Dados do Trabalho

Título

Brazilian Profile of 223Ra in Metastatic Prostate Cancer: A Multicentric, Retrospective Study.

Introdução/Justificativa

Although Ra-223 therapy has been available since 2013 for metastatic castrate-resistant prostate cancer (mCRPC), only in 2017 was Ra-223 approved by the National Health Surveillance Agency in Brazil.

Objetivos

To perform a multicenter analysis of the profile of mCPRC submitted to Ra-223 in the Brazilian Nuclear Medicine institutions and to describe their clinical outcomes.

Materiais e Métodos

A retrospective analytical study of mCRPC patients who underwent Ra-223 treatment was undertaken. All clinical and laboratory data as well as follow-up data (time to death, progression, or bone event) was evaluated.

Resultados

A total of 303 patients submitted to 1402 Ra-223 cycles from 9 centers were studied. The mean patient age was 74 years (43 – 100 years). Previous treatments prior to Ra-223 were chemotherapy (58.4%), radiation therapy (54.5%) and hormone therapy (92.3%). Ra-223 was used as second line treatment in 13.9%, third line in 26.4% and fourth or more in 58.4%. The mean number of Ra-223 cycles was 4.6. and 51% of patients completed all six cycles and 52.9% progressed during Ra-223.
Mean OS for all 303 patients completing 6 cycles compared to less than 6 cycles was 21.6 vs 8.6 months, respectively. However, when stratified according to Brazilian regions the mean OS for the southeast region was 25 months vs 10 months, respectively and the central region was 19 months vs 4 months, respectively. In contrast, southern region was 4 months and northeast region was 5 months (the latter two did not have 6 cycles completed).

Conclusão

The overall survival benefit of Ra-223 for patients completing 6 cycles was very high. However, there were major discrepancies when stratified according to regions, which most likely reflects patient referral discrepancies. The data is an important and clear demonstration of the country´s educational discrepancies as to the proper timing for Ra-223 to have maximum benefit.