New possibilities of radionuclide therapy for patients with castration-resistant prostate cancer with bone metastases. The first experience of using radium-223 at the Chelyabinsk Regional Clinical Center for Oncology and Nuclear Medicine

Background. The search for new effective methods of treating bone metastases in patients with prostate cancer is one of the urgent problems of modern oncology. One of these promising areas is the treatment with open radionuclides, in particular, radium-223 (Ra-223); a registration study demonstrated an increase in the overall survival rate of patients with castration-resistant prostate cancer (CRPC) with symptomatic bone metastases. Description of the clinical case. The article presents our own experience of using Ra-223 in a CRPC patient. A patient with castration resistance (an increase in the total PSA level in dynamics, the appearance of new foci during bone scintigraphy) was prescribed a course of 6 injections of Ra-223 55 kBq/kg every 4 weeks. As a result of the treatment, the patient’s general condition improved, the pain syndrome decreased, the level of alkaline phosphatase returned to normal, and the total PSA decreased by more than 2 times. According to bone scintigraphy, stabilization of the tumor process has been achieved. Conclusion. Due to the appearance of Ra-223, another therapeutic method with a significant increase in overall survival and a favorable toxicity profile that does not worsen the quality of life became available to patients with CRPC with bone metastases without visceral lesions.

castration-resistant prostate cancer, radionuclide therapy, radium-223