Factors affecting 223Ra therapy : clinical experience after 532 cycles from a single institution
Elba C. Etchebehere, Denai R. Milton, John C. Araujo, Nancy M. Swanston, Homer A. Macapinlac, Eric M. Rohren
ARTIGO
Inglês
Purpose The aim of this study was to identify baseline features that predict outcome in Ra-223 therapy.
Methods We retrospectively reviewed 110 patients with metastatic castration-resistant prostate cancer treated with Ra-223. End points were overall survival (OS), progression-free survival (PFS),... Ver mais
Methods We retrospectively reviewed 110 patients with metastatic castration-resistant prostate cancer treated with Ra-223. End points were overall survival (OS), progression-free survival (PFS),... Ver mais
Purpose The aim of this study was to identify baseline features that predict outcome in Ra-223 therapy.
Methods We retrospectively reviewed 110 patients with metastatic castration-resistant prostate cancer treated with Ra-223. End points were overall survival (OS), progression-free survival (PFS), bone event-free survival (BeFS), and bone marrow failure (BMF). The following parameters were evaluated prior to the first Ra-223 cycle: serum levels of hemoglobin (Hb), prostate-specific antigen (PSA), alkaline phosphatase (ALP), Eastern Cooperative Oncology Group (ECOG) status, pain score, use of chemotherapy, and external beam radiation therapy (EBRT). During/after Ra-223 we evaluated: the total number of radium cycles (Ra-Tot), the PSA doubling time (PSA(DT)), and the use of chemotherapy, EBRT, abiraterone, and enzalutamide.
Results A significant reduction of ALP (p < 0.001) and pain score (p = 0.041) occurred throughout the (223) Ra cycles. The risk of progression was associated with declining ECOG status [hazard ratio (HR) = 3.79; p < 0.001] and decrease in PSA(DT) (HR = 8.22; p < 0.001). Ra-Tot, ALP, initial ECOG status, initial pain score, and use of abiraterone were associated with OS (p <= 0.008), PFS (p <= 0.003), and BeFS (p <= 0.020). Ra-Tot, ALP, initial ECOG status, and initial pain score were significantly associated with BMF (p <= 0.001) as well as Hb (p < 0.001) and EBRT (p=0.009). On multivariable analysis, only Ra-Tot and abiraterone remained significantly associated with OS (p < 0.001; p=0.033, respectively), PFS (p < 0.001; p=0.041, respectively), and BeFS (p < 0.001; p=0.019, respectively). Additionally, Ra-Tot (p=0.027) and EBRT (p=0.013) remained significantly associated with BMF.
Conclusion Concomitant use of abiraterone and Ra-223 seems to have a beneficial effect, while the EBRT may increase the risk of BMF Ver menos
Methods We retrospectively reviewed 110 patients with metastatic castration-resistant prostate cancer treated with Ra-223. End points were overall survival (OS), progression-free survival (PFS), bone event-free survival (BeFS), and bone marrow failure (BMF). The following parameters were evaluated prior to the first Ra-223 cycle: serum levels of hemoglobin (Hb), prostate-specific antigen (PSA), alkaline phosphatase (ALP), Eastern Cooperative Oncology Group (ECOG) status, pain score, use of chemotherapy, and external beam radiation therapy (EBRT). During/after Ra-223 we evaluated: the total number of radium cycles (Ra-Tot), the PSA doubling time (PSA(DT)), and the use of chemotherapy, EBRT, abiraterone, and enzalutamide.
Results A significant reduction of ALP (p < 0.001) and pain score (p = 0.041) occurred throughout the (223) Ra cycles. The risk of progression was associated with declining ECOG status [hazard ratio (HR) = 3.79; p < 0.001] and decrease in PSA(DT) (HR = 8.22; p < 0.001). Ra-Tot, ALP, initial ECOG status, initial pain score, and use of abiraterone were associated with OS (p <= 0.008), PFS (p <= 0.003), and BeFS (p <= 0.020). Ra-Tot, ALP, initial ECOG status, and initial pain score were significantly associated with BMF (p <= 0.001) as well as Hb (p < 0.001) and EBRT (p=0.009). On multivariable analysis, only Ra-Tot and abiraterone remained significantly associated with OS (p < 0.001; p=0.033, respectively), PFS (p < 0.001; p=0.041, respectively), and BeFS (p < 0.001; p=0.019, respectively). Additionally, Ra-Tot (p=0.027) and EBRT (p=0.013) remained significantly associated with BMF.
Conclusion Concomitant use of abiraterone and Ra-223 seems to have a beneficial effect, while the EBRT may increase the risk of BMF Ver menos
FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP
2014/03317-8
Fechado
Factors affecting 223Ra therapy : clinical experience after 532 cycles from a single institution
Elba C. Etchebehere, Denai R. Milton, John C. Araujo, Nancy M. Swanston, Homer A. Macapinlac, Eric M. Rohren
Factors affecting 223Ra therapy : clinical experience after 532 cycles from a single institution
Elba C. Etchebehere, Denai R. Milton, John C. Araujo, Nancy M. Swanston, Homer A. Macapinlac, Eric M. Rohren
Fontes
European journal of nuclear medicine and molecular imaging (Fonte avulsa) |