Abstract
A 70-year-old man affected by bone metastases from castration resistant prostate cancer underwent Alpharadin (223Ra-dichloride) therapy (6 administrations of 50 kBq per kg i.v., once every 4 weeks). The inter-fraction variability of the absorbed dose to lesions was evaluated for four injections. Dosimetric assessments were performed following the MIRD approach and a recently published methodology. The mean absorbed dose and standard deviation for 4 lesions [mean (σ %)] were: 434 mGy (15 %) and 516 mGy (21 %) for the right and left humeral head, 1205 mGy (14 %) and 781 mGy (8 %) for the right and left glenoid. The estimated total absorbed dose after the whole treatment, considering also the relative-biological effectiveness of alpha particles (RBE = 5), yielded a D RBE range of 13–36 Gy. A good correlation between 99mTc and 223Ra uptake was obtained (R 2 = 0.7613). The tumour–non-tumour (TNT) ratio of 8 lesions (those above, plus 4 additional), monitored by six 99mTc-MDP bone scans over a period of about 10 months, evidenced a TNT reduction in two lesions (−42 and −48 %), but in most lesions the TNT remained fairly constant, evidencing that 223Ra-dichloride therapy tends to prevent further progression of osseous disease, leading to chronicity of the metastatic status.
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The patient enrolled in this research was participating in a multicenter study (protocol 88-8223/16216) sponsored by Bayer HealthCare Pharmaceuticals, entitled “Radium-223 chloride in treatment of CRPC patients with bone metastasis”. The authors declare that this study complies with the current law of the country (Italy) where it was performed.
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Pacilio, M., Ventroni, G., Cassano, B. et al. A case report of image-based dosimetry of bone metastases with Alpharadin (223Ra-dichloride) therapy: inter-fraction variability of absorbed dose and follow-up. Ann Nucl Med 30, 163–168 (2016). https://doi.org/10.1007/s12149-015-1044-9
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DOI: https://doi.org/10.1007/s12149-015-1044-9