2017
DOI: 10.1159/000485102
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The Clinical Efficacy of Radium-223 for Bone Metastasis in Patients with Castration-Resistant Prostate Cancer: An Italian Clinical Experience

Abstract: Background/Aim: Prostate cancer frequently causes bone metastases and skeletal events that impair quality of life (QoL) and survival. The alpha emitter radium-223 is a new drug that improves treatment in men with castration-resistant prostate cancer (CRPC) and bone metastases. Our aim was to evaluate the effectiveness of radium-223. Subjects and Methods: In this retrospective study we enrolled 48 subjects. Pain reduction, alkaline phosphatase (ALP), time to first symptomatic skeletal event, and QoL were the va… Show more

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Cited by 18 publications
(17 citation statements)
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“…As reported in the literature and in our experience, therapy with radium-223 leads to improvement in bone pain 10,27,34 , which favoured dose reduction or discontinuation of pain medication in 12 of our 63 pts; in 38 pts, additional pain medication or dose increase was not needed, while adequate pain control was not achieved in only 8 pts and intensification of pain therapy was required. In the ALYSMPCA trial, 2% of pts in the radium-223 group and 1% of pts in the placebo group had no pain or analgesic use at baseline, and radium-223 treatment favoured less use of opioids compared to placebo 10 .…”
Section: Discussionsupporting
confidence: 66%
“…As reported in the literature and in our experience, therapy with radium-223 leads to improvement in bone pain 10,27,34 , which favoured dose reduction or discontinuation of pain medication in 12 of our 63 pts; in 38 pts, additional pain medication or dose increase was not needed, while adequate pain control was not achieved in only 8 pts and intensification of pain therapy was required. In the ALYSMPCA trial, 2% of pts in the radium-223 group and 1% of pts in the placebo group had no pain or analgesic use at baseline, and radium-223 treatment favoured less use of opioids compared to placebo 10 .…”
Section: Discussionsupporting
confidence: 66%
“…Diagnosis with neuroimaging in the form of MRI with gadolinium is preferred over the traditional method of cerebrospinal fluid (CSF) cytology due to its inferior morbidity for the patient and superior sensitivity (76–87%) [ 5 ]. In castration-resistant prostate cancer with metastatic skeletal disease, radium alpha 223 (a selective calcimimetic bone-seeking radionuclide for bone metastases) has shown a significant benefit with regards to pain reduction and improved quality of life and may be considered as a therapeutic option in patients who continue to progress after docetaxel and prednisone treatment [ 6 ]. Treatment for leptomeningeal disease is palliative with aims to improve quality of life and maintain neurological function, although external beam radiation, systemic, and intra-CSF chemotherapy (via surgical placement of an intraventricular catheter system) are possible [ 3 ].…”
Section: Discussionmentioning
confidence: 99%
“…Recent literature suggests that the incidence of brain and leptomeningeal involvement has increased since the use of docetaxel. Caffo et al proposed that this is due to the inability of docetaxel to penetrate the blood-brain barrier, hence limiting its cerebral concentrations and thus rendering it less effective at eradicating tumour cells from the central nervous system (CNS) [ 6 ]. In the future, such cases may continue to rise secondary to the use of effective modern systemic treatments and prolonged patient survival or improvements in diagnostic techniques [ 3 , 7 - 8 ].…”
Section: Discussionmentioning
confidence: 99%
“…Since its FDA approval and clinical introduction, lots of studies have been carried out concerning the clinical outcomes of 223-Radium dichloride (223-Ra) treatment in patients with metastatic castration-resistant prostate cancer (mCRPC) [6][7][8][9][10][11][12] . Despite this, to our knowledge, at present, it has never been reported the significance and pre-therapeutic prognostic value of previous primary radical treatment in patients treated with 223-Ra therapy.…”
Section: Introductionmentioning
confidence: 99%