Pain predicts overall survival in men with metastatic castration-resistant prostate cancer treated with radium-223.

Radium-223 dichloride is an alpha emitter approved for metastatic castration-resistant prostate cancer (mCRPC). Unfortunately, little data are available on the prognostic factors during radium-223-based therapy.

Patients with histologically confirmed progressive CRPC with two or more bone metastases and symptomatic disease were eligible. Previous therapy with a novel hormonal therapy was allowed. The patients received six intravenous injections of radium-223 every 4 weeks. A visual analog scale (VAS) was adopted to evaluate patients' basal pain.

A total of 25 patients were evaluated. Of these, 6 (24%) reported VAS <4. After a median follow-up of 8 months, all patients died with a median overall survival of 8.3 months (95% CI: 5.2-11.8 months), 12.6 months in the patients with VAS <4 vs 6.6 months in the patients with VAS ≥4 (P=0.03).

The present study suggests that VAS could be prognostic of the survival of mCRPC treated with radium-223 irrespective of the limitations of a small number of patients and the retrospective nature of the data.

OncoTargets and therapy. 2018 Dec 17*** epublish ***

Giandomenico Roviello, Rosj Gallicchio, Giovanni Bozza, Maria Grazia Rodriquenz, Michele Aieta, Giovanni Storto

Division of Medical Oncology, Department of Onco-Hematology, IRCCS CROB, Referral Cancer Center of Basilicata, 85028 Rionero in Vulture, PZ, Italy, ., Nuclear Medicine Department, IRCCS CROB, Referral Cancer Center of Basilicata, 85028 Rionero in Vulture, PZ, Italy.

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