Investigation of the safety of Radium-223 chloride in combination with external beam radiotherapy for bone metastases of prostate cancer.

IF 2 4区 医学 Q2 BIOLOGY
Soichi Makino, Kazunari Miyazawa, Yoji Katsuoka, Takeru Ooe, Ken Aikawa, Akira Segawa, Hiroshi Kobayashi
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Abstract

This study aimed to investigate the safety of combining radium-223 chloride (Ra-223) therapy with external beam radiation therapy (EBRT) for patients with multiple bone metastases from castration-resistant prostate cancer (CRPC), including lesions requiring urgent treatment such as those causing neurological symptoms due to spinal cord compression. We retrospectively analyzed data from patients with CRPC and bone metastases treated with Ra-223 therapy at our hospital between September 1, 2018, and December 31, 2023. Adverse events were evaluated using the Common Terminology Criteria for Adverse Events version 4.0. Of the 23 patients referred, data from 17 were included; 8 received concurrent Ra-223 therapy and EBRT, whereas others received only Ra-223 therapy. The median follow-up period was 20 months. Grade (G) 2 or higher adverse events occurred in seven patients (41.2%), and G 3 or higher in 2 (11.7%). None of the patients who received EBRT with fields involving the gastrointestinal tract experienced diarrhea, constipation, bleeding, perforation, or obstruction. Ra-223 therapy with EBRT did not increase adverse events compared with studies of Ra-223 therapy without EBRT. One case of G 5 Pneumocystis carinii pneumonia, likely because of steroid use for neurological symptoms and the patient's underlying diabetes mellitus, was noted. The effects of EBRT cannot be entirely excluded, so minimizing field size and dose is recommended when combining Ra-223 therapy and EBRT. Our findings indicate that concurrent Ra-223 therapy and EBRT could be safe for managing patients with symptomatic bone metastases and castration-resistant prostate cancer who require specialized treatment, provided sufficient attention is given to the field and the prescribed dose.

223氯化镭联合外束放疗治疗前列腺癌骨转移的安全性探讨。
本研究旨在探讨镭-223氯(Ra-223)联合外束放射治疗(EBRT)治疗去势抵抗性前列腺癌(CRPC)多发骨转移患者的安全性,包括需要紧急治疗的病变,如因脊髓压迫引起的神经系统症状。我们回顾性分析了2018年9月1日至2023年12月31日在我院接受Ra-223治疗的CRPC和骨转移患者的数据。不良事件采用不良事件通用术语标准4.0版进行评估。在23例转诊患者中,纳入了17例的数据;8名患者同时接受Ra-223治疗和EBRT治疗,而其他患者仅接受Ra-223治疗。中位随访期为20个月。7例(41.2%)患者发生(G) 2级及以上不良事件,2例(11.7%)患者发生(G) 3级及以上不良事件。接受涉及胃肠道的EBRT治疗的患者均未出现腹泻、便秘、出血、穿孔或梗阻。与不使用EBRT的Ra-223治疗相比,Ra-223联合EBRT治疗没有增加不良事件。报告1例g5卡氏肺囊虫肺炎,可能是由于使用类固醇治疗神经症状和患者潜在的糖尿病。EBRT的影响不能完全排除,因此建议在将Ra-223治疗与EBRT联合使用时尽量减少电场大小和剂量。我们的研究结果表明,如果对该领域和规定的剂量给予足够的重视,Ra-223治疗和EBRT同时治疗对于需要专门治疗的症状性骨转移和去势抵抗性前列腺癌患者是安全的。
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来源期刊
CiteScore
3.60
自引率
5.00%
发文量
86
审稿时长
4-8 weeks
期刊介绍: The Journal of Radiation Research (JRR) is an official journal of The Japanese Radiation Research Society (JRRS), and the Japanese Society for Radiation Oncology (JASTRO). Since its launch in 1960 as the official journal of the JRRS, the journal has published scientific articles in radiation science in biology, chemistry, physics, epidemiology, and environmental sciences. JRR broadened its scope to include oncology in 2009, when JASTRO partnered with the JRRS to publish the journal. Articles considered fall into two broad categories: Oncology & Medicine - including all aspects of research with patients that impacts on the treatment of cancer using radiation. Papers which cover related radiation therapies, radiation dosimetry, and those describing the basis for treatment methods including techniques, are also welcomed. Clinical case reports are not acceptable. Radiation Research - basic science studies of radiation effects on livings in the area of physics, chemistry, biology, epidemiology and environmental sciences. Please be advised that JRR does not accept any papers of pure physics or chemistry. The journal is bimonthly, and is edited and published by the JRR Editorial Committee.
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