The Role of Radium 223 Planar Whole-Body Scan in the Management of Patients with Bone Metastates

Abstract

The multidisciplinary treatment with targeted alpha therapy, as the treatment with Radium 223, plays an important role in the management of patients with castration resistance prostate cancer and metastatic bone disease. The AUA approved the Ra223 as the second line of treatment of castration resistance prostate cancer in patients with bone metastases, in the absence of visceral metastases. Currently the EMA authorizes the use of Ra223 at a dose of 55 kBq / kg for a total of 6 administrations in patients with CRPC, but the dose of Ra223 needs to be made on an individual patient basis taking into consideration the potential clinical benefits and risk. We have outlined a new methodology, which can be executed in all departments of nuclear medicine in collaboration with health-related physics at no cost. Our methodology allows a correct evaluation of the doses of Radium 223 to be administered and of the number of cycles to be performed, to increase the therapeutic efficacy. We can avoid overtreatment or undertreatment of patients ensuring a perfect fit between patients and Ra223 treatment. The multidisciplinary approach between nuclear physician, oncologist and health related physics is crucial throughout the treatment process to improve QoL in patients at risk.