title: Dosing, administration, and safety of radium-223: How I do it.
abstract: Radium-223 dichloride is a first-in-class bone-directed radiopharmaceutical that has been shown to prolong survival in men with metastatic castrate resistant prostate cancer (mCRPC). Unlike other radiopharmaceuticals, radium-223 uniquely uses alpha-emission to deliver high intensity, short range cytoxic treatments resulting in minimal myelosuppression. Following the results of the ALSYMPCA trial, radium-223 (Xofigo) was FDA approved in the United States in May 2013 and approved by Health Canada in December 2013 for the treatment of mCRPC with symptomatic bone metastases and no visceral disease. This 'How I do it' article describes the background of radium 223 as well as the methods and techniques that our institution uses for safe and effective administration and notes the subtle differences when administering the drug in Canada.
authors.affiliation: Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Tu D
authors.initials: TD
authors.lastname: Dan
authors.forename: Laura
authors.initials: L
authors.lastname: Doyle
authors.forename: Amar J
authors.initials: AJ
authors.lastname: Raval
authors.forename: Andrew
authors.initials: A
authors.lastname: Pridjian
authors.forename: Leonard G
authors.initials: LG
authors.lastname: Gomella
authors.forename: Robert B
authors.initials: RB
authors.lastname: Den
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D002170:Canada; D006801:Humans; D007880:Legislation, Drug; D008297:Male; D010353:Patient Education as Topic; D018579:Patient Selection; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology; D011868:Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects; D011883:Radium / Q000008:administration & dosage* / Q000009:adverse effects; D012449:Safety; D014481:United States
chemical_list: D000970:Antineoplastic Agents; D011868:Radioisotopes; C581106:radium Ra 223 dichloride; D011883:Radium