Radium-223 treatment in castration resistant bone metastatic prostate cancer. Should be the primary tumor always treated?

Maria Rosaria Valerio, Vittorio Gebbia, Vincenzo Serretta, Nicolò Borsellino, Vittorio Gebbia, Chiara Sanfilippo, Francesco Verderame, Vincenzo Serretta, Chiara Carola Sanfilippo, Chiara Maria Licari, Cristina Scalici Gesolfo

Risultato della ricerca: Article

Abstract

Introduction: Radium-223 (223Ra) improves symptoms and survival in patients with bone metastatic castration-resistant prostate cancer (mCRPC). Study aim: To evaluate the impact of a previous radical prostatectomy (RP) on the outcome of 223Ra therapy in mCRPC patients. The primary prostate tumor left untreated could progress during 223Ra treatment. Materials and methods: mCRPC symptomatic patients treated with 223Ra were enrolled. Luteinizing Hormone-Releasing Hormone analogue was maintained. No other anticancer therapy was given. 223Ra was administered i.v. at the dose of 55 kBq/kg every 4 weeks for 6 cycles. Patients were stratified according to previous RP or not. Hematological toxicity was monitored. Statistical analysis of 223Ra discontinuations, progressions, and deaths were performed. Results: Forty-four patients were enrolled, 16 (36.4%) previously received RP, 5 (11.3%) prostate radiotherapy and 23 (52.3%) maintained the primary prostate tumor after local treatment. All patients presented only bone metastases, 24 patients (54.5%) had more than 20. Twenty-six (59.1%) patients were treated after first or second line systemic chemotherapy. Treatment interruptions occurred in 14 patients (50%) with prostate and in 4 (25%) without (P = 0.04). After a median follow-up of 18 months (6−30 months), 15 (53.6%), and 7 (43.7%) progressions (P = 0.34) and 13 and 1 (6.2%) deaths (P = 0.04) occurred in patients with and without prostate respectively. Conclusion: The presence of the primary prostate tumor seems to play a detrimental role in mCRPC patients undergoing 223Ra treatment in absence of other concomitant anticancer therapy. On the other hand a previous RP might play a protective role. 2019 Elsevier Inc. All rights reserved.
Lingua originaleEnglish
pagine (da-a)964-969
Numero di pagine6
RivistaUrologic Oncology
Volume37
Stato di pubblicazionePublished - 2019

All Science Journal Classification (ASJC) codes

  • Oncology
  • Urology

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    Valerio, M. R., Gebbia, V., Serretta, V., Borsellino, N., Gebbia, V., Sanfilippo, C., Verderame, F., Serretta, V., Sanfilippo, C. C., Licari, C. M., & Scalici Gesolfo, C. (2019). Radium-223 treatment in castration resistant bone metastatic prostate cancer. Should be the primary tumor always treated? Urologic Oncology, 37, 964-969.