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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Skeletal Tumor Burden on Baseline 18F-Fluoride PET/CT Predicts Bone Marrow Failure After 223Ra Therapy

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Etchebehere, Elba C. [1, 2] ; Araujo, John C. [3] ; Milton, Denai R. [4] ; Erwin, William D. [5] ; Wendt, III, Richard E. ; Swanston, Nancy M. [1] ; Fox, Patricia [4] ; Macapinlac, Homer A. [1] ; Rohren, Eric M. [1]
Total Authors: 9
[1] Univ Texas MD Anderson Canc Ctr, Dept Nucl Med, 1400 Pressler, FCT 16-6005, Unit 1483, Houston, TX 77030 - USA
[2] Univ Estadual Campinas, Dept Nucl Med, Campinas, SP - Brazil
[3] Univ Texas MD Anderson Canc Ctr, Dept Genitourinary Med Oncol, Houston, TX 77030 - USA
[4] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 - USA
[5] III, Univ Texas MD Anderson Canc Ctr, Dept Imaging Phys, Houston, TX 77030 - USA
Total Affiliations: 5
Document type: Journal article
Source: CLINICAL NUCLEAR MEDICINE; v. 41, n. 4, p. 268-273, APR 2016.
Web of Science Citations: 15

Purpose Determine if skeletal tumor burden on F-18-fluoride PET/CT (fluoride PET/CT) predicts the risk of bone marrow failure (BMF) after Ra-223 dichloride therapy (Ra-223). Methods Forty-one metastatic prostate cancer patients (43-89 years old; mean, 71 +/- 9 years.) underwent fluoride PET/CT prior to Ra-223. Bone marrow failure was the primary end point and was defined as (1) development of hematologic toxicity (World Health Organization grade 3 or 4) associated with no recovery after 6 weeks or (2) death due to BMF after the last Ra-223 dose. Bone marrow failure was correlated to fluoride PET/CT skeletal tumor burden (TLF10 {[}total lesion on fluoride PET/CT with SUVmax of 10 or greater]), use of chemotherapy, serum hemoglobin concentration, serum ALP, and serum prostate-specific antigen. Results The number of Ra-223 cycles ranged from 2 to 6 (mean, 5). Of the 41 patients, 16 developed BMF (G3 = 12; G4 = 4). A significantly increased risk of developing BMF was observed in patients with TLF10 of 12,000 or greater (hazard ratio {[}HR], 11.09; P < 0.0001), hemoglobin of less than 10 g/dL (HR, 7.35; P = 0.0002), and AP > 146 UI/L (HR, 4.52; P = 0.0100). Neither concomitant (HR, 0.91; P = 0.88) nor subsequent use of chemotherapy (HR, 0.14; P = 0.84) increased the risk of BMF, nor was prostate-specific antigen greater than 10 mu g/L (HR, 0.90; P = 0.86). Moreover, in a multivariable analysis, TLF10 was the only independent predictor of BMF (HR, 6.66; P = 0.0237). Conclusions Ra-223 was beneficial and reduced the risk of death even in patients with a high skeletal tumor burden. Fluoride PET/CT is able to determine which patients will benefit from Ra-223 and which will develop BMF. (AU)

FAPESP's process: 14/03317-8 - Fluoride-18F PET/CT to evaluate effectiveness of treatment of metastatic prostate cancer with Ra-223
Grantee:Elba Cristina Sá de Camargo Etchebehere
Support type: Scholarships abroad - Research