Radium-223 for metastatic, castration- resistant prostate cancer: A retrospective chart review study of real-world use in a tertiary hospital in Taiwan

Background: Radium-223 is an alpha-emitting, bone-targeting radiopharmaceutical that con-fers a survival benefit in patients with confirmed bone-metastatic, castration-resistant pros-tate cancer with no visceral metastases. We studied real-world use of radium-223 in eligible patients from a tertiary hospital.Methods: We retrospectively collected clinical data of patients treated with radium-223 in Tungs' Taichung MetroHarbor Hospital by chart review. Data included biochemical parameters, pain scores, other prostate cancer treatments received and adverse events (AEs).Results: Of 36 patients included in the study, 12 patients received radium-223 as first-line ther-apy, 11 as second-line treatment and 13 as third-line treatment. Prostate-specific antigen significantly increased from baseline in patients who received radium-223 as third-line treat-ment and in patients who received radium-223 post-chemotherapy. Pain scores significantly decreased when radium-223 was given as second-line and as third-line treatment. In the pa-tients who were naive to novel anti-hormone (NAH) therapy and chemotherapy, mean alkaline phosphatase level significantly decreased from baseline. The most common AE was anemia, found in 16.7% of patients.Conclusion: Radium-223 had early biochemical benefits, while in the later stages of the dis-ease, it reduced bone pain in this real-world cohort of chemotherapy-naive, NAH-naive pa-tients, and patients with prior therapy, from a tertiary institution in Taiwan. Copyright (c) 2022, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).