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Table 1 Indication criteria for treatment with Radium-223

From: Application of the HTA Core Model for complex evaluation of the effectiveness and quality of Radium-223 treatment in patients with metastatic castration resistant prostate cancer

prostate cancer stage

metastatic castration resistant prostate cancer

bone metastases

≥ 2 symptomatic bone metastases, skeletal scintigraphy not older than 6 months, other imaging modalities: 18F-NaF-PET/CT, 11C/18F-choline-PET/CT, 18F/68Ga-PSMA-PET/CT, whole-body MRI

the absence of visceral metastases

lymph nodes ≤3 cm in the short axis are allowed in any location, CT scan, or possibly 18F-choline-PET/CT, 68Ga-PSMA-PET/CT

symptomatology

analgesic therapy or palliative external radiotherapy due to bone pain

ECOG PSa

patients with ECOG 0–2

prediction

expected survival ≥6 months

hematological parameters

hemoglobin ≥100 g/l

platelets ≥100 × 109/l

neutrophils ≥1.5 × 109/l

contraindications

no contraindications for the Radium-223 therapy are known

warning

increased caution is indicated in patients with inflammatory bowel disease (risk of bowel disease aggravation), with diffuse skeletal metastatic affection, after chemotherapy (increased risk of myelotoxicity - bone marrow damage)

  1. aECOG PS Eastern Cooperative Oncology Group Performance Status (assessing the overall patient status in the range of 0–5 points)
  2. Source: Own processing