Radium-223 dichloride in clinical practice: a review

  • Luigia Florimonte
  • Luca Dellavedova
  • Lorenzo Stefano Maffioli
Review Article


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.


Radium-223 dichloride Bone metastasis α-Emitters Overall survival 



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

Compliance with ethical standards



Conflicts of interest

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

Ethical approval

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


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Luigia Florimonte
    • 1
  • Luca Dellavedova
    • 2
  • Lorenzo Stefano Maffioli
    • 3
  1. 1.Nuclear Medicine DepartmentFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  2. 2.Nuclear Medicine DepartmentA.S.S.T Ovest Milanese, Ospedale di LegnanoLegnanoItaly
  3. 3.Nuclear Medicine and Multi-Hospital Oncology DepartmentA.S.S.T Ovest Milanese Ospedale di LegnanoLegnanoItaly

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