Initial experience of radium-223 treatment for metastatic castrate resistant prostate cancer in community setting.
Bibliographic record
Abstract
e16106 Background: The many advantages associated with Ra-223 cytotoxic mechanism of action and excretion makes it a stronger, less myelotoxic and nephrotoxic option than its counterparts (Sm153 and Sr89). We report the shortterm pain evolution, side effects and hematologic profile of patients with metastatic castrate-resistant prostate cancer (mCRPC) undergoing Ra-223 treatment. Methods: Clinical data from 19 mCRPC patients treated with Ra-223 was collected from a large multi-disciplinary group. In accordance with the FDA’s recommended dosage, Ra-223’s monthly injections were composed of 1 dose of 50 kBq/kg, for 6 months. Up to the third injection, the World Health Organization’s (WHO) ladder for cancer pain was assessed and the pain pattern evaluated and classified in groups: no or minimal pain relief, worsening and improvement of pain. Also, short-term incidence of side effects was reported together with the hematologic parameters at each injection. Data is expressed as a median (range). Results: This cohort was composed of 19 Caucasian men aged 74 (53-85) years old, and all suffered bone metastasis. At baseline, 13.3% graded the pain at 1 according to the WHO pain score. At the first follow-up, 27 (19-35) days after the first injection, 21.5% (2/19) noticed pain relief, and 37.5% had a WHO score of 1. 22 (21-22) days after the second injection, 44.4% (8/18) had reduced pain symptoms, and 37.5% had a WHO score of 1. At the third follow-up, 35 (22-35) days after the third injection, 50% (6/12) had pain relief, and 50% had a WHO score of 1. Also, for 10.5% (n=2) of our cohort, pain symptoms worsened while 21% (n=4) reached total pain remission by the third injection. Increased bowl movement frequency was observed in 10.5% of our cohort, diarrhea in 31.6%, constipation in 5.3%, nausea in 26.3%, vomiting in 5.3%, bone pain flair response in 26.3% and lower limb edema in 10.5%. Conclusions: Our short-term results demonstrated promising bone-pain relief effect of Ra-223 in 50% of our patients even after a maximum of only three injections. Encountered side effects were mild including mostly gastro-intestinal symptoms, but a 21.3% platelet reduction was observed by the third injection.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".