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Dynamic changes of bone metastasis predict bone‐predominant status to benefit from radium‐223 dichloride for patients with castration‐resistant prostate cancer
BACKGROUND: To best employ radium‐223 dichloride (Ra‐223) for patients with castration‐resistant prostate cancer (CRPC) and bone metastasis, we investigated the bone‐predominant status in patients treated with Ra‐223. METHODS: We retrospectively evaluated 127 CRPC patients who underwent treatment wi...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666734/ https://www.ncbi.nlm.nih.gov/pubmed/32964674 http://dx.doi.org/10.1002/cam4.3459 |
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author | Hashimoto, Kohei Miyoshi, Yasuhide Shindo, Tetsuya Hori, Masakazu Tsuboi, Yasumasa Kobayashi, Ko Fukuta, Fumimasa Tanaka, Toshiaki Miyamoto, Shintaro Maehana, Takeshi Okada, Manabu Nishiyama, Naotaka Yanase, Masahiro Kato, Ryuichi Hotta, Hiroshi Kunishima, Yasuharu Takahashi, Atsushi Hinotsu, Shiro Sakata, Koh‐ichi Kitamura, Hiroshi Uemura, Hiroji Masumori, Naoya |
author_facet | Hashimoto, Kohei Miyoshi, Yasuhide Shindo, Tetsuya Hori, Masakazu Tsuboi, Yasumasa Kobayashi, Ko Fukuta, Fumimasa Tanaka, Toshiaki Miyamoto, Shintaro Maehana, Takeshi Okada, Manabu Nishiyama, Naotaka Yanase, Masahiro Kato, Ryuichi Hotta, Hiroshi Kunishima, Yasuharu Takahashi, Atsushi Hinotsu, Shiro Sakata, Koh‐ichi Kitamura, Hiroshi Uemura, Hiroji Masumori, Naoya |
author_sort | Hashimoto, Kohei |
collection | PubMed |
description | BACKGROUND: To best employ radium‐223 dichloride (Ra‐223) for patients with castration‐resistant prostate cancer (CRPC) and bone metastasis, we investigated the bone‐predominant status in patients treated with Ra‐223. METHODS: We retrospectively evaluated 127 CRPC patients who underwent treatment with Ra‐223. The patients were divided into three groups based on the types of dynamic changes of bone metastasis between diagnosis and just before Ra‐223: (a) only known lesions; (b) de novo lesions; (c) new progressive lesions. We developed the risk assessment using predictive factors based on progression‐free survival (PFS). RESULTS: During the median follow‐up period of 10.4 months, the median PFS in the only known lesions group was 11.3 months compared to 8.1 months in the de novo lesions group and 5.1 months in the new progressive lesions group (P < .001). In multivariate analysis, the type of the new progressive lesions in bone metastasis (HR 1.45, 95% CI 1.13‐1.66, P = .003), performance status of >1 (HR 1.74, 95% CI 1.04‐2.89, P = .034), PSA value of >100 ng/mL (HR 1.59, 95% CI 1.02‐2.50, P = .043), and PSA doubling time (PSADT) of <3 months (HR 1.53, 95% CI 1.11‐2.03, P = .007) were independent unfavorable predictive factors for PFS. The risk assessment for PFS was highlighted when the type of dynamic changes of bone metastasis was combined with PSADT just before Ra‐223 treatment. This was associated with non‐bone metastasis progression, especially visceral metastasis, and overall survival. CONCLUSIONS: Risk assessment in combination with dynamic changes of bone metastasis and PSADT determines the bone‐predominant metastasis type to benefit from Ra‐223. |
format | Online Article Text |
