Using external beam radiation treatment as an adjunct in radium-223 treatment

Castrate-resistant prostate cancer (CRPC) commonly metastasizes to the bone, afflicting 90% of these patients. Radium-223 dichloride (²²³Ra) has proven promising in the treatment of CRPC patients, prolonging life and reducing bone-turnover systemically. However, many patients undergoing ²²³Ra treatment require further palliation of pain. External beam radiation treatment (EBRT) may therefore be used in between ²²³Ra injections to provide accelerated pain relief. This can allow patients to continue their ²²³Ra regimens and gain its associated benefits (i.e., improved overall survival, and delayed time to PSA progression or skeletal-related events). We report the case of a 65-year-old male whose pain persisted after his first cycle of ²²³Ra, and was successfully treated with a single fraction of EBRT. The clinically-significant benefits observed with both treatments support the use of EBRT as an adjunct therapy with ²²³Ra.