Viviana Frantellizzi1, Fabio Monari2, Manlio Mascia3, Renato Costa4, Giuseppe Rubini5, Angela Spanu6, Alessio Farcomeni7, Elisa Lodi Rizzini8, Luca Cindolo9, Alessandra Murabito4, Valentina Lavelli5, Susanna Nuvoli6, Laura Cosma10, Valeria Dionisi2, Anna Giulia Nappi5, Marco Andreola10, Giuseppe De Vincentis10. 1. Department of Molecular Medicine Sapienza, "Sapienza" University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. viviana.frantellizzi@uniroma1.it. 2. Radiation Oncology Center, S.Orsola-Malpighi Hospital, Bologna, Italy. 3. Unit of Nuclear Medicine, "Spirito Santo" Hospital, Pescara, Italy. 4. Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy. 5. Nuclear Medicine Department, University of Bari "Aldo Moro", Bari, Italy. 6. Unit of Nuclear Medicine, Department of Medical Surgical and Experimental Sciences, University of Sassari, Sassari, Italy. 7. Department of Economics & Finance, University of Rome "Tor Vergata", Rome, Italy. 8. Nuclear Medicine Unit, S.Orsola-Malpighi Hospital, Bologna, Italy. 9. Department of Urology, "Villa Stuart" Private Hospital, Rome, Italy. 10. Department of Radiological Sciences, Oncology and Anatomical Pathology Sapienza, "Sapienza" University of Rome, Rome, Italy.
Abstract
BACKGROUND: Radium-223 prolongs overall survival (OS) and delays time to the first symptomatic skeletal events in patients with symptomatic metastatic castration-resistant prostate cancer (mCRPC). There is a lack of evidence on the safety and efficacy of Radium-223 treatment in the very elderly population. AIMS: Aim of this multicentre study is to analyze mCRPC patients treated with Radium-223 in terms of OS and to assess whether there are differences between young and elderly, as well as to verify efficacy and safety in patients ≥ 75 years of age. METHODS: 430 mCRPC patients of six Italian Centres were analyzed in this multicenter retrospective study. At baseline and after each cycle were collected clinical and diagnostic patients' parameters. The whole cohort was divided into two groups based on the age of the patients (< 75 years old and ≥ 75 years old). RESULTS: 47% of the patients were < 75 years old and 53% were ≥ 75 years old. The primary outcome, OS, does not show significant differences between the two subgroups if other basal parameters are considered. Considering clinical covariates in univariate models (p < 0.05) several clinical aspects have an impact on OS, except for age (p = 0.072). Age continues to have no significant impact on the OS (p = 0.274) even in multivariate models in the two groups. The toxic effects are similar in the two groups. CONCLUSIONS: Radium-223 prolongs survival in both younger and older patients at the same baseline condition and is a good option in the symptomatic mCRPC setting compared to other agents.
BACKGROUND:Radium-223 prolongs overall survival (OS) and delays time to the first symptomatic skeletal events in patients with symptomatic metastatic castration-resistant prostate cancer (mCRPC). There is a lack of evidence on the safety and efficacy of Radium-223 treatment in the very elderly population. AIMS: Aim of this multicentre study is to analyze mCRPC patients treated with Radium-223 in terms of OS and to assess whether there are differences between young and elderly, as well as to verify efficacy and safety in patients ≥ 75 years of age. METHODS: 430 mCRPC patients of six Italian Centres were analyzed in this multicenter retrospective study. At baseline and after each cycle were collected clinical and diagnostic patients' parameters. The whole cohort was divided into two groups based on the age of the patients (< 75 years old and ≥ 75 years old). RESULTS: 47% of the patients were < 75 years old and 53% were ≥ 75 years old. The primary outcome, OS, does not show significant differences between the two subgroups if other basal parameters are considered. Considering clinical covariates in univariate models (p < 0.05) several clinical aspects have an impact on OS, except for age (p = 0.072). Age continues to have no significant impact on the OS (p = 0.274) even in multivariate models in the two groups. The toxic effects are similar in the two groups. CONCLUSIONS:Radium-223 prolongs survival in both younger and older patients at the same baseline condition and is a good option in the symptomatic mCRPC setting compared to other agents.
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