Retrospective analysis of xofigo treatments

Conclusions: Less than half of the patients in this study completed the full series of 6 injections, with patient death being the leading cause for premature termination of treatment. Furthermore, half the patients that died during treatment received 2 injections or less. These findings suggests that referrals for this treatment may be coming too late in the course of the patient’s disease course. Rising PSA levels was the second most common cause for treatment discontinuation. In patients who had both PSA and ALP levels monitored during treatment, PSA remained stable or increased in 83% of the patients who completed 3 or more injections while 73% had decreasing ALP levels. This suggests that ALP levels could potentially be a better marker of treatment response than PSA; however, no definitive conclusion can be drawn due to small size of this study. These findings are of relevance because the clinical (survival, etc.) benefit of less than 6 injections has not been established, and incomplete treatment could potentially lead to more harm than benefit.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Technologist Student Papers I Source Type: research

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Conclusions The recent, first randomized clinical trial demonstrated overall and progression free survival benefits after SBRT to oligometastatic disease which supports prior retrospective case series (6). The spine is a common site of metastatic bone disease, and as high quality data continue to mature, along with completion of additional randomized clinical trials, it is expected that utility of SBRT to the spine will increase in the future. Spine SBRT is unique due to the requirement of sharp dose falloff to prevent serious neurologic morbidity. With recent advances in radiotherapy planning, robotic patient positionin...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
This article offers a narrative review on the armamentarium of bone-targeting radiopharmaceuticals based on currently approved investigational and potentially useful radionuclides and examines their efficacy for the treatment of painful skeletal metastases. In addition, the article also highlights the processes, opportunities, and challenges involved in the development of bone-seeking radiopharmaceuticals. Radium-223 is the first agent in this class to show an overall survival advantage in castration-resistant prostate cancer (CRPC) patients with bone metastases. This review summarizes recent advances, current clinical pra...
Source: Current Medicinal Chemistry - Category: Chemistry Authors: Tags: Curr Med Chem Source Type: research
The objective of this study was to determine the impact of intravenous (IV) acetaminophen when added to the perioperative analgesic regimen for robotic-assisted laparoscopic prostatectomy (RALP) on hospital length of stay (LOS), postoperative pain scores, and opioid consumption. In this prospective, randomized, double-blind, placebo-controlled trial, a total of 86 patients undergoing RALP were prospectively enrolled and randomly assigned to receive either 1 g IV acetaminophen (study group; n = 43) or IV placebo (n = 43) within 15 minutes following the induction of anesthesia and pr...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
Painful osseous metastasis resulting from castration-resistant prostate carcinoma is a common clinical problem. Historically, nuclear medicine offered several palliative beta-emitting radiopharmaceuticals targeting the skeleton with the goal of decreasing pain. However, these have largely been replaced by the alpha-emitting agent 223radium (Ra). 223Ra received Food and Drug Administration approval in 2013 for the treatment of metastatic castration-resistant prostate cancer with symptomatic bone metastases without visceral metastases. 223Ra offers an improved therapeutic profile due to its alpha-particle emissions resulting...
Source: American Journal of Clinical Oncology - Category: Cancer & Oncology Tags: Review Articles Source Type: research
This study explores the experiences of patients, and their family members providing care, while living with advanced prostate cancer.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Patient-reported outcomes (PROs) are increasingly assessed as part of trials for new medical treatments for multiple myeloma. Pain, particularly bone pain, is an important symptom for patients with myeloma. Although time to pain progression has been evaluated as an endpoint in prostate cancer trials, this endpoint has yet to be applied in multiple myeloma despite the importance of this symptom. We sought to evaluate key issues for defining time to pain progression endpoints using two trials of anti-myeloma products submitted to the FDA.We combined data from two trials, each of which used the 0-10 point worst pain intensity...
Source: Blood - Category: Hematology Authors: Tags: 904. Outcomes Research-Malignant Conditions: Poster I Source Type: research
CONCLUSION: Although surgery doesn't improve cancer specific survival in patients with skeletal metastatic prostate cancer in the short term, but offers better local control, improves biochemical relapse-free survival, might prevent excessive interventions, reduce bone pain and metastasis. PMID: 30393838 [PubMed - as supplied by publisher]
Source: Urology Journal - Category: Urology & Nephrology Authors: Tags: Urol J Source Type: research
Abstract Painful osseous metastasis resulting from castration-resistant prostate carcinoma is a common clinical problem. Historically, nuclear medicine offered several palliative beta-emitting radiopharmaceuticals targeting the skeleton with the goal of decreasing pain. However, these have largely been replaced by the alpha-emitting agent radium (Ra). Ra received Food and Drug Administration approval in 2013 for the treatment of metastatic castration-resistant prostate cancer with symptomatic bone metastases without visceral metastases. Ra offers an improved therapeutic profile due to its alpha-particle emissions ...
Source: Clinical Prostate Cancer - Category: Cancer & Oncology Authors: Tags: Am J Clin Oncol Source Type: research
ConclusionsApproximately two-thirds of patients who undergo treatment with radium-223 will experience an improvement in pain and, if it occurs, it will most likely occur within the first two cycles. Patients should be counseled about this timeline and, if pain improvement isn't achieved, palliative radiation and oral analgesic readjustment should be considered. Pain response is not associated with survival and should not be used to evaluate the effectiveness of treatment.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
By SAURABH JHA Of my time arguing with doctors, 30 % is spent convincing British doctors that their American counterparts aren’t idiots, 30 % convincing American doctors that British doctors aren’t idiots, and 40 % convincing both that I’m not an idiot. A British doctor once earnestly asked whether American physicians carry credit card reading machines inside their white coats. Myths about the NHS can be equally comical. British doctors don’t prostate every morning in deference to the NHS, like the citizens of Oceania sang to Big Brother in Orwell’s dystopia. Nor, in their daily rounds, do the...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: OP-ED Uncategorized AlfieEvans Source Type: blogs
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