Author(s): Soares De Pinho, Inês ; Esperança Martins, Miguel ; Machado, Bárbara ; Dâmaso, Sara ; Brás, Raquel ; Cantinho, Guilhermina ; Fernandes, Isabel ; Costa, Luis
Date: 2024
Persistent ID: http://hdl.handle.net/10400.5/95443
Origin: Repositório da Universidade de Lisboa
Subject(s): Bone disease; Flare; Prostate cancer; Radium-223; Response
Radium-223 dichloride (Ra223) is the first targeted alpha agent approved for treating metastatic castration-resistant prostate cancer (mCRPC) with bone-exclusive disease. A benefit in overall survival and time to the first symptomatic skeletal-related event was shown in the Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA) trial. However, this trial did not describe a bone scan response to Ra223, and there is no universal consensus about how it should be monitored. Furthermore, a scintigraphy flare phenomenon may lead to false-positive tracer uptake in responsive cases, thereby misleading the interpretation of imaging results. We present the case of a 67-year-old male with mCRPC and exclusive bone disease treated with Ra223. The bone scintigraphy after the end of the treatment showed an apparent aggravation of the lesions, corresponding to a flare phenomenon, with an almost complete resolution after three months. The patient maintained a scintigraphic response for seven months.
