Table 2.
Lab work/imaging (normal values) |
Baseline (within 3 mo before Radium-223) |
Interim (between injections #3 and #4) |
Completion (within 3 mo after Radium-223) |
Follow-up (6–12 mo after Radium-223) |
---|---|---|---|---|
Hb (12.9–16.9/dL) |
11.2 | 11.0 | 8.4 | 9.6 |
Platelets (156–369 × 109/L) |
209 | 141 | 119 | 37 |
Absolute neutrophils (2.240–7.680 × 109/L) | 4.400 | 1.500 | 1.300 | 2.100 |
PSA (ng/mL) |
33 | 168 | 310 | 396 |
Alkaline phosphatase (38–126 IU/L) |
110 | 79 | 94 | 201 |
Whole-body bone scan | Widespread bone metastases including bilateral proximal humerus, right parasagittal skull, sternum, ribs, spine, and pelvis | Previous bone metastases show interval decrease in uptake. New foci of mildly increased uptake are present in the right skull, ribs, right acromion and left femur | Significant increase in bone uptake, less pronounced in previously treated lesions and more pronounced in lesions developing after Xofigo | |
Diagnostic CT-chest, abdomen, and pelvis | Widespread bone metastases consistent with bone scan. No evidence of local recurrence in the prostatectomy bed. Stable 1.1 cm right external iliac chain node | No significant change in bone metastases. There is new lymphadenopathy including the axillae, mediastinum, retroperitoneum, and pelvis | Progression of widespread bone metastases consistent with bone scan as well as extensive lymphadenopathy |