Onkológia 5/2016

Radium 223Ra in the treatment of bone malignancies

Radium 223Ra (radium-223) in aqueous isotonic radium dichloride solution is a modern bone seeking nuclear medicine agent (radiopharmaceutical) which mimics calcium and acts via high-energy alpha decay. Many preclinical and clinical research studies have already confirmed the antitumor action of radium 223Ra in progressive metastatic bone tumors. Current studies and clinical trials are focused to explain the mechanisms of radium action and validate the treatment in proper patient groups. Thanks to the results of ALSYMPCA (ALpharadin in SYMptomatic Prostate CAncer) trial, confirming the overall survival benefit of radium 223Ra, it has been approved in developed countries to treat selected castration-resistant prostate cancer patients with symptomatic bone metastases. The presented review article introduces the general and still poorly known facts about radium 223Ra from the point of view of nuclear medicine physicians and pharmacists, which are directly involved in the discovery, research, manufacturing, clinical guidelines development, and, last but not least, clinical administration of the radiopharmaceutical to individual patients.

Keywords: radium 223Ra, radionuclide therapy, alpha particles, beta particles, bone tumors, metastases, prostate cancer