Real-world Outcomes and Factors Predicting Survival and Completion of Radium 223 in Metastatic Castrate-resistant Prostate Cancer.

AIMS: To analyse outcomes in metastatic castrate-resistant prostate cancer (mCRPC) patients treated with radium 223 (Ra-223) across the Yorkshire and Humber Cancer Network. MATERIALS AND METHODS: A regional, multicentre, retrospective cohort study of 189 men undergoing Ra-223 for mCRPC between March 2014 and April 2017 was undertaken. Factors predicting overall survival and completion of planned treatment were assessed. RESULTS: The median overall survival for the entire cohort was 10.5 months. Those completing five to six cycles of Ra-223 had a higher overall survival of 18.6 months. On multivariable analysis, four factors remained independent significant predictors of overall survival: age (P = 0.005, hazard ratio 1.07 [1.02-1.12]); number of cycles of Ra-223: 5-6 versus 1-4 (P ≤ 0.001, hazard ratio 0.10 [0.005-0.20]); baseline alkaline phosphatase (P = 0.044, hazard ratio 1.06 [1.002-1.12]); neutrophil-to-lymphocyte ratio (P = 0.033, hazard ratio 1.19 [1.01-1.40]). Baseline performance status 0 versus 2 (P = 0.026, odds ratio 0.080 [0.001-0.74]) and higher baseline haemoglobin (P = 0.028, odds ratio 1.04 [1.004-1.074]) were independent predictors of the completion of five to six cycles of Ra-223. CONCLUSIONS: Younger age, completion of five to six cycles of Ra-223, lower alkaline phosphatase and neutrophil-to-lymphocyte ratio are predictors of overall survival. This is the first study to report neutrophil-to-lymphocyte ratio as an independent predictor of overall survival in a Ra-223 cohort. Good performance status and higher baseline haemoglobin predict the completion of five to six cycles of Ra-223.

[Breast cancers associated with pregnancy