Login to Access Video or Poster Abstract: MP53-20
Sources of Funding: None

Introduction

RAD is one of the new life prolonging therapeutic aproaches in symptomatic mCRPC prior to or after docetaxel treatment. According to guidelines RAD should be initiated early in the progression of mCRPC and it is not to be used as palliative therapy. We analysed the data of RAD therapy in a large single centre cohort of mCRPC patients with the purpose to explore the guideline compliance._x000D_

Methods

A total of 94 patients with symptomatic mCRPC were retrospectively analyzed. All patients had skeletal metastases and no evidence of visceral metastases. The following data were analyzed: proper pretherapeutic work-up including PSA, Hb, platelets, alk. Phos., VAS, creatinine, ECOG performance status, in-house versus external referals, number of cycles, type of pre-treatment. Oncologic outcome parameters such as cancer specific & overall survival as well as biochemical and clinical-free survival were evaluated using descriptive statistical analysis. _x000D_

Results

Mean patient age was 72.9 (52-84) years. 46 (48.9%) pts received prior DOC; 34 (36.2%) were DOC-naive and in 14 (14.9%) pts the status was unknown. Mean PSA was 267,69 (2.5-4710) ng/ml, mean alk.Phosp. was 177,4 (54.5-594) U/l and mean HB was 12.01 (9.8-15.1) g/dl. Required lab values were missing in 22.3% of pts. ECOG performance status was 0,1 and 2 in 45 (47.9%), 14 (14.9%) and 8 (8.5%), resp.; in the remainder no ECOG was documented. Pts received a mean number of 4 (1-6) cycles; 43 (47.8%) pts received 6 cycles whereas 17 (18.9%), 5 (5.6%) and 25 (27.8%) pts received 4, 5, and 3 cycles, resp. Reason for early discontinuation was: disease progression in 12, poor performance status in 10 and bone marrow suppression in 4. All in-house referals but only 21.5% of outside referals received 6 cycles Rad223. After a mean follow-up of 23.2 (3-30) months, 25 (26.6%) are DOD, 63 (67%) pts are alive and in 6 (6.4%) pts the status is unknown. There was a significant difference in survival rates between 3 and 6 cycles with 62.5% vs 81.1% (p < 0.02) as well as between outside and in-house referals (p < 0.02)._x000D_

Conclusions

Although RAD is guideline recommended therapy, clinical reality demonstrates that there the treatment is still inappropriately in 50% of the patients with a significant difference between tertiary referal centres and the community. Observed survival differences are most probably due to the low number of cycles which reflect the terminal stage of disease. More information has to be distributed in the community. _x000D_

Funding

None