Efficacité et tolérance du dichlorure de radium 223 chez les patients traités pour cancer de la prostate résistant à la castration avec métastases osseuses

Abstract

IntroductionThe aim of our study was to evaluate the efficacy and tolerance of 223RaCl2 in patients with mCRPC with bone metastases, then analyse the impact of any change in treatment protocol on the efficacy of 223RaCl2 in mCRPC patients with bone metastases, by determining overall survival, progression-free survival and events occurring during therapeutic monitoring. Materiel and methodsOur retrospective, analytical and descriptive study, carried out in Luxembourg, included patients eligible for le 223RaCl2 treatment who were assessed during and at the end of treatment, and 3 to 4months after the end of treatment. ResultsOur sample included 41 cases. The mean age of patients was 74years (min=52, max=87), with 32 (78.1%) deaths recorded. Median overall survival was 18.0months (95% CI: 12.1–23.9): 11months for those who experienced progression during treatment versus 47 months for those who experienced a partial response. Median progression-free survival was 15.0 months (95% CI: 0.0–36.4). Overall survival was positively correlated with progression-free survival (Rho Spearman=0.713, P-value<0.001); however, a one-month increase in progression-free survival decreased the risk of death by 6% and thus increased overall survival (HR=0.937, 95% CI : 0.903–0.973, P<0.001). ConclusionAdministration of the complete 223RaCl2 protocol improved overall survival and progression-free survival in patients treated for mCRPC with bone metastases, with good hematological tolerability despite the occurrence of complications such as epiduritis and fractures.