Department of Molecular Medicine Sapienza, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
Radiation Oncology Center, S.Orsola-Malpighi Hospital, Bologna, Italy.
Aging Clin Exp Res. 2021 Mar;33(3):651-658. doi: 10.1007/s40520-020-01573-5. Epub 2020 May 1.
Radium-223 prolongs overall survival (OS) and delays time to the first symptomatic skeletal events in patients with symptomatic metastatic castration-resistant prostate cancer (mCRPC). There is a lack of evidence on the safety and efficacy of Radium-223 treatment in the very elderly population.
Aim of this multicentre study is to analyze mCRPC patients treated with Radium-223 in terms of OS and to assess whether there are differences between young and elderly, as well as to verify efficacy and safety in patients ≥ 75 years of age.
430 mCRPC patients of six Italian Centres were analyzed in this multicenter retrospective study. At baseline and after each cycle were collected clinical and diagnostic patients' parameters. The whole cohort was divided into two groups based on the age of the patients (< 75 years old and ≥ 75 years old).
47% of the patients were < 75 years old and 53% were ≥ 75 years old. The primary outcome, OS, does not show significant differences between the two subgroups if other basal parameters are considered. Considering clinical covariates in univariate models (p < 0.05) several clinical aspects have an impact on OS, except for age (p = 0.072). Age continues to have no significant impact on the OS (p = 0.274) even in multivariate models in the two groups. The toxic effects are similar in the two groups.
Radium-223 prolongs survival in both younger and older patients at the same baseline condition and is a good option in the symptomatic mCRPC setting compared to other agents.
镭-223 可延长有症状转移性去势抵抗性前列腺癌（mCRPC）患者的总生存期（OS）并延迟首次有症状骨骼事件的发生时间。在非常高龄的人群中，镭-223 治疗的安全性和疗效证据不足。
本多中心研究旨在分析接受镭-223 治疗的 mCRPC 患者的 OS，并评估年轻和老年患者之间是否存在差异，以及验证≥75 岁患者的疗效和安全性。
本多中心回顾性研究分析了来自意大利 6 家中心的 430 例 mCRPC 患者。在基线和每个周期后，收集了患者的临床和诊断参数。根据患者年龄（<75 岁和≥75 岁）将整个队列分为两组。
47%的患者<75 岁，53%的患者≥75 岁。如果考虑其他基础参数，两组之间的主要结局 OS 没有显著差异。在单变量模型中考虑临床协变量（p<0.05）时，除了年龄（p=0.072）外，几个临床方面对 OS 有影响。即使在两组的多变量模型中，年龄对 OS 也没有显著影响（p=0.274）。两组的毒性作用相似。
镭-223 可延长具有相同基线条件的年轻和老年患者的生存时间，并且与其他药物相比，是有症状 mCRPC 患者的一个较好选择。
