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A National Multicenter Study on overall survival in elderly metastatic castrate-resistant prostate cancer patients treated with Radium-223

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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.

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Authors and Affiliations

  1. Department of Molecular Medicine Sapienza, “Sapienza” University of Rome, Viale Regina Elena 324, 00161, Rome, Italy

    Viviana Frantellizzi

  2. Radiation Oncology Center, S.Orsola-Malpighi Hospital, Bologna, Italy

    Fabio Monari & Valeria Dionisi

  3. Unit of Nuclear Medicine, “Spirito Santo” Hospital, Pescara, Italy

    Manlio Mascia

  4. Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy

    Renato Costa & Alessandra Murabito

  5. Nuclear Medicine Department, University of Bari “Aldo Moro”, Bari, Italy

    Giuseppe Rubini, Valentina Lavelli & Anna Giulia Nappi

  6. Unit of Nuclear Medicine, Department of Medical Surgical and Experimental Sciences, University of Sassari, Sassari, Italy

    Angela Spanu & Susanna Nuvoli

  7. Department of Economics & Finance, University of Rome “Tor Vergata”, Rome, Italy

    Alessio Farcomeni

  8. Nuclear Medicine Unit, S.Orsola-Malpighi Hospital, Bologna, Italy

    Elisa Lodi Rizzini

  9. Department of Urology, “Villa Stuart” Private Hospital, Rome, Italy

    Luca Cindolo

  10. Department of Radiological Sciences, Oncology and Anatomical Pathology Sapienza, “Sapienza” University of Rome, Rome, Italy

    Laura Cosma, Marco Andreola & Giuseppe De Vincentis

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  1. Viviana Frantellizzi
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Corresponding author

Correspondence to Viviana Frantellizzi.

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This study was approved by the local Ethical Committee and was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments.

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Frantellizzi, V., Monari, F., Mascia, M. et al. A National Multicenter Study on overall survival in elderly metastatic castrate-resistant prostate cancer patients treated with Radium-223. Aging Clin Exp Res 33, 651–658 (2021). https://doi.org/10.1007/s40520-020-01573-5

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