鐳-223治療轉移性攝護腺癌—單一機構經驗分享
陳柏諺、江品葭、康智雄、羅浩倫、江博暉
高雄長庚紀念醫院 泌尿科
Radium-223 in the treatment of metastatic prostate cancer: preliminary experience in Taiwan
Po Yen Chen, Ping Chia Chiang, Chih-hsiung Kang, Hao Lun Lo, Po Hui Chiang
Department of Urology, Department of Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Purpose: Radium-223 is an alpha-emitting radiopharmaceutical which significantly prolongs overall survival in patients with castration-resistant prostate cancer (CRPC) and symptomatic bone metastases. Our aim is to present the clinical and oncological outcomes of the Radium-223 for the patients with metastatic prostate cancer in Taiwan.
Materials and Methods: We retrospectively reviewed patients who were diagnosed of metastatic prostate cancer with bone pain since 2017 to 2019 March. We arranged Radium-223 for the patients and collected the parameters including age, gender, clinical stage, previous treatments, Gleason score, previous clinical status (HSPC or CRPC), PSA, ALK-P, LDH. The primary endpoints are bone pain, LDH, ALK-P, and PSA decrease.
Results: A total of 8 patients (2 HSPC patients and 6 CRPC patients) have received 4.1 times Radium-223 therapy in mean with median follow up 8.3 months. All the patients reported improved bone pain. 5 patients (62.5%) reported decrease ALK-P and 3 among them (37.5%) patients reported decrease ≥ 30% ALK-P. 2 out of 8 (25%) had reduction of LDH. Furthermore, there were 3 patients (37.5%) PSA drops 28.6%, 98.9%, 99.9% respectively. There were no significant adverse effect during follow up for the patients.
Conclusion: Radium-223 treatment for the patients with bone pain in metastatic prostate cancer is a novel therapy. We present the preliminary data with promising clinical outcomes in our current experience.