alternative-id":["10.1002\/cncr.24286"],"URL":"https:\/\/doi.org\/10.1002\/cncr.24286","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,5,20]]}}}