Japanese
English
- 有料閲覧
- Abstract 文献概要
- 1ページ目 Look Inside
- 参考文献 Reference
前立腺がんの骨転移は造骨性が多く,去勢抵抗性前立腺がん(CRPC)の末期になると約90%が骨転移を有し,骨痛や病的骨折などの症候性骨関連事象を呈する。α線放射線治療薬の塩化ラジウム-223(Ra-223)は,骨痛の軽減などQOLの改善とともに,骨治療薬として初めてCRPCの全生存期間延長を示した。有害事象として,貧血・好中球減少・血小板減少など血液毒性や,悪心・下痢・骨痛などの非血液毒性があるが,軽微であり忍容性は高い。化学療法前の新規ホルモン剤を投与中に前立腺特異抗原(PSA)上昇を来している時や骨痛などの症状が出てきた時が,Ra-223の6回投与完遂の至適タイミングである。
In patients with castration resistant prostate cancer(CRPC), the most frequent site of metastases is bone particularly with osteoblastic change, which accounts for 90% at the late stage of CRPC and is accompanied by symptomatic skeletal symptoms(SSEs)such as bone pain or pathological fractures. Radium-223(Ra-223)dichloride emits α particles and has been proven to improve overall survival(OS)and QOL by reducing SSEs in metastatic CRPC patients. Although hemotoxic adverse events(AEs)of Ra-223 treatment including anemia, neutropenia and thrombocytopenia, and non-hemotoxic AEs including nausea, diarrhea and bone pain have been reported, they were mild and well tolerated. The completion of 6 injections of Ra-223 is important for prolonging OS. The optimal time of Ra-223 administration is recommended the duration when PSA is increasing regardless of abiraterone or enzalutamide treatment prior to chemotherapy.