[Clinical application of samarium-cobalt extracting magnet for projectile splinter in soft tissue (author's transl)].
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UNLABELLED: Palliation of bone pain in patients with cancer metastatic to bone is being evaluated in several cancer centers by the administration of the bone-seeking phosphonate ethylenediaminetetramethylenephosphonic acid (EDTMP) chelated with the beta particle-emitting radionuclide 153Sm. METHODS: In this study, 153Sm-EDTMP was intravenously injected into 19 patients over a 1-min period. Patients received up to four injections of 18.5 MBq (0.5 mCi) or 37 MBq (1.0 mCi) per kilogram of body weight. Skeletal retention was calculated from urinary excretion. RESULTS: No uptake of 153Sm-EDTMP in nonskeletal tissues was observed in whole-body gamma camera images. The mean skeletal uptake for all patients was 54% +/- 16% of the injected dose (%ID). This resulted in the bone marrow receiving 89 cGy/GBq +/- 27 cGy/GBq (3.28 cGy/mCi +/- 0.99 cGy/mCi), with calculated marrow doses ranging from 27 cGy to 338 cGy. For each patient, the estimated radiation absorbed dose to the marrow was correlated to the percent decrease in platelet number, ranging from 7.4% to 78.9%. CONCLUSION: Since the deviation of uptake between the four injections for a given patient (7.6% ID) was less than the deviation for all patients (16% ID), the initial dose may be used to estimate the skeletal uptake for the remaining doses. These radiation dose estimates permit patients at risk to be identified prior to reaching myelotoxicity and develop dose-response models. Thirteen patients (68%) reported significant pain relief from this radionuclide therapy. Bone pain appears to be alleviated by 153Sm-EDTMP with limited red marrow doses and no toxic effects in other organs.
Thirty-five patients with painful bone metastases arising from a variety of tumor types underwent a clinical trial in which 153Sm-EDTMP was injected as a single intravenous dose. The injection ranged in amount from 330 MBq to 1110 MBq of 153Sm-EDTMP. Pain relief usually occurred within one week after administration. The duration of pain relief lasted from 2 to 17 weeks. A detectable degree of pain palliation was experienced by 80% of the treated patients; 54% reported substantial or complete pain relief. Due to the small number of patients, no clear-cut dose-related response was detectable. Moderate myelosuppression was observed in one patient (WHO grade III). The metastatic lesion-to-normal bone ratios remained constant (varying from 1.5 to 4.8) for at least 5 days post-injection. 153Sm cleared very rapidly from the blood. Less than 1% of the injected dose remained in circulation at 4 hours post-injection. No local accumulation of the tracer could be detected outside the skeleton. Urinary excretion was quite complete at 6 hours post-injection. The biodistributions of 153Sm-EDTMP and 99mTc-DPD are very similar in metastatic and normal bone; thus, bone scanning can be used for patient selection and followup. According to our results, it seems that higher doses of 153Sm-EDTMP can be given safely and without any irreversible myelosuppression.
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Hydroxyapatite (HA), a natural constituent of bone, was studied as a particulate carrier for beta-emitting radionuclides in radiation synovectomy. Particles were radiolabeled with 153Sm or 186Re and their in vivo safety was investigated following intra-articular injection into knees of normal rabbits and rabbits with antigen-induced arthritis (AIA). Radiolabeling efficiency was greater than 95%; in vitro studies showed minimal (< or = 1%) loss of activity from particles over a 6-day period with 153Sm-labeled HA and about 5% loss of activity over a 5-day period with 186Re-labeled HA. The total cumulative extra-articular leakage of 153Sm over 6 days was 0.28% in normal rabbits and 0.09% in AIA rabbits. Leakage of 186Re from the joint was 3.05% over a 4-day period with 80% of extra-articular activity found in the urine. Histopathological evaluation of treated knees showed that HA particles are distributed throughout the synovium, embedded in the synovial fat pad. The ease and efficiency with which this HA carrier is labeled, coupled with observed extremely low leakage rates from the joint, make radiolabeled HA particles an attractive candidate as a radiation synovectomy agent for evaluation in rheumatoid arthritis patients.
