{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:13:22Z","timestamp":1788599602491,"version":"build-2803163510"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    The effectiveness and safety of radium-223 (Ra-223) in patients with metastatic castration-resistant prostate cancer (mCRPC) and bone metastasis in real-world clinical practice in China remain to be fully examined. This single-center, retrospective, real-world study included Chinese patients with mCRPC treated with Ra-223 between January 2021 and August 2023 in Fudan University Shanghai Cancer Center (Shanghai, China). This study examined the patient characteristics, overall survival (OS), 5-point Visual Analog Scale for pain and safety, as well as factors potentially influencing treatment effectiveness. Ninety-three patients were included. Among them, 25 (26.9%) patients were administered all six injections of Ra-223, and 41 (44.1%) patients received more than 3 injections. After a median follow-up of 19.8 months, median OS was 14.1 (95% confidence interval [CI]: 12.0\u201316.2) months. Multivariable analysis showed a total number of Ra-223 injections &gt;3 was an independent protective factor of OS (hazard ratio [HR] = 0.443, 95% CI: 0.234\u20130.837;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.012) after adjusting for age, combination therapy, and previous chemotherapy. For those administered all six injections of Ra-223, no patients had a pain score of 4 and only 4.2% of patients showed a pain score of 3. In total, 62.5% of patients had almost no pain (0 point). Median alkaline phosphatase showed a downward trend during the six-injection treatment period. The most common adverse event was anemia (30.1%), followed by thrombocytopenia (15.1%), nausea (9.7%), weakness (8.6%), and decreased white blood cells (7.5%). This real-world study strongly suggests that Ra-223 has good effectiveness and tolerability in Chinese patients with mCRPC and bone metastases.\n                  <\/jats:p>","DOI":"10.4103\/aja202598","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:00:20Z","timestamp":1772553620000},"page":"561-567","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Real-world effectiveness and safety of radium-223 therapy in castration-resistant prostate cancer with bone metastases"],"prefix":"10.4103","volume":"28","author":[{"given":"Hong-Kai","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201321, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China"},{"name":"Shanghai Genitourinary Cancer Institute, Shanghai 200032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Hang","sequence":"additional","affiliation":[{"name":"Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201321, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China"},{"name":"Shanghai Genitourinary Cancer Institute, Shanghai 200032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China"},{"name":"Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai 201321, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201321, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China"},{"name":"Shanghai Genitourinary Cancer Institute, Shanghai 200032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201321, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China"},{"name":"Shanghai Genitourinary Cancer Institute, Shanghai 200032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Jian","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201321, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China"},{"name":"Shanghai Genitourinary Cancer Institute, Shanghai 200032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-Wen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201321, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China"},{"name":"Shanghai Genitourinary Cancer Institute, Shanghai 200032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Bo","family":"Deng","sequence":"additional","affiliation":[{"name":"Pharmaceuticals, Bayer Healthcare Company Ltd., Beijing 100176, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He-Xun","family":"Jiang","sequence":"additional","affiliation":[{"name":"Pharmaceuticals, Bayer Healthcare Company Ltd., Beijing 100176, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Wang","sequence":"additional","affiliation":[{"name":"Pharmaceuticals, Bayer Healthcare Company Ltd., Beijing 100176, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Li","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China"},{"name":"Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai 201321, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding-Wei","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 201321, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China"},{"name":"Shanghai Genitourinary Cancer Institute, Shanghai 200032, 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