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Medientyp:
E-Artikel
Titel:
223Ra Therapy in Patients With Advanced Castration-Resistant Prostate Cancer With Bone Metastases : Lessons from Daily Practice
:
Lessons from Daily Practice
Beteiligte:
van der Doelen, Maarten J.;
Kuppen, Malou C.P.;
Jonker, Marianne A.;
Mehra, Niven;
Janssen, Marcel J.R.;
van Oort, Inge M.;
Gerritsen, Winald R.
Beschreibung:
<jats:sec>
<jats:title>Purpose</jats:title>
<jats:p>To identify pre-therapeutic variables associated with overall survival (OS) in patients treated with <jats:sup>223</jats:sup>Ra.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>Data from 45 CRPC patients treated with <jats:sup>223</jats:sup>Ra were retrospectively analyzed. All patients who received at least one <jats:sup>223</jats:sup>Ra injection were included in the study. Cox proportional hazard regression models were used to estimate hazard ratio’s (HR) and to test for association.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>Twenty-one patients (47%) received six <jats:sup>223</jats:sup>Ra injections and 24 patients (53%) received one to five <jats:sup>223</jats:sup>Ra injections. Median OS since start of <jats:sup>223</jats:sup>Ra was 13.0 months (95% confidence interval (CI) 8.2–17.8). Patients who completed <jats:sup>223</jats:sup>Ra therapy had a median OS of 19.7 months (95% CI 14.9–24.6), while patients who received one to five <jats:sup>223</jats:sup>Ra injections had a median OS of 5.9 months (95% CI 3.8–8.1; <jats:italic toggle="yes">P</jats:italic> < 0.001).</jats:p>
<jats:p>Univariable analysis showed poor baseline ECOG performance status (PS), baseline opioid use, lowered baseline hemoglobin, and elevated prostate-specific antigen, alkaline phosphatase and lactate dehydrogenase (LD) levels were significantly associated with OS. Multivariable Cox regression analysis demonstrated that poor baseline ECOG PS (HR 10.6) and high LD levels (HR 7.7) were pre-therapeutic variables that predicted poor OS.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>In a multivariable Cox regression model, good baseline ECOG PS and low LD levels were significantly associated with longer OS in patients treated with <jats:sup>223</jats:sup>Ra. These variables may be used for stratification of CRPC patients for <jats:sup>223</jats:sup>Ra therapy. Prospective studies to evaluate these variables are warranted, to develop a nomogram to select patients properly. In this retrospective study, predictors of overall survival in 45 metastatic castration-resistant prostate cancer patients treated with <jats:sup>223</jats:sup>Ra therapy were evaluated. Baseline ECOG performance status and lactate dehydrogenase levels turned out to be significant in a multivariable prediction model for overall survival.</jats:p>
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