Souza Stephan, Ribeiro Felipe, Brito Ana, Minekawa Thaís, Lopes Flávia, Matedi Sumara, Fockink Renata, Anjos Dalton, Gomes Gustavo, Silva Laura, Camacho Mariana, Santos Allan, Araújo Whemberton, Teixeira Ana, Martins Raul, Sanches Adelina, Hanaoka Nilton, Tavares Rafael, Villela-Pedras Felipe, Mourato Felipe, Torricelli Caroline, Alves Thiago, Tavares Marcelo, Lima Mariana, Moraes André, Sasse André, Almeida Paulo, Etchebehere Elba
University of Campinas (UNICAMP), Campinas, Brazil.
Real Hospital Português, Recife, Brazil.
EJNMMI Rep. 2025 Apr 24;9(1):14. doi: 10.1186/s41824-025-00245-9.
Radium-223 (Ra) therapy has been available since 2013 for metastatic castrate-resistant prostate cancer (mCRPC). However, only in 2017 Ra was approved by the National Health Surveillance Agency in Brazil. We aimed to perform a multicenter analysis of mCRPC patients treated with Ra in referral centers in Brazil and describe their clinical outcomes. For this reason, we retrospectively analyzed mCRPC patients who underwent Ra treatment. Clinical and laboratory data were evaluated.
308 patients submitted to 1402 Ra cycles from 9 centers were studied. Previous treatments prior to Ra were chemotherapy (59.1%), radiation therapy (54.8%) and hormone therapy (92.2%). Ra was used as the fifth or more line of treatment in 58.4% of the patients. The mean number of Ra cycles was 4.6; 51% of patients completed all 6 cycles and 52.9% progressed during Ra. Concomitant treatment with Ra occurred in 69.4% of patients. The median overall survival (OS) for all patients was 13.7 months. The OS was higher for patients completing 6 cycles compared to < 6 cycles (22.6 vs 6.4 months, respectively). When stratified according to Brazilian regions, the median OS for the southeast region was higher (range: 14.5-30.2 months) than the other regions.
The OS of Ra for patients completing 6 cycles was very high. However, there were major discrepancies when stratified according to different regions in the nation. The data is an important demonstration of the country's educational referral discrepancies related to proper patient management for Ra therapy, which has a major impact on maximum OS benefit.
自2013年起，镭-223（Ra）疗法可用于转移性去势抵抗性前列腺癌（mCRPC）。然而，直到2017年，Ra才被巴西国家卫生监督局批准。我们旨在对巴西转诊中心接受Ra治疗的mCRPC患者进行多中心分析，并描述其临床结局。因此，我们回顾性分析了接受Ra治疗的mCRPC患者。对临床和实验室数据进行了评估。
研究了来自9个中心的308例接受1402个Ra周期治疗的患者。Ra治疗前的既往治疗包括化疗（59.1%）、放疗（54.8%）和激素治疗（92.2%）。58.4%的患者将Ra用作第五线或更后的治疗线。Ra周期的平均数量为4.6；51%的患者完成了全部6个周期，52.9%的患者在接受Ra治疗期间病情进展。69.4%的患者同时接受了其他治疗。所有患者的中位总生存期（OS）为13.7个月。完成6个周期的患者的OS高于未完成6个周期的患者（分别为22.6个月和6.4个月）。根据巴西地区分层时，东南部地区的中位OS更高（范围：14.5 - 30.2个月），高于其他地区。
完成6个周期治疗的患者接受Ra治疗后的OS非常高。然而，根据该国不同地区分层时存在重大差异。这些数据有力地证明了该国在Ra治疗患者合理管理方面存在教育转诊差异，这对最大程度的OS获益有重大影响。