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A Knudsen effusion cell mass spectrometric technique was used to study vapor species over CeCl(3) and SmCl(3). Monomer, dimer, and trimer (Sm(3)Cl(9)) molecules, and LnCl(4-), Ln(2)Cl(7-), Ln(3)Cl(10-) (Ln = Ce, Sm) negative ions, were observed in saturated vapor in the temperature range 958-1227 K. Partial vapor pressures of neutral constituents were determined and the enthalpies of sublimation (Delta(s)H, 298 K, kJ.mol(-1)) to monomers and associated molecules obtained: 328 +/- 6 (CeCl(3)), 306 +/- 6 (SmCl(3)), 453 +/- 16 (Ce(2)Cl(6)), 408 +/- 12 (Sm(2)Cl(6)), and 468 +/- 40 (Sm(3)Cl(9)). Equilibrium constants for various chemical reactions were measured and the enthalpies of reactions obtained using the second and third laws of thermodynamics. The enthalpies of formation (Delta(f)H, 298 K, kJ.mol(-1)) of molecules and ions have been calculated as follows: -730 +/- 6 (CeCl(3)), -722 +/- 6 (SmCl(3)), -1663 +/- 16 (Ce(2)Cl(6)), -1649 +/- 13 (Sm(2)Cl(6)), -2617 +/- 40 (Sm(3)Cl(9)), -1250 +/- 15 (CeCl(4)(-)), -1252 +/- 15 (SmCl(4-)), -2184 +/- 35(Ce(2)Cl(7-)), -2172 +/- 26 (Sm(2)Cl(7-)), -3183 +/- 43 (Ce(3)Cl(10-)), and -3147 +/- 43 (Sm(3)Cl(10-)).
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A phase II study of 153Sm ethylenediaminetetramethylene phosphonate (153Sm-EDTMP) palliative treatment was conducted on 23 patients with painful disseminated skeletal metastases. The administered activity of 153Sm-EDTMP was determined by prospective dosimetry and the radiation absorbed dose to bone marrow was fixed at 2 Gy. Symptomatic relief of bone pain was experienced by 14 of 23 evaluable patients (61%) with a median duration of 8 weeks (range 0-40). Toxicity was limited to myelosuppression with median nadir counts of leucocytes 3.3 x 10(9)/1 (range 1.0-7.5) and platelets 133 x 10(9)/1 (range 24-176) occurring at 2 weeks and 4 weeks, respectively. Retreatment with 153Sm-EDTMP was studied in 15 patients, including in 4 of the 23 patients treated with a single dose. The retreatment median radiation absorbed dose to red marrow was 1.9 Gy given at a median of 9 weeks (range 6-38) after initial treatment. Good control of pain was obtained in 13 of these patients (87%). Both the median duration of pain control (24 weeks) and survival (9 months) in the retreated group were substantially greater than for patients treated with a single dose, where duration was 8 weeks and survival 4 months. Additional toxicity in the retreated patients was confined to anaemia which required blood transfusion in 9 of the 15 patients (60%).
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Reaction of equimolar quantities of Sm[N(SiMe(3))(2)](3) and Al(i-Bu)(3) with 6 equiv of iso-propyl alcohol in toluene leads to the formation of the mixed-metal alkoxide complex [[(i-Pr-O)(i-Bu)Al(mu-O-i-Pr)(2)Sm(O-i-Pr)(HO-i-Pr)](mu-O-i-Pr)](2) (1). An analogous reaction between 1:1 Sm[N(SiMe(3))(2)](3)/Al(i-Bu)(3) and 6 equiv of tert-butyl alcohol, followed by addition of THF, produces the THF adduct [(THF)(2)Sm(O-t-Bu)(2)(mu-O-t-Bu)(2)Al(i-Bu)(2)] (2). Compound 1 crystallizes in the space group P1 while 2 crystallizes in space group Cmcm. Cell parameters for 1: a = 11.028(2) A, b = 12.168(2) A, c = 12.879(2) A, alpha = 82.84(1) degrees, beta = 64.88(1) degrees, gamma = 70.80(1) degrees, Z = 1. Cell parameters for 2: a = 11.304(2) A, b = 22.429(4) A, c = 15.768(2) A, Z = 4. Attempts to prepare the bulkier derivatives result in the formation of lanthanide aryloxide species only; reaction between equimolar amounts of Ln[N(SiMe(3))(2)](3) (Ln = Sm, Nd) and Al(i-Bu)(3) with 6 equiv of HO-2,4,6-Me(3)C(6)H(2), followed by the addition of THF or pyridine, yields the Lewis base adducts Sm(OAr)(3)(THF)(3) (3) and [Nd(mu-OAr)(OAr)(2)(py)(2)](2) (4). Compound 3 crystallizes in the space group Pbca while 4 crystallizes in space group P2(1)/c. Cell parameters for 3: a = 16.5822(9) A, b = 15.5668(9) A, c = 29.902(2) A, Z = 8. Cell parameters for 4: a = 13.4496(8) A, b = 20.034(1) A, c = 16.206(1) A, beta = 113.782(1) degrees, Z = 2. Reaction of Al(2)(O-t-Bu)(6) with [Sm(OAr)(3)](2) (Ar = 2,6-i-Pr(2)C(6)H(3)) yields the adduct (ArO)(3)Sm[(mu-O-t-Bu)(2)Al(2)(O-t-Bu)(4)] (5), which crystallizes in the space group P2(1)/n. Cell parameters for 5: a = 14.0960(7) A, b = 27.3037(15) A, c = 16.7893(9) A, beta = 92.216(1) degrees, Z = 4.
The compound Sm[N(SiMe(3))(2)](3) has been investigated experimentally by X-ray crystallography and computationally by DFT methods. The structure is analogous to that of other tris[bis(trimethylsilyl)amido]lanthanides, featuring positional disorder of the metal atom above and below the plane defined by the three N donor atoms, resulting in a trigonal pyramidal configuration. One of the methyl groups of each amido ligand is placed above the apex of the pyramid at close distance to the metal center suggesting the presence of agostic interactions. The DFT calculations have been carried out on the real molecule and on a Si[N(SiH(3))(SiH(2)Me)](3) model where the unique Me group was placed above the apex of the pyramid to probe the agostic interaction. In both cases, the optimized geometry reproduces very well the experimental structure and indicates the presence of beta-Si-C agostic interactions. A comparison of the optimized geometries obtained in the presence/absence of the Sm d and the Si d orbitals serves to illustrate the relevance of these orbitals for (i). the establishment of the pyramidal configuration at Sm, (ii). the Sm-N bond length, and (iii). the Sm-(beta-Si-C) bond length. The bonding analysis, which was carried out by both Mulliken and NBO methods, not only confirms the importance of the metal d orbitals for the Sm-N and Sm-(beta-Si-C) chemical bonding but also illustrates the relevance of electrostatic terms in the agostic interaction. Sm-N and N-Si pi bonding is present according to the bonding analysis but is not important for enforcing the planar configuration at N, nor the pyramidal configuration at Sm.
Bis(diphosphanylamide) complexes of the lanthanides have been synthesized. Two approaches to obtain these compounds are shown. Reaction of YbCl3 with a slight excess of [K(THF)n][N(PPh2)2] gives [((Ph2P)2N)2 YbCl(THF)2], which can be further reacted with K(C5Me5) to give the corresponding pentamethylcyclopentadienyl complex [((Ph2P)2N)2Yb(C5Me5)]. In a second approach to bis(diphosphanylamide) complexes of the lanthanides, Na(C(5)H(5)) was treated with SmCl3 to generate [(C5H5)SmCl2(THF)3] in situ. Further reaction with 2 equiv of [K(THF)n][N(PPh2)2] gave the desired complex [((Ph2P)2N)2Sm(C5H5)(THF)].
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(C(5)Me(5))(2)Sm (2 equiv) reacts with Ph(2)EEPh(2) to give (C(5)Me(5))(2)SmEPh(2) (E: P, 1; As, 2), while (C(5)Me(5))(2)Sm(THF)(2) (2 equiv) reacts with Ph(2)EEPh(2) to give (C(5)Me(5))(2)Sm(EPh(2))(THF) (E: P, 3; As, 4). 3 and 4 are also available from the reactions of 1 and 2 with THF. 3 and 4 undergo further reaction to produce the THF ring-opened products (C(5)Me(5))(2)Sm[O(CH(2))(4)EPh(2)](THF) (E: P, 5; As, 6).(C(5)Me(5))(2)Sm (4 equiv) reacts with Ph(2)EEPh(2) to give the mixed-valent (C(5)Me(5))(2)Sm(&mgr;-EPh(2))Sm(C(5)Me(5))(2) (E: P, 7; As, 8). These compounds are also available from the reaction of 1 and 2 with (C(5)Me(5))(2)Sm. The X-ray crystal structure of 2, crystallized from hexanes (P2(1)/n; a = 26.188(24) Å, b = 9.911(10) Å, c = 23.280(23) Å, beta = 97.150(12) degrees, V = 5995(2) Å(3), D(calcd) = 1.488 Mg/m(3); Z = 8; T = 156 K), revealed, in addition to a conventional seven-coordinate bent metallocene geometry with 2.698 Å Sm-C(C(5)Me(5)) and 2.970 Å Sm-As average distances, two very different Sm-As-C(Ph) angles, 74.2 and 118.7 degrees. As a result, one phenyl group is closer to the metal (2.901 Å minimum Sm-C distance). 4, crystallized from toluene (P2(1)/n; a = 10.713(9) Å, b = 14.143(11) Å, c = 21.620(16) Å, beta = 101.08(6) degrees, V = 3215(4) Å(3), D(calcd) = 1.492 Mg/m(3); Z = 4; T = 163 K), and 6, crystallized from hexanes (P2(1)/n; a = 9.3958(16) Å, b = 22.245(3) Å, c = 17.931(3) Å, beta = 96.497(11) degrees, V = 3724(1) Å(3), D(calcd) = 1.416 Mg/m(3); Z = 4; T = 163 K), have conventional eight-coordinate, bent metallocene structures.