Survival benefit of early radium-223 dichloride therapy in castration-resistant prostate cancer patients with osteoblastic bone metastases
Year: 2025
Type: article
Study design: Observational Study
Abstract: The aim of the retrospective cohort study was to evaluate the overall survival of patients with castration-resistant prostate cancer and osteoblastic bone metastases without visceral metastases treated with 223Radium dichloride (223Ra).The cohort included 55 patients aged 48 to 86, with a median age of 71.Overall survival from the first administered cycle (from 7/2015 to 7/2019) was evaluated in 10/2024.The median overall survival was, despite a smaller cohort, 16.27 months (CI: 11.87-20.98months), comparable to other large real-world studies.Asymptomatic or mildly symptomatic patients with good performance status (ECOG 0-1) at the start of therapy had a significantly higher median survival than more symptomatic patients with ECOG 2 and 3 (22.42 vs. 8.06 and 3.28 months).The number of completed cycles of 223Ra was inversely proportional to the patients' performance status (ECOG) -Kendall's Tau-c = -0.625;p < 0.0001.Previous treatment with chemotherapy (41.2 % of patients) was associated with significantly worse survival on multivariable analysis.A decrease of serum PSA by more than 50% (12.7% of patients) was significantly associated with longer survival (31 months; p = 0.0043).Severe (Grade 3) anemia, leukopenia, and thrombocytopenia occurred in only 9.1%, 3.6%, and 3.6% of patients.Earlier indication of 223Ra dichloride therapy in asymptomatic or mildly symptomatic patients with good performance status (ECOG 0-1) and without prior chemotherapy improved survival in our cohort.The decrease in serum PSA during treatment was a good prognostic factor associated with longer survival.Key words: radium-223 dichloride; metastatic castration-resistant prostate cancer; osteoblastic bone metastases Bone metastases affect approximately 90% of patients with metastatic prostate cancer [1] and significantly impact both the quality of life and overall survival [2].In Slovakia, since 2015, patients with castration-resistant prostate cancer (CRPC) exhibiting osteoblastic bone metastases confirmed via bone scintigraphy, and without visceral metastases, are eligible for radionuclide therapy using radioactive radium-223 ( 223 Ra dichloride).Radium-223 is the first clinically approved
Source: Neoplasma
Authors: Eva Takacsova, Marek Bartovic, Jan Ivancik, Iveta Waczulikova
Institutions: Comenius University Bratislava, Slovak Medical University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410503523