Case Report
Pak J Nucl Med. 2017; 7(1): 38-41

Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report

Authors: Tatiana Kochetova, Valeriy Krylov.

View PDF DOI: 10.24911/PJNMed.7.7

Abstract

Ra-223 therapy is recommended for Castration Resistant Prostate Cancer (CRPC) patients with bone metastases. The standard protocol is 5-6 cycles of therapy with 4 weeks intervals to gain survival benefit. We report a case of a chemo-nave CRPC patient who after 1.5 years of androgendeprivation therapy had widespread bone metastases, PSA of 4186 ng/ml, alkaline phosphatase (ALP) at 2982 U/l, bone marrow involvement with anaemia and thrombocytopaenia. 223RaCl2 therapy was started in August 2014. After the first two cycles of 223RaCl2 PSA dropped to 70 ng/ml, ALP to 877 U/l. The third cycle was delayed for 5.5 months due to technical reasons. Unexpectedly, during Ra-223 therapy interruption the positive changes were still ongoing. PSA-level decreased further, to 0.28 ng/l and ALP to 254 U/l. Hb level increased from 101 to 125 g/l, PLT from 105 to 180x109/l. After the interruption the patient received 4 planned cycles. Control bone scan after the 4th cycle revealed pathological uptake only in shoulder joints and sternum. In the follow-up period the patient demonstrated minimal disease signs: with normal ALP level, PSA 0.11 ng/ml. Ra-223 Therapy can give anti-tumour effect, as can be seen from the significant decrease in the PSA level. Breaks in Ra-223 Therapy are not dramatic. After interruption, it can be continued again. This fact can be taken into account while planning therapy. As shown here, clinical cases such the one we have reported, may allow a degree of flexibility to the standard recommendations on a case to case basis.

Keywords:   Radium-223, Castration resistant prostate cancer, Bone metastases


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Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report


Authors
Tatiana Kochetova
Nuclear Therapy Department, A Tsyb Medical Radiological Research Center, National Medical Research Radiological Center Ministry of Health of the Russian Federation
PubMed articlesGoogle scholar articles

Valeriy Krylov
Nuclear Therapy Department, A Tsyb Medical Radiological Research Center, National Medical Research Radiological Center Ministry of Health of the Russian Federation
PubMed articlesGoogle scholar articles


Correspondence to:
. Nuclear Therapy Department, A Tsyb Medical Radiological Research Center, National Medical Research Radiological Center Ministry of Health of the Russian Federation;

Publication history
Published in print 24 Jun 2018
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Pubmed Style

Tatiana Kochetova, Valeriy Krylov. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pak J Nucl Med. 2017; 7(1): 38-41. doi:10.24911/PJNMed.7.7


Web Style

Tatiana Kochetova, Valeriy Krylov. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. http://www.pjnmed.com/?mno=302240 [Access: April 03, 2020]. doi:10.24911/PJNMed.7.7


AMA (American Medical Association) Style

Tatiana Kochetova, Valeriy Krylov. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pak J Nucl Med. 2017; 7(1): 38-41. doi:10.24911/PJNMed.7.7


Vancouver/ICMJE Style

Tatiana Kochetova, Valeriy Krylov. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pak J Nucl Med. (2017), [cited April 03, 2020]; 7(1): 38-41. doi:10.24911/PJNMed.7.7


Harvard Style

Tatiana Kochetova, Valeriy Krylov (2017) Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pak J Nucl Med, 7 (1), 38-41. doi:10.24911/PJNMed.7.7


Turabian Style

Tatiana Kochetova, Valeriy Krylov. 2017. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pakistan Journal of Nuclear Medicine, 7 (1), 38-41. doi:10.24911/PJNMed.7.7


Chicago Style

Tatiana Kochetova, Valeriy Krylov. "Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report." Pakistan Journal of Nuclear Medicine 7 (2017), 38-41. doi:10.24911/PJNMed.7.7


MLA (The Modern Language Association) Style

Tatiana Kochetova, Valeriy Krylov. "Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report." Pakistan Journal of Nuclear Medicine 7.1 (2017), 38-41. Print. doi:10.24911/PJNMed.7.7


APA (American Psychological Association) Style

Tatiana Kochetova, Valeriy Krylov (2017) Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pakistan Journal of Nuclear Medicine, 7 (1), 38-41. doi:10.24911/PJNMed.7.7


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