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前立腺癌は,2014年の男性部位別癌罹患数は73,764人,年齢調整罹患率は10万人あたり58.7(1985年人口モデル)で第4位であり,2011年と比較しやや減少がみられるが,2016年の死亡数は11,803人,膵臓に次いで6番目であり,年齢調整罹患率は10万人あたり7.1(1985年人口モデル)とここ数年横ばいである。今後,罹患数・死亡数ともに増加すると予想されている1)。
Radiopharmaceuticals used for treatment of prostate cancer are Strontium-89(Sr-89)and Radium-223(Ra-223). Sr-89 is a pure beta emitter for pain relief of metastatic bone cancer. Ra-223 is an alpha emitter for the treatment of bone metastasis with castration resistant prostate cancer(CRPC). Ra-223 has a lower frequency of adverse events such as bone marrow suppression compared with Sr-89, but the combination with abiraterone acetate and the corticosteroid prednisone or prednisolone is prohibited. The optimal administration method is to be studied in the future.
As for the diagnostic tool, quantitative evaluation of bone scintigraphy(Tc-99m MDP/HMDP)has high utility as an imaging biomarker for predicting the therapeutic effect and prognosis.
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