id | pubmed-7666734 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76667342020-11-20 Dynamic changes of bone metastasis predict bone‐predominant status to benefit from radium‐223 dichloride for patients with castration‐resistant prostate cancer Hashimoto, Kohei Miyoshi, Yasuhide Shindo, Tetsuya Hori, Masakazu Tsuboi, Yasumasa Kobayashi, Ko Fukuta, Fumimasa Tanaka, Toshiaki Miyamoto, Shintaro Maehana, Takeshi Okada, Manabu Nishiyama, Naotaka Yanase, Masahiro Kato, Ryuichi Hotta, Hiroshi Kunishima, Yasuharu Takahashi, Atsushi Hinotsu, Shiro Sakata, Koh‐ichi Kitamura, Hiroshi Uemura, Hiroji Masumori, Naoya Cancer Med Cancer Biology BACKGROUND: To best employ radium‐223 dichloride (Ra‐223) for patients with castration‐resistant prostate cancer (CRPC) and bone metastasis, we investigated the bone‐predominant status in patients treated with Ra‐223. METHODS: We retrospectively evaluated 127 CRPC patients who underwent treatment with Ra‐223. The patients were divided into three groups based on the types of dynamic changes of bone metastasis between diagnosis and just before Ra‐223: (a) only known lesions; (b) de novo lesions; (c) new progressive lesions. We developed the risk assessment using predictive factors based on progression‐free survival (PFS). RESULTS: During the median follow‐up period of 10.4 months, the median PFS in the only known lesions group was 11.3 months compared to 8.1 months in the de novo lesions group and 5.1 months in the new progressive lesions group (P < .001). In multivariate analysis, the type of the new progressive lesions in bone metastasis (HR 1.45, 95% CI 1.13‐1.66, P = .003), performance status of >1 (HR 1.74, 95% CI 1.04‐2.89, P = .034), PSA value of >100 ng/mL (HR 1.59, 95% CI 1.02‐2.50, P = .043), and PSA doubling time (PSADT) of <3 months (HR 1.53, 95% CI 1.11‐2.03, P = .007) were independent unfavorable predictive factors for PFS. The risk assessment for PFS was highlighted when the type of dynamic changes of bone metastasis was combined with PSADT just before Ra‐223 treatment. This was associated with non‐bone metastasis progression, especially visceral metastasis, and overall survival. CONCLUSIONS: Risk assessment in combination with dynamic changes of bone metastasis and PSADT determines the bone‐predominant metastasis type to benefit from Ra‐223. John Wiley and Sons Inc. 2020-09-22 /pmc/articles/PMC7666734/ /pubmed/32964674 http://dx.doi.org/10.1002/cam4.3459 Text en © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Cancer Biology Hashimoto, Kohei Miyoshi, Yasuhide Shindo, Tetsuya Hori, Masakazu Tsuboi, Yasumasa Kobayashi, Ko Fukuta, Fumimasa Tanaka, Toshiaki Miyamoto, Shintaro Maehana, Takeshi Okada, Manabu Nishiyama, Naotaka Yanase, Masahiro Kato, Ryuichi Hotta, Hiroshi Kunishima, Yasuharu Takahashi, Atsushi Hinotsu, Shiro Sakata, Koh‐ichi Kitamura, Hiroshi Uemura, Hiroji Masumori, Naoya Dynamic changes of bone metastasis predict bone‐predominant status to benefit from radium‐223 dichloride for patients with castration‐resistant prostate cancer |
title | Dynamic changes of bone metastasis predict bone‐predominant status to benefit from radium‐223 dichloride for patients with castration‐resistant prostate cancer |
title_full | Dynamic changes of bone metastasis predict bone‐predominant status to benefit from radium‐223 dichloride for patients with castration‐resistant prostate cancer |
title_fullStr | Dynamic changes of bone metastasis predict bone‐predominant status to benefit from radium‐223 dichloride for patients with castration‐resistant prostate cancer |
title_full_unstemmed | Dynamic changes of bone metastasis predict bone‐predominant status to benefit from radium‐223 dichloride for patients with castration‐resistant prostate cancer |
title_short | Dynamic changes of bone metastasis predict bone‐predominant status to benefit from radium‐223 dichloride for patients with castration‐resistant prostate cancer |
title_sort | dynamic changes of bone metastasis predict bone‐predominant status to benefit from radium‐223 dichloride for patients with castration‐resistant prostate cancer |
topic | Cancer Biology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666734/ https://www.ncbi.nlm.nih.gov/pubmed/32964674 http://dx.doi.org/10.1002/cam4.3459 |
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