Radium-223 Therapy for Patients with Metastatic Castrate-Resistant Prostate Cancer: An Update on Literature with Case Presentation

Table 1

Case #1: summary of pertinent laboratory results and imaging findings.

Lab work/imaging; (normal values)	Baseline; (within 3 mo before Radium-223)	Interim; (between injections #3 and #4)	Completion; (within 3 mo after Radium-223)	Follow-up; (6–12 mo after Radium-223)
Hb; (12.9–16.9/dL)	14.6	13.6	12.8	13.2
Platelets; (156–369 × 10^9/L)	272	256	214	267
Absolute neutrophils; (2.240–7.680 × 10^9/L)	3.000	2.100	3.200	4.100
PSA; (ng/mL)	133	232	385	1283
Alkaline phosphatase; (38–126 IU/L)	123	51	78	234
Whole-body bone scan	Widespread bone metastases with the most intense lesions located along the T-spine, L-spine, and pelvis		Previous bone metastases demonstrate interval decrease in uptake. No evidence of new bone metastasis	Some of previous skeletal metastases show interval increase in uptake; others show stable uptake. A few new tracer foci in the L-spine and pelvis are suspicious for metastases
Diagnostic CT-chest, abdomen, and pelvis	Widespread bone metastases consistent with bone scan. No evidence of soft tissue metastasis		No significant change in bone metastasis compared to baseline study. No evidence of visceral metastasis or lymphadenopathy	A few areas of diffuse osteosclerosis have developed, for example, right posterior iliac bone consistent with bone scan. Otherwise no significant change in bone metastases