Nurses play critical role in radium-223 administration for prostate cancer bone metastases

  • May 8, 2014

Radium-223 dichloride improved survival, pain and quality of life in patients with symptomatic bone metastases and castration-resistant prostate cancer, yet several factors must be considered prior to administration of the agent, according to study results presented at the 2014 Oncology Nursing Society Annual Congress.

“Educating patients on the unique properties and therapeutic benefits of radium-223, along with radiation safety, myelosuppression and interventions for adverse events, is an essential part of the nursing role,” the researchers wrote. “Nurses need to be knowledgeable about administration guidelines, workflow and reimbursement options to provide optimal patient care and management.”

Researchers reviewed data from the phase 3 ALSYMPCA trial, which included 921 patients who were randomly assigned to six injections of 50 kBq/kg radium-223 every 4 weeks or placebo.

Overall, radium-223 significantly improved OS (HR=0.70) and prolonged time to first symptomatic skeletal event (HR=0.66) compared with placebo.

Patients assigned radium-223 experienced delayed opioid use (HR=.62) and demonstrated improved quality of life (P=.02).

However, as a new therapeutic option, researchers noted nurses must consider “important handling, administration, safety, and patient counseling information for radium-223.”

More patients assigned radium-223 experienced thrombocytopenia (12% vs. 6%), neutropenia (5% vs. 1%), diarrhea (25% vs. 15%) and vomiting (18% vs. 14%). More patients assigned placebo discontinued treatment due to adverse events (21% vs. 16%).

“Nurses are an essential part of the oncology team, providing invaluable education about radium-223 as a new therapeutic option, its clinical relevance, and the incorporation of this knowledge into clinical practice,” the researchers wrote. “This information will help guide treatment considerations and patient care.”

For more information:

Curley T. Poster #77. Presented at: Oncology Nursing Society Annual Congress; May 1-4, 2014; Anaheim, Calif.

Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.