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Tumori. 2018 Mar-Apr;104(2):128-136. doi: 10.1177/0300891618765571. Epub 2018 Apr 18.

223Ra-chloride therapy in men with hormone-refractory prostate cancer and skeletal metastases: Real-world experience.

Author information

1
1 Nuclear Medicine Unit, University Hospital of Pisa, Pisa, Italy.
2
2 Medical Oncology Unit, University Hospital of Pisa, Pisa, Italy.
3
3 Nuclear Medicine Unit, CRO IRCCS, Aviano (PN), Italy.
4
4 Radiotherapy Unit, CRO IRCCS, Aviano (PN), Italy.
5
5 Medical Oncology Unit, CRO IRCCS, Aviano (PN), Italy.
6
6 Nuclear Medicine Unit, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
7
7 Medical Oncology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
8
8 Radiotherapy Unit, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.

Abstract

BACKGROUND:

Radium-223 (223Ra) chloride, an alpha emitter, has been shown to improve overall survival (OS) and pain control, and to delay skeletal-related events, in patients with castration-resistant prostate cancer (CRPC) and bone metastases. Our retrospective observational study presents the first Italian experience on the efficacy and safety of 223Ra therapy in routine clinical practice.

METHODS:

A total of 83 patients with metastatic CRPC were treated with 223Ra at 3 Italian centers between August 2013 and August 2016. 223Ra-chloride (55 kBq/kg) was administered every 4 weeks for a total of 6 cycles. Primary endpoints were OS and progression-free survival (PFS). Secondary endpoints included toxicity, pain evaluation using numeric rating scale (NRS), symptomatic skeletal-related events and biomarkers response.

RESULTS:

Patients had a median age of 75 (range 53-89) years. The majority of men showed a Gleason score of 7, 8, or 9. Forty-one patients completed 6 treatment cycles; 33 stopped treatment before completing 6 cycles. Nine were still receiving therapy at the time of data collection. At the end of therapy, NRS pain scores significantly improved ( p < .000001). OS was a mean of 10.1 months, while median OS had not been attained. According to Kaplan-Meier estimation, OS and PFS were 17.5 and 7.7 months, respectively. There was a significant correlation between OS and PFS with the number of 223Ra cycles; patients receiving all 6 cycles experienced the major benefit from the therapy. 223Ra was well-tolerated.

CONCLUSIONS:

223Ra alpha therapy is an important therapeutic option for men with CRPC and symptomatic skeletal metastases.

KEYWORDS:

Brachytherapy; hormone-refractory prostate cancer; neoplasm metastasis; radium

PMID:
29714668
DOI:
10.1177/0300891618765571
[Indexed for MEDLINE]

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