Biomedicines (Apr 2023)

The DASciS Software for BSI Calculation as a Valuable Prognostic Tool in mCRPC Treated with 223RaCl2: A Multicenter Italian Study

  • Maria Silvia De Feo,
  • Viviana Frantellizzi,
  • Matteo Bauckneht,
  • Alessio Farcomeni,
  • Luca Filippi,
  • Elisa Lodi Rizzini,
  • Valentina Lavelli,
  • Maria Lina Stazza,
  • Tania Di Raimondo,
  • Giuseppe Fornarini,
  • Sara Elena Rebuzzi,
  • Mammini Filippo,
  • Paolo Mammucci,
  • Andrea Marongiu,
  • Fabio Monari,
  • Giuseppe Rubini,
  • Angela Spanu,
  • Giuseppe De Vincentis

DOI
https://doi.org/10.3390/biomedicines11041103
Journal volume & issue
Vol. 11, no. 4
p. 1103

Abstract

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Background/Aim: Radium-223 dichloride (223RaCl2) represents a therapeutic option for metastatic castration-resistant prostate cancer (mCRPC) patients dealing with symptomatic bone metastases. The identification of baseline variables potentially affecting the life-prolonging role of 223RaCl2 is still ongoing. Bone scan index (BSI) defines the total load of bone metastatic disease detected on a bone scan (BS) and is expressed as a percentage value of the whole bone mass. The aim of this multicenter study was to assess the impact of baseline BSI on overall survival (OS) in mCRPC patients treated with 223RaCl2. For this purpose, the DASciS software developed by the Sapienza University of Rome for BSI calculation was shared between six Italian Nuclear Medicine Units. Methods: 370 pre-treatment BS were analyzed through the DASciS software. Other clinical variables relevant to OS analysis were taken into account for the statistical analysis. Results: Of a total of 370 patients, 326 subjects had died at the time of our retrospective analysis. The median OS time from the first cycle of 223RaCl2 to the date of death from any cause or last contact was 13 months (95%CI 12–14 months). The mean BSI value resulted in 2.98% ± 2.42. The center-adjusted univariate analysis showed that baseline BSI was significantly associated with OS as an independent risk factor (HR 1.137, 95%CI: 1.052–1.230, p = 0.001), meaning that patients with higher BSI values had worse OS. When adjusting for other measures on multivariate analysis, in addition to Gleason score and baseline values of Hb, tALP, and PSA, baseline BSI was confirmed to be a statistically significant parameter (HR 1.054, 95%CI: 1.040–1.068, p 223RaCl2. The DASciS software was revealed to be a valuable tool for BSI calculation, showing rapid processing time and requiring no more than a single demonstrative training for each participating center.

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