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

Table 2

Case #2: 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)	11.2	11.0	8.4	9.6
Platelets; (156–369 × 10^9/L)	209	141	119	37
Absolute neutrophils (2.240–7.680 × 10^9/L)	4.400	1.500	1.300	2.100
PSA; (ng/mL)	33	168	310	396
Alkaline phosphatase; (38–126 IU/L)	110	79	94	201
Whole-body bone scan	Widespread bone metastases including bilateral proximal humerus, right parasagittal skull, sternum, ribs, spine, and pelvis		Previous bone metastases show interval decrease in uptake. New foci of mildly increased uptake are present in the right skull, ribs, right acromion and left femur	Significant increase in bone uptake, less pronounced in previously treated lesions and more pronounced in lesions developing after Xofigo
Diagnostic CT-chest, abdomen, and pelvis	Widespread bone metastases consistent with bone scan. No evidence of local recurrence in the prostatectomy bed. Stable 1.1 cm right external iliac chain node		No significant change in bone metastases. There is new lymphadenopathy including the axillae, mediastinum, retroperitoneum, and pelvis	Progression of widespread bone metastases consistent with bone scan as well as extensive lymphadenopathy