高雄長庚單一中心及回顧文獻統合分析：去勢抗性前列腺癌併骨轉移病患以不同次序接受鐳223治療之六次療程完成率

江品葭¹、江博暉²、陳彥達¹、王弘仁¹、鄭元佐¹、康智雄¹、陳建旭¹、柳易揚¹、蘇祐立³、陳彥豪³、羅浩倫¹*

高雄長庚紀念醫院泌尿科¹、忠孝泌尿專科醫院²、高雄長庚紀念醫院腫瘤科³

KCGMH Experience and Meta-Analysis: 6-Cycle Complete Rate of Radium-223 Therapy in Mcrpc Patients with Different Treatment Sequences

Ping-Chia Chiang¹, Po-Hui Chiang², Yen-Ta Chen¹, Hung-Jen Wang¹, Yuan-Tso Cheng¹, Chih-Hsiung Kang¹, Chien-Hsu Chen¹, Yi-Yang Liu¹, Yu-Li Su³, Yen-Hao Chen³, Hao-Lun Luo¹*

Urology Department of Kaohsiung Chung Gung Memorial Hospital¹, Jhong Siao Urological Hospital², Oncology Department of Kaohsiung Chung Gung Memorial Hospital³

Purpose: We investigate the potentially higher 6-cycle complete rate of Radium-223 in chemo-naïve mCRPC patients and in those having Ra-223 as the first line treatment for CRPC with bone metastasis.

Materials and Methods: 61 male patients who had Radium-223 therapy during April, 2018 to December, 2021 were enrolled. 11 patients were excluded due to incomplete data and lost follow-up. Forest plots and Funnel plots were created by RevMan 5.4 using a fixed effects analysis model to compare results with previously published cohorts as meta-analysis.

Results: Our cohort showed significant higher treatment complete rate in chemo-naïve group (75% vs 30.8%, p=0.008) and in first-line group comparing to third-line group (83.3% vs 40% vs 38.5%, p=0.03). Meta-analysis results under fixed-effects model showed higher 6-cycle completion in chemo-naïve group (OR=6.57, 95% Cl: 1.95-23.42, I²=52%, p=0.13, three trials). Meta-analysis results also showed higher 6-cycle completion in first-line group comparing to third-line group (OR=1.94, 95% Cl: 1.00-3.77, I²=37%, p=0.2, three trials) and in second-line group comparing to third-line group (OR=1.45, 95% Cl: 0.99-2.12, I²=0%, p=0.95, three trials).

Conclusion: Earlier use of Radium-223 for mCRPC patients was associated with better treatment complete rate in real-world results from Taiwan and while combining data from other cohorts.