{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:01:45Z","timestamp":1789722105894,"version":"4.0.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Radium\u2010233 dichloride is an alpha emitter that specifically targets bone metastases in prostate cancer. Results of a previously reported phase III randomized trial showed survival benefit for radium\u2010223 compared to best supportive care in castration\u2010resistant prostate cancer (CRPC) with bone metastases. However, real\u2010world data are also needed with wider inclusion criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We report results of a retrospective multicenter study including all patients with metastatic CRPC treated with radium\u2010223 in all five university hospitals in Finland since the introduction of the treatment. We identified 160 patients who had received radium\u2010223 in Finland in 2014\u20132019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median overall survival (OS) was 13.8\u00a0months (range 0.5\u201357\u2009months), and the median real\u2010world progression\u2010free survival (rwPFS) was 4.9\u00a0months (range 0.5\u201329.8\u00a0months). Alkaline phosphatase (ALP) values within the normal range before and during the radium\u2010223 treatment or the reduction of elevated ALP to normal range during treatment were associated with better OS when compared to elevated ALP values before and during treatment (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). High prostate\u2010specific antigen (PSA) level (\u2265100\u2009\u03bcg\/L) before radium\u2010223 treatment was associated with poor OS compared to low PSA level (&lt;20\u2009\u03bcg\/L) (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0001). Most patients (57%) experienced pain relief. Pain relief indicated better OS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002). Radium\u2010223 treatment was well tolerated. Toxicity was mostly low grade. Only 12.5% of the patients had grade III\u2013IV adverse events, most commonly anemia, neutropenia, leucopenia, and thrombocytopenia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Radium\u2010223 was well tolerated in routine clinical practice, and most patients achieved pain relief. Pain relief, ALP normalization, lower baseline PSA, and PSA decrease during radium\u2010223 treatment were prognostic for better survival. The efficacy of radium\u2010223 in mCRPC as estimated using OS was comparable to earlier randomized trial in this retrospective real\u2010world study. Our results support using radium\u2010223 for mCRPC patients with symptomatic bone metastases even in the era of new\u2010generation androgen receptor\u2010targeted agents.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5262","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T11:58:35Z","timestamp":1664193515000},"page":"4064-4076","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Radium\u2010223 dichloride treatment in metastatic castration\u2010resistant prostate cancer in Finland: A real\u2010world evidence multicenter study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0732-2788","authenticated-orcid":false,"given":"Anniina","family":"Hyv\u00e4kk\u00e4","sequence":"first","affiliation":[{"name":"Cancer Research Unit, Institute of Biomedicine, and Department of Oncology FICAN West Cancer Center, University of Turku, Turku University Hospital 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