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:: Volume 20, Issue 1 (1-2022) ::
Int J Radiat Res 2022, 20(1): 75-81 Back to browse issues page
Treatment outcome of radium-223 treatment for castration-resistant prostate cancer and bone metastases at a single university hospital
T. Takayama, T. Sugihara, T. Kameda, M. Yamazaki, M. Komatsubara, J. Kamei, A. Fujisaki, S. Ando, T. Fujimura
Department of Urology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan , ttakayam@jichi.ac.jp
Abstract:   (812 Views)
Background: We investigated therapeutic outcomes of Radium-223 (Ra-223) treatment in patients with metastatic castration-resistant prostate cancer (mCRPC) and bone metastases. Materials and Methods: Outcomes were retrospectively examined in 20 patients starting Ra-223 treatment at a single university hospital from January 2017 to January 2020. Results: Median patient age was 70 years. Median values included prostate specific antigen (PSA) 10.73 ng/ml, PSA doubling time (PSADT) 3.7 months, alkaline phosphatase (ALP) 315 IU/L, lactate dehydrogenase (LDH) 186 IU/L, neutrophil-to-lymphocyte ratio (NLR) 2.22, and Gleason score 9. Extent of disease (EOD) was 3 or more in 55%, and Eastern Cooperative Oncology Group performance status was 0 in 80%. 16 patients (80%) completed Ra-223 treatment. Ra-223 was administered in 11 (55%) with ≤ 3 lines of treatment and 9 (45%) with ≥ 4. Concomitant drug was enzalutamide and abiraterone in 6 and 7 patients, respectively. Bone modifier agents (BMA) were used in 11 patients. Symptomatic skeletal events (SSE) occurred in 5 patients and were associated with abiraterone combination. BMA during Ra-223 treatment did not affect SSE. Median overall survival from initiation of Ra-223 treatment was 32.7 months. Prognosis was significantly better with PSADT ≤ 3 months, EOD ≤ 2, no SSE, no opioid use, and completion of Ra-223 treatment. PSA, LDH, NLR, PSADT, and Ra-223 treatment line after mCRPC were associated with Ra-223 completion. Anemia of Grade 3 occurred in 1 patient. Conclusion: Ra-223 treatment is safe, with good prognosis if completed. Combination treatment with abiraterone during Ra-223 treatment may cause SSE.
Keywords: Radium-223, abiraterone, PSADT, SSE.
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Type of Study: Original Research | Subject: Radiobiology
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Takayama T, Sugihara T, Kameda T, Yamazaki M, Komatsubara M, Kamei J, et al . Treatment outcome of radium-223 treatment for castration-resistant prostate cancer and bone metastases at a single university hospital. Int J Radiat Res. 2022; 20 (1) :75-81
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Volume 20, Issue 1 (1-2022) Back to browse issues page
International Journal of Radiation Research
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