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Strontium-89 for prostate cancer with bone metastases: the potential of cancer control and improvement of overall survival

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Abstract

Objective

Strontium-89 (Sr-89) has been considered to have a tumoricidal effect with minimal adverse events. However, few reports have investigated these effects in detail. In this study, we examined the tumoricidal and pain-relief effects of Sr-89 on prostate cancer with bone metastasis as well as survival.

Methods

A retrospective study was performed involving 31 prostate cancer patients with bone metastasis treated with Sr-89. Using PSA as an evaluation criterion of cancer control, patients were divided into PSA responder and non-responder groups, and the survival rates of these groups were compared. In addition, using the total amount of painkillers administered as an evaluation criterion of pain relief, patients were divided into pain responder and non-responder groups, and the survival rates of these groups were also compared. As secondary investigation items, age, PSA (ng/ml), pain site, extent of the disease, the presence or absence of castration-resistant prostatic cancer (CRPC), the presence or absence of a past medical history of treatment with docetaxel in CRPC cases, Gleason Score, hemoglobin (g/dl), platelet (Plt) (/μl), serum carboxyterminal telopeptide of type I collagen (ng/ml), and bone-alkaline phosphatase (BAP) (U/l) were investigated.

Results

Longer survival was expected for the PSA responder group than for the PSA non-responder group, and whether the spine was the pain site and the presence or absence of CRPC were useful as predictors of this. Plt was suggested to be a useful indicator. Furthermore, the survival time was significantly longer in the pain responder group than in the pain non-responder group, and whether the pain site was present in the spine was considered to be a predictor; however, no significant difference was noted in any of the items assumed to be biomarkers.

Conclusions

Sr-89 has the potential to control PSA and prolong survival. A large-scale prospective study of the therapeutic effect of Sr-89 is expected.

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References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  PubMed  Google Scholar 

  2. Namiki M, Akaza H, Lee SE, Song JM, Umbas R, Zhou L, et al. Prostate Cancer Working Group report. Jpn J Clin Oncol. 2010;40(Suppl 1):i70–5.

    Article  PubMed  Google Scholar 

  3. Nakata S, Ohtake N, Yamanaka H. Epidemiology of prostate cancer in Japan. Nihon Rinsyo. 2011;69(Suppl 5):181–6 (in Japanese).

    Google Scholar 

  4. Armstrong AJ, Tannock IF, de Wit R, George DJ, Eisenberger M, Halabi S. The development of risk groups in men with metastatic castration-resistant prostate cancer based on risk factors for PSA decline and survival. Eur J Cancer. 2010;46:517–25.

    Article  CAS  PubMed  Google Scholar 

  5. Blake GM, Zivanovic MA, Blaquiere RM, Fine DR, McEwan AJ, Ackery DM. Strontium-89 therapy: measurement of absorbed dose to skeletal metastases. J Nucl Med. 1988;29:549–57.

    CAS  PubMed  Google Scholar 

  6. Zyskowski A, Lamb D, Morum P, Hamilton D, Johnson C. Strontium-89 treatment for prostate cancer bone metastases: does a prostate-specific antigen response predict for improved survival? Australas Radiol. 2001;45:39–42.

    Article  CAS  PubMed  Google Scholar 

  7. Armstrong AJ, Tannock IF, de Wit R, George DJ, Eisenberger M, Halabi S. The development of risk groups in men with metastatic castration-resistant prostate cancer based on risk factors for PSA decline and survival. Eur J Cancer. 2010;46:517–25.

    Article  CAS  PubMed  Google Scholar 

  8. de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet. 2010;376:1147–54.

    Article  PubMed  Google Scholar 

  9. Scher HI, Fizazi K, Saad F, Taplin ME, Sternberg CN, Miller K, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012;367:1187–97.

    Article  CAS  PubMed  Google Scholar 

  10. Porter AT, McEwan AJ, Powe JE, Reid R, McGowan DG, Lukka H, et al. Results of a randomized phase-III trial to evaluate the efficacy of strontium-89 adjuvant to local field external beam irradiation in the management of endocrine resistant metastatic prostate cancer. Int J Radiat Oncol Biol Phys. 1993;25:805–13.

    Article  CAS  PubMed  Google Scholar 

  11. Turner SL, Gruenewald S, Spry N, Gebski V, Metastron Users Group. Less pain does equal better quality of life following strontium-89 therapy for metastatic prostate cancer. Br J Cancer. 2001;84:297–302.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Yoshimura M, Saito K, Park J, Akata S, Koizumi K, Tokuue K, et al. Tumoricidal effect of strontium-89. Clin Nucl Med. 2011;36:296–9.

    Article  PubMed  Google Scholar 

  13. Tu SM, Lin SH, Podoloff DA, Logothetis CJ. Multimodality therapy: bone-targeted radioisotope therapy of prostate cancer. Clin Adv Hematol Oncol. 2010;8:341–51.

    PubMed  Google Scholar 

  14. Vengalil S, O’Sullivan JM, Parker CC. Use of radionuclides in metastatic prostate cancer: pain relief and beyond. Curr Opin Support Palliat Care. 2012;6:310–5.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Ibaraki Medical Centre, Tokyo Medical University, 3-20-1 Chuou, Ami, Inashiki, Ibaraki, 300-0395, Japan

    Isao Kuroda

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  1. Isao Kuroda
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Correspondence to Isao Kuroda.

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Kuroda, I. Strontium-89 for prostate cancer with bone metastases: the potential of cancer control and improvement of overall survival. Ann Nucl Med 28, 11–16 (2014). https://doi.org/10.1007/s12149-013-0775-8

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  • DOI: https://doi.org/10.1007/s12149-013-0775-8

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