Effects of six-cycle completion and earlier use of radium-223 therapy on prognosis for metastatic castration-resistant prostate cancer: A real-world multicenter retrospective study

Objectives: To evaluate the effect of 6-cycle completion and earlier use of radium-233 dichloride (Ra223) on the prognosis of patients with metastatic castration-resistant prostate cancer (mCRPC).Methods: We retrospectively evaluated 75 patients with bone metastases-predominant mCRPC who were treated with Ra223 between August 2016 and August 2021. The primary purpose of the study was to assess the effect of Ra223 completion (6 cycles) on patient prognosis, and the secondary purpose was to investigate factors associated with Ra223 incompletion (fewer than 6 cycles) and overall survival.Results: The median age of the patients was 72 years. The median number of Ra223 administrations was 6 (interquartile range, 5-6), and the median Ra223 completion rate was 75%. The median time from mCRPC diagnosis to Ra223 administration was 17 months, and the median number of prior treatments was 2. Multivariable analysis indicated that unfavorable performance status (>0), prostate-specific antigen (PSA) level >10 ng/ml, extension of bone metastasis score 3 to 4, and Ra223 incompletion were significantly associated with poor overall survival. In addition, EOD 3 to 4 and 3 or more prior CRPC treatments were significantly associated with Ra223 incompletion.Conclusion: Six-cycle completion and earlier administration of Ra233 are potentially associated with favorable survival. Unfavorable factors (EOD 3-4 and >= 3 prior treatments) were significantly associated with Ra223 incompletion. (C) 2021 Elsevier Inc. All rights reserved.

目的：评估完成6个周期以及更早使用氯化镭 - 233（Ra223）对转移性去势抵抗性前列腺癌（mCRPC）患者预后的影响。 方法：我们回顾性评估了2016年8月至2021年8月期间接受Ra223治疗的75例以骨转移为主的mCRPC患者。该研究的主要目的是评估完成Ra223治疗（6个周期）对患者预后的影响，次要目的是调查与未完成Ra223治疗（少于6个周期）以及总生存期相关的因素。 结果：患者的中位年龄为72岁。Ra223给药的中位次数为6次（四分位间距为5 - 6次），Ra223完成率的中位数为75%。从mCRPC诊断到使用Ra223的中位时间为17个月，先前治疗的中位次数为2次。多变量分析表明，体能状态不佳（>0）、前列腺特异性抗原（PSA）水平>10 ng/ml、骨转移评分扩展至3 - 4分以及未完成Ra223治疗与较差的总生存期显著相关。此外，骨转移范围（EOD）3 - 4分以及先前3次或更多次的CRPC治疗与未完成Ra223治疗显著相关。 结论：完成6个周期以及更早使用Ra233可能与良好的生存期相关。不利因素（EOD 3 - 4分以及先前≥3次治疗）与未完成Ra223治疗显著相关。（C）2021爱思唯尔公司。保留所有权利。