RADIONUCLIDE THERAPY FOR BONE LESIONS IN CASTRATION-RESISTANT PROSTATE CANCER (STATE-OF-THE-ART LITERATURE REVIEW)

Abstract

The scope of scientific literature was reviewed to summarize the data on the 223Ra-dichloride therapy for castrationresistant forms of prostate cancer. Key advantages of the alpha-emitters over beta-emitting radionuclides are highlighted in the treatment of hormone-resistant bone metastases. Data demonstrating an association between the 223Ra-dichloride treatment effectiveness and absorbed therapeutic doses were analyzed. Dependence between the 223Ra and 18F-fluoride absorbed doses in bone metastases was evaluated, which should be taken into account in a positron emission tomography monitoring. Results of studies examining the uptake of 18F-fluoride to predict the 223Ra-dichloride accumulation during the first course of treatment were analyzed. Research areas requiring further concern have been identified through the literature review, namely: study of the relationship between an absorbed dose and other clinically relevant endpoints, including pain index, changes in alkaline phosphatase or prostate antigen levels, survival rates, and development of alternative treatment regimens depending on the therapeutic radiopharmaceutical dose. Key words: castration-resistant prostate cancer, bone metastases, 223Ra-dichloride radionuclide therapy.