Radium-223 Treatment in Castration-Resistant Bone Metastatic Prostate Cancer

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Small sample study, favoring RP:

"TAKE-HOME MESSAGE

Radium-223 (223Ra) is indicated for patients with bony metastatic castrate-resistant prostate cancer. It is not known whether treatment of the primary tumor confers benefit. In this study, the authors reviewed outcomes in patients receiving 223Ra on the basis of prior radical prostatectomy (n = 16) or not (n = 28), including radiation therapy (n = 5) or no primary tumor treatment (n = 23). Demographics were similar between the two groups, including age and performance status. Fewer patients in the prostatectomy group had to interrupt therapy (25% vs 41%; P=.044), and mortality was much lower among those without a prostate at last follow-up (6% vs 43%; P=.04; median follow-up was 18 months).

These data suggest that those with prior prostatectomy fare better with 223Ra treatment than those without prior prostatectomy, a finding that requires validation but may enhance our knowledge of prognosis and improve clinical decision-making."

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