Radium-223 as an Approved Modality for Treatment of Bone Metastases.

Radium-223 dichloride (Ra) is an α-emitter radionuclide approved for treatment of osteoblastic metastases in castrate-resistant prostate cancer (mCRPC) patients. Ra increases overall survival, improves bone pain, increases the median time to the first skeletal-related event, reduces the use of external beam radiation therapy for bone pain palliation, reduces the rates of spinal cord compression, and hospitalization. Ra therapy has minimal side effects; the most common hematological side effects are anemia, thrombocytopenia and neutropenia while the nonhematological side effects that may occur are bone pain flare, nausea, fatigue, and diarrhea.

Is interim F-fluoride PET/CT a predictor of outcomes after radium-223 therapy?

Objective: To determine whether an interim F-fluoride positron-emission tomography/computed tomography (PET/CT) study performed after the third cycle of radium-223 dichloride (RaCl) therapy is able to identify patients that will not respond to treatment.

Materials And Methods: We retrospectively reviewed 34 histologically confirmed cases of hormone-refractory prostate cancer with bone metastasis in patients submitted to RaCl therapy. All of the patients underwent baseline and interim F-fluoride PET/CT studies.

Therapy assessment of bone metastatic disease in the era of radium.

Purpose: Defining an optimal imaging modality for assessment of therapy and the best time of evaluation are pivotal for ideal patient's management.

Methods: Ra (Xofigo®, formerly Alpharadin) has been approved by the FDA and European Medicines Agency for treatment of metastatic castration-resistant prostate cancer with painful osseous involvement.

Results: PET/CT imaging using various radiotracers such as F-FDG, F-FCH, Ga-PSMA and F-NaF have been investigated to mitigate the limitations of conventional imaging modalities.