E-ISSN 2305-1620 | ISSN 2221-0288
 

Case Report

Online Publishing Date:
19 / 06 / 2018

 


Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report

Tatiana Kochetova, Valeriy Krylov.


Abstract
Ra-223 therapy is recommended for Castration Resistant Prostate Cancer (CRPC) patients with bone metastases. The standard protocol is 5-6 cycles of therapy with 4 weeks intervals to gain survival benefit. We report a case of a chemo-naive CRPC patient who after 1.5 years of androgendeprivation therapy had widespread bone metastases, PSA of 4186 ng/ml, alkaline phosphatase (ALP) at 2982 U/l, bone marrow involvement with anaemia and thrombocytopaenia. 223RaCl2 therapy was started in August 2014. After the first two cycles of 223RaCl2 PSA dropped to 70 ng/ml, ALP to 877 U/l. The third cycle was delayed for 5.5 months due to technical reasons. Unexpectedly, during Ra-223 therapy interruption the positive changes were still ongoing. PSA-level decreased further, to 0.28 ng/l and ALP to 254 U/l. Hb level increased from 101 to 125 g/l, PLT from 105 to 180x109/l. After the interruption the patient received 4 planned cycles. Control bone scan after the 4th cycle revealed pathological uptake only in shoulder joints and sternum. In the follow-up period the patient demonstrated minimal disease signs: with normal ALP level, PSA 0.11 ng/ml. Ra-223 Therapy can give anti-tumour effect, as can be seen from the significant decrease in the PSA level. Breaks in Ra-223 Therapy are not dramatic. After interruption, it can be continued again. This fact can be taken into account while planning therapy. As shown here, clinical cases such the one we have reported, may allow a degree of flexibility to the standard recommendations on a case to case basis.

Key words: Radium-223, Castration resistant prostate cancer, Bone metastases


 
ARTICLE TOOLS
Abstract
PDF Fulltext
How to cite this articleHow to cite this article
Citation Tools
Related Records
 Articles by Tatiana Kochetova
Articles by Valeriy Krylov
on Google
on Google Scholar


How to Cite this Article
Pubmed Style

Kochetova T, Krylov V. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pak J Nucl Med. 2017; 7(1): 38-41. doi:10.24911/PJNMed.7.7


Web Style

Kochetova T, Krylov V. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. https://www.pjnmed.com/?mno=302240 [Access: February 27, 2024]. doi:10.24911/PJNMed.7.7


AMA (American Medical Association) Style

Kochetova T, Krylov V. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pak J Nucl Med. 2017; 7(1): 38-41. doi:10.24911/PJNMed.7.7



Vancouver/ICMJE Style

Kochetova T, Krylov V. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pak J Nucl Med. (2017), [cited February 27, 2024]; 7(1): 38-41. doi:10.24911/PJNMed.7.7



Harvard Style

Kochetova, T. & Krylov, . V. (2017) Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pak J Nucl Med, 7 (1), 38-41. doi:10.24911/PJNMed.7.7



Turabian Style

Kochetova, Tatiana, and Valeriy Krylov. 2017. Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pakistan Journal of Nuclear Medicine, 7 (1), 38-41. doi:10.24911/PJNMed.7.7



Chicago Style

Kochetova, Tatiana, and Valeriy Krylov. "Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report." Pakistan Journal of Nuclear Medicine 7 (2017), 38-41. doi:10.24911/PJNMed.7.7



MLA (The Modern Language Association) Style

Kochetova, Tatiana, and Valeriy Krylov. "Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report." Pakistan Journal of Nuclear Medicine 7.1 (2017), 38-41. Print. doi:10.24911/PJNMed.7.7



APA (American Psychological Association) Style

Kochetova, T. & Krylov, . V. (2017) Successful Ra-223 treatment with a long interval between the second and the third cycles: a case report. Pakistan Journal of Nuclear Medicine, 7 (1), 38-41. doi:10.24911/PJNMed.7.7





Most Viewed Articles
Most Accessed Articles

  • Determination of the optimum filter for 99mTc SPECT breast imaging using a wire mesh collimator
    Xianling Dong, M I Saripan, R Mahmud, S Mashohor, Aihui Wang
    Pak J Nucl Med. 2017; 7(1): 9-15
    » Abstract » doi: 10.24911/PJNMed.7.2

  • Behaviour of wedges for different field sizes and depths
    Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi
    Pak J Nucl Med. 2017; 7(1): 20-27
    » Abstract » doi: 10.24911/PJNMed.7.4

  • Pre-operative cardiac risk stratification for noncardiac surgery in cancer patients using myocardial perfusion scintigraphy
    Iqbal Munir, Amrah Javaid, Khalid Nawaz, Mohammed Hathaf Al-Rowaily, Muaadh Abdualrehman Al-Asbahi
    Pak J Nucl Med. 2017; 7(1): 28-33
    » Abstract » doi: 10.24911/PJNMed.7.5

  • Clinical characteristics and long-term outcome of patients with differentiated carcinoma of thyroid with bone metastases: a retrospective study
    Sadaf Tufail Butt, Shazia Fatima, Noreen Marwat, Kahkashan Mir, Ayesha Ammar, Mohammad Faheem
    Pak J Nucl Med. 2017; 7(1): 34-37
    » Abstract » doi: 10.24911/PJNMed.7.6

  • A brief review of targetted radionuclide therapies
    Mohammed Hathaf Al-Rowaily, Daniele Dondi, MarcoChinol, Iqbal Munir, Muaadh Abdualrehman Alasbahi
    Pak J Nucl Med. 2017; 7(1): 4-8
    » Abstract » doi: 10.24911/PJNMed.7.1

  • Most Downloaded
    Top Downloaded Articles

  • Behaviour of wedges for different field sizes and depths
    Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi
    Pak J Nucl Med. 2017; 7(1): 20-27
    » Abstract » doi: 10.24911/PJNMed.7.4

  • Determination of the optimum filter for 99mTc SPECT breast imaging using a wire mesh collimator
    Xianling Dong, M I Saripan, R Mahmud, S Mashohor, Aihui Wang
    Pak J Nucl Med. 2017; 7(1): 9-15
    » Abstract » doi: 10.24911/PJNMed.7.2

  • Characterization of SIEMENS Symbia T SPECT camera in Monte Carlo simulation environment
    Xianling Dong, Mahmud Iqbal Saripan, Rozi Mahmud, Syamsiah Mashohor, Aihui Wang,
    Pak J Nucl Med. 2018; 8(1): 18-26
    » Abstract » doi: 10.24911/PJNMed.175-1540569779

  • A historic review of the discovery of the medical uses of radioiodine
    Barbara Hertz, Pushan Bharadwaj, Bennett Greenspan
    Pak J Nucl Med. 2020; 10(1): 60-63
    » Abstract » doi: 10.24911/PJNMed.175-1582813482

  • A brief review of targetted radionuclide therapies
    Mohammed Hathaf Al-Rowaily, Daniele Dondi, MarcoChinol, Iqbal Munir, Muaadh Abdualrehman Alasbahi
    Pak J Nucl Med. 2017; 7(1): 4-8
    » Abstract » doi: 10.24911/PJNMed.7.1

  • Most Cited Articles
    Most Cited Articles