Possibility of local radiation therapy of the prostate during radium223 therapy

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Introduction. Patients with metastatic castration-resistant prostate cancer (mCRPC) are a complex and heterogeneous group whose primary treatment goals are to both prolong life and preserve quality of life. Among patients with mCRPC, there is a group with a progressive tumor process in the prostate gland, in which local irradiation along with systemic Ra 223 (Ra223) therapy would lead to improved oncological outcomes.Purpose of the study. To evaluate the efficacy and safety of Ra223 in patients with mCRPC in routine clinical practice and to assess the feasibility of local radiation therapy of the prostate in patients with mCRPC receiving Ra223 therapy.Materials and methods. This study included 189 patients with mCRPC who received 1 to 6 injections of Ra223 as part of routine clinical practice. The patients were divided into two groups. Group 1 included patients who received systemic therapy only – 153 (81%), while group 2 consisted of patients who received local irradiation of the prostate gland along with Ra223 therapy – 36 (19%) patients.Conclusions. The use of radium223 in combination with localized radiotherapy for the treatment of the prostate has shown promising results in increasing disease control rate (DCR) in patients with mCRPC. Concurrent localized irradiation of the prostate against the radium223 therapy background did not show the result in increased hematological toxicity, which favorably affecting the tolerability of the radionuclide treatment. At the same time, localized radiation reactions occurring during localized prostate irradiation did not prevent patients from completing the full course (six injections) of the radionuclide radium223 treatment.