{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:25:51Z","timestamp":1787664351046,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radium\u2010223 dichloride (Ra\u2010223) is an effective treatment for metastatic castration\u2010resistant prostate cancer (mCRPC) with bone metastases. However, predictive factors associated with treatment efficacy remain unclear. This study evaluated prognostic factors associated with the efficacy of Ra\u2010223 and investigated outcomes according to enzalutamide (ENZ) combination patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 34 patients with mCRPC treated with Ra\u2010223 between 2016 and 2024. Progression\u2010free survival (PFS) and overall survival (OS) were evaluated according to time to CRPC, pre\u2010treatment prostate\u2010specific antigen (PSA), PSA doubling time (PSADT), metastatic burden, and ENZ treatment patterns. Cutoff values were determined using the Contal\u2013O'Quigley method. This study was approved by the Institutional Review Board of Gunma University (Approval No. 1662).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median time to CRPC, pre\u2010treatment PSA level, and PSADT were 17\u2009months, 6.2\u2009ng\/mL, and 2.2\u2009months, respectively. Shorter time to CRPC (\u2264\u200919\u2009months), higher pre\u2010treatment PSA (&gt;\u20092.67\u2009ng\/mL), and shorter PSADT (\u2264\u20092\u2009months) were significantly associated with shorter PFS. Patients with \u2265\u20094 bone metastatic regions had significantly worse OS than those with \u2264\u20093 regions. Among the ENZ treatment patterns, continuous ENZ administration combined with Ra\u2010223 was associated with significantly longer PFS than discontinuation of ENZ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Time to CRPC, pre\u2010treatment PSA, and PSADT may represent potentially useful candidate markers for identifying patients more likely to benefit from Ra\u2010223 therapy. Continued ENZ administration during Ra\u2010223 therapy was associated with favorable PFS in selected patients; however, this finding should be considered exploratory and requires validation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70591","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:54:30Z","timestamp":1785754470000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Outcomes of Radium\u2010223 Therapy in Metastatic Castration\u2010Resistant Prostate Cancer: Predictive Value of\n                    <scp>PSA<\/scp>\n                    Doubling Time and Enzalutamide Continuation"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2482-7690","authenticated-orcid":false,"given":"Kodai","family":"Abe","sequence":"first","affiliation":[{"name":"Department of Urology Gunma University Graduate School of Medicine &amp; Gunma University Hospital  Maebashi Gunma Japan"},{"name":"Department of Urology Tomioka General Hospital  Tomioka Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8416-2394","authenticated-orcid":false,"given":"Yoshiyuki","family":"Miyazawa","sequence":"additional","affiliation":[{"name":"Department of Urology Gunma University Graduate School of Medicine &amp; Gunma University Hospital  Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Department of Urology Gunma University Graduate School of Medicine &amp; Gunma University Hospital  Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Onose","sequence":"additional","affiliation":[{"name":"Department of Urology Gunma University Graduate School of Medicine &amp; Gunma University Hospital  Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Maeno","sequence":"additional","affiliation":[{"name":"Department of Urology Gunma University Graduate School of Medicine &amp; Gunma University Hospital  Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Department of Urology Gunma University Graduate School of Medicine &amp; Gunma University Hospital  Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azusa","family":"Kanayama","sequence":"additional","affiliation":[{"name":"Department of Urology Gunma University Graduate School of Medicine &amp; Gunma University Hospital  Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4757-4633","authenticated-orcid":false,"given":"Akira","family":"Ohtsu","sequence":"additional","affiliation":[{"name":"Department of Urology Gunma University Graduate School of Medicine &amp; Gunma University Hospital  Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Fujizuka","sequence":"additional","affiliation":[{"name":"Department of Urology Gunma University Graduate School of Medicine &amp; 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