Department of Radiation Therapy, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, 5-1, Tsukudocho, Shinjuku-Ku, Tokyo, 162-8543, Japan.
Department of Urology, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, 5-1, Tsukudocho, Shinjuku-Ku, Tokyo, 162-8543, Japan.
Sci Rep. 2021 Mar 19;11(1):6476. doi: 10.1038/s41598-021-86033-4.
The aim of this study was to review our initial experience of using radium 223 (Ra-223) for metastatic castration-resistant prostate cancer (CRPC) and to evaluate whether pretreatment PSA levels correlate with completion of Ra-223 treatment. In addition, we examined change ratios of PSA, ALP and BAP after the third administration to evaluate the correlation of these change ratios with completion of the subsequent Ra-223 treatment. Forty patients were enrolled in this retrospective study. Ra-223 treatment was considered completed in patients who received five or six administrations. Patient backgrounds and changes in biomarkers were compared between patient groups (complete vs. incomplete Ra-223 treatment). PSA levels before treatment were significantly lower in the complete compared with the incomplete group (cutoff value; 21.7). ALP and BAP levels had decreased after the third administration in the complete group, compared with baseline levels, while levels in the incomplete group had increased. Significant difference was seen in ALP levels, while was not seen in BAP levels between the two groups. Ra-223 treatment should be considered for CRPC with low PSA levels. Changes in PSA and ALP during Ra-223 treatment might provide markers to identify patients likely to complete Ra-223 treatment, with implications for prognosis.
本研究旨在回顾我们使用镭 223（Ra-223）治疗转移性去势抵抗性前列腺癌（CRPC）的初步经验，并评估预处理 PSA 水平是否与 Ra-223 治疗的完成情况相关。此外，我们还检查了第三次给药后 PSA、ALP 和 BAP 的变化率，以评估这些变化率与随后 Ra-223 治疗完成情况的相关性。本回顾性研究共纳入 40 例患者。接受五或六次给药的患者被认为完成了 Ra-223 治疗。比较了完全和不完全 Ra-223 治疗组患者的背景和生物标志物变化。完全组治疗前 PSA 水平明显低于不完全组（临界值：21.7）。与基线相比，完全组在第三次给药后 ALP 和 BAP 水平降低，而不完全组的水平升高。两组间 ALP 水平差异有统计学意义，BAP 水平差异无统计学意义。对于 PSA 水平较低的 CRPC 患者，应考虑使用 Ra-223 治疗。Ra-223 治疗期间 PSA 和 ALP 的变化可能为确定可能完成 Ra-223 治疗的患者提供标志物，对预后有一定的影响。
