Efficacy and tolerance of radium-223 dichloride in patients treated for castration-resistant prostate cancer with bone metastases

Introduction. - The aim of our study was to evaluate the efficacy and tolerance of (RaCl2)-Ra-223 in patients with mCRPC with bone metastases, then analyse the impact of any change in treatment protocol on the efficacy of (RaCl2)-Ra-223 in mCRPC patients with bone metastases, by determining overall survival, progression -free survival and events occurring during therapeutic monitoring. Materiel and methods. - Our retrospective, analytical and descriptive study, carried out in Luxembourg, included patients eligible for le (RaCl2)-Ra-223 treatment who were assessed during and at the end of treatment, and 3 to 4 months after the end of treatment. Results. - Our sample included 41 cases. The mean age of patients was 74 years (min = 52, max = 87), with 32 (78.1%) deaths recorded. Median overall survival was 18.0 months (95% CI: 12.1-23.9): 11 months for those who experienced progression during treatment versus 47 months for those who experienced a partial response. Median progression -free survival was 15.0 months (95% CI: 0.0-36.4). Overall survival was positively correlated with progression -free survival (Rho Spearman = 0.713, Pvalue < 0.001); however, a one -month increase in progression -free survival decreased the risk of death by 6% and thus increased overall survival (HR = 0.937, 95% CI : 0.903-0.973, P < 0.001). Conclusion. - Administration of the complete (RaCl2)-Ra-223 protocol improved overall survival and progression -free survival in patients treated for mCRPC with bone metastases, with good hematological tolerability despite the occurrence of complications such as epiduritis and fractures. (C) 2024 Elsevier Masson SAS. All rights reserved.