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Radium-223 dichloride in clinical practice: a review

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Abstract

The onset of skeletal metastases is typical of advanced-stage prostate cancer and requires a multidisciplinary approach to alleviate bone pain and try to delay disease progression. The current therapeutic armamentarium includes conventional analgesics, chemotherapeutic agents, immunotherapy, androgen-deprivation therapy, osteoclast inhibitors (bisphosphonates, denosumab), surgical interventions, external-beam radiotherapy and radionuclide metabolic therapy. Many studies in recent decades have demonstrated the efficacy of various radiopharmaceuticals, including strontium-89 and samarium-153, for palliation of pain from diffuse skeletal metastases, but no significant benefit in terms of disease progression and overall survival has been shown. The therapeutic landscape of metastatic skeletal cancer significantly changed after the introduction of radium-223, the first bone-homing radiopharmaceutical with disease-modifying properties. In this paper we extensively review the literature on the use of radium-223 dichloride in metastatic castration-resistant prostate cancer.

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Acknowledgments

The authors gratefully acknowledge the assistance of Mrs. Sara Vaghi in editing the manuscript and for secretarial support.

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Authors and Affiliations

  1. Nuclear Medicine Department, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy

    Luigia Florimonte

  2. Nuclear Medicine Department, A.S.S.T Ovest Milanese, Ospedale di Legnano, Via Papa Giovanni Paolo II, Legnano, Italy

    Luca Dellavedova

  3. Nuclear Medicine and Multi-Hospital Oncology Department, A.S.S.T Ovest Milanese Ospedale di Legnano, Via Papa Giovanni Paolo II, Legnano, Italy

    Lorenzo Stefano Maffioli

Authors
  1. Luigia Florimonte
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  2. Luca Dellavedova
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  3. Lorenzo Stefano Maffioli
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Correspondence to Lorenzo Stefano Maffioli.

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L.M. has received financial support to attend EANM symposia from Bayer. The other authors declare no conflicts of interest.

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This article does not describe any studies with human participants or animals performed by any of the authors.

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Florimonte, L., Dellavedova, L. & Maffioli, L.S. Radium-223 dichloride in clinical practice: a review. Eur J Nucl Med Mol Imaging 43, 1896–1909 (2016). https://doi.org/10.1007/s00259-016-3386-5

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  • DOI: https://doi.org/10.1007/s00259-016-3386-5

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