In:
Radiation, MDPI AG, Vol. 2, No. 3 ( 2022-09-01), p. 273-284
Abstract:
The optimal sequence and combination of radium-223 therapy (Ra-223) for castration-resistant prostate cancer with bone metastasis (mCRPC) remain unclear. This study aimed to explore the prognostic factors after Ra-223 administration and to determine the optimal treatment strategy. We enrolled 64 patients with mCRPC who underwent Ra-223 therapy from June 2016 to July 2022 at a single institution in Japan. Overall survival (OS) and pain progression-free survival (p-PFS), which was proposed as a measure of quality of life (QOL), were analyzed using Cox proportional hazards models and log-rank tests, and between-factor analysis was performed with the Mann–Whitney U (MWU) test. Univariable and multivariable analyses revealed prognostic factors; specifically, early treatment (≤third line), completion of six treatment cycles, low bone scan index (BSI) ( 〈 0.61), alkaline phosphatase (ALP) ( 〈 140 U/L), prostate-specific antigen (PSA; 〈 22.9 ng/mL), lactate dehydrogenase (LDH; 〈 240 U/L), high hemoglobin (Hb) (≥11.4 g/dL), and prior denosumab use significantly prolonged OS. Low BSI, low ALP, and early Ra-223 treatment also prolonged p-PFS in the log-rank tests. The MWU test showed that high BSI (≥0.61) was associated with high PSA and high ALP and a tendency for Hb to decrease. Late Ra-223 treatment (≥fourth line) was significantly associated with low Hb and high PSA. Early Ra-223 treatment was significantly associated with improved OS, and administering Ra-223 before novel hormonal or anticancer agents may be meaningful.
Type of Medium:
Online Resource
ISSN:
2673-592X
DOI:
10.3390/radiation2030021
Language:
English
Publisher:
MDPI AG
Publication Date:
2022
detail.hit.zdb_id:
3057630-1
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