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Du, Yong; Carrio, Ignasi; Vincentis, Giuseppe de; Fanti, Stefano; Ilhan, Harun; Mommsen, Caroline; Nitzsche, Egbert; Sundram, Francis; Vogel, Wouter; Oyen, Wim; Lewington, Val (2017): Practical recommendations for radium-223 treatment of metastatic castration-resistant prostate cancer. In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 44, No. 10: pp. 1671-1678
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Purpose Radium Ra 223 dichloride (radium-223, Xofigo (R)) is the first targeted alpha therapy for patients with castration-resistant prostate cancer and symptomatic bone metastases. Radium-223 provides a new treatment option for this setting, but also necessitates a new treatment management approach. We provide straightforward and practical recommendations for European nuclear medicine centres to optimize radium-223 service provision. Methods An independent research consultancy agency observed radium-223 procedures and conducted interviews with all key staff members involved in radium-223 treatment delivery in 11 nuclear medicine centres across six countries (Germany, Italy, the Netherlands, Spain, Switzerland and the UK) experienced in administering radium-223. The findings were collated and discussed at a meeting of experts from these centres, during which key consensus recommendations were defined. Results The recommendations cover centre organization and preparation;patient referral;radium-223 ordering, preparation and disposal;radium-223 treatment delivery/administration;and patient experience. Guidance includes structured coordination and communication within centres and multidisciplinary teams, focusing on sharing best practice to provide high-quality, patient-centred care throughout the treatment pathway. Conclusions These expert recommendations are intended to complement existing management guidelines. Sharing best practice and experience will help nuclear medicine centres to optimize radium-223 service provision and improve patient care.