Radium-223 dichloride in clinical practice: a review.
The onset of skeletal metastases is typical of advanced-stage prostate cancer and requires a multidisciplinary approach to alleviate bone pain and try to delay disease progression. The current therapeutic armamentarium includes conventional analgesics, chemotherapeutic agents, immunotherapy, androgen-deprivation therapy, osteoclast inhibitors (bisphosphonates, denosumab), surgical interventions, external-beam radiotherapy and radionuclide metabolic therapy. Many studies in recent decades have demonstrated the efficacy of various radiopharmaceuticals, including strontium-89 and samarium-153, for palliation of pain from diffuse skeletal metastases, but no significant benefit in terms of disease progression and overall survival has been shown. The therapeutic landscape of metastatic skeletal cancer significantly changed after the introduction of radium-223, the first bone-homing radiopharmaceutical with disease-modifying properties. In this paper we extensively review the literature on the use of radium-223 dichloride in metastatic castration-resistant prostate cancer.
Nuclear Medicine Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy.
Luigia
L
Florimonte
Nuclear Medicine Department, A.S.S.T Ovest Milanese, Ospedale di Legnano, Via Papa Giovanni Paolo II, Legnano, Italy.
Luca
L
Dellavedova
Nuclear Medicine and Multi-Hospital Oncology Department, A.S.S.T Ovest Milanese Ospedale di Legnano, Via Papa Giovanni Paolo II, Legnano, Italy. lsmaffioli@yahoo.com.
Lorenzo Stefano
LS
Maffioli
D001859:Bone Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D015897:Comorbidity; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D064129:Prostatic Neoplasms, Castration-Resistant / Q000401:mortality* / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000401:mortality*; D011868:Radioisotopes / Q000627:therapeutic use; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D011883:Radium / Q000627:therapeutic use*; D015996:Survival Rate; D016896:Treatment Outcome
D011868:Radioisotopes; D019275:Radiopharmaceuticals; C581106:radium Ra 223 dichloride; D011883:Radium
Bone metastasis; Overall survival; Radium-223 dichloride; α-Emitters