Safe Use of Radium-223 Dichloride (RaCl) Across a Wide Range of Clinical Scenarios, Incorporating a 10-year Single-Institution Radiation Safety Experience.

Radium Ra dichloride (RaCl) is an effective therapeutic radiopharmaceutical presently approved for the treatment of prostate cancer metastatic to bone. It is unique by virtue of being the first alpha-emitting radiopharmaceutical to achieve approval for use in the clinic, reaching this status both in the United States and Europe in 2013. In over ten years of research and approved clinical usage, the authors have encountered very few radiation-safety incidents of concern with RaCl; in this review, they relate their first-hand experience with this radiopharmaceutical and share some lessons learned, including situations of bleeding, surgery and patient demise.