Ra-223 Alpha Treatment in Prostate Cancer
Journal Title: Nükleer Tıp Seminerleri - Year 2018, Vol 4, Issue 3
Abstract
Prostate cancer is the second most frequent malignant disease in men. Several therapeutic agents have been approved during the last decade. In this group of patients, serum testosterone levels are initially suppressed by anti-hormonal treatments for disease control. However, almost all patients eventually acquire resistance to anti-hormonal treatments, ending up with metastases. Radium-223 (Ra-223) (Xofigo®) is the first alpha-emitting radiopharmaceutical approved for the treatment of patients with metastatic castration-resistance prostate cancer (mCRPC) with bone metastases. Radium-223 dichloride is a calcium-mimetic agent that specifically targets bone lesions. The radiobiological effects of Ra-223 are mainly based on the direct damage to tumor-cell DNA via alpha particles. Thanks to their high linear energy transfer and a very short range, alpha particles produce a dense ionization around the disintegration site. The high linear energy transfer leads to cytotoxic effects that are independent of the oxygen concentration. Ra-223 has been demonstrated to prolong overall survival as well as to provide palliative pain relief and improved quality of life in patients with mCRPC with bone metastases in several studies, particularly in the phase III ALSYMPCA trial. This review focuses on the mechanisms and effectiveness of Ra-223 treatment, with emphasis on the contribution of current studies to our understanding and clinical practice.
Authors and Affiliations
Nalan Alan Selçuk, Faruk Yencilek
New Radiopharmaceuticals and Preclinical Imaging
Advances in the field of nuclear medicine are concerned with the development of specific diagnosis and treatment radiopharmaceuticals. The success of molecular imaging and treatment depends on the selective accumulation...
Last Step in Diagnostic Imaging: Integrated PET/MR Systems and First Experiences in Turkey
The integration of PET and MRI imaging, to make these devices simultaneously work in a single system has been an ongoing research project for at least 20 years. The incompatibility of MRI and PET was mainly due to the hi...
Sentinel Lymph Node Biopsy for Gastrointestinal Cancers
In the treatment of gastrointestinal cancer (GIC), the exact assessment of the lymph node status is the most important factor in determining the clinical outcome of patients. The benefit of sentinel lymph node imaging in...
Imaging in Prostate Cancer Staging
Prostate cancer is frequently encountered among men and it is also a health problem with high diagnostic and treatment costs. Studies showed that appropriate risk stratification can improve oncologic outcomes, therefore...
Acute Local Radiation Injury and Treatment Methods
Local radiation injury (LRI) is the clinical condition that results from exposure to high-dose ionizing radiation at a certain area of the body. In the early period of an emergency, the diagnosis of LRI is based primaril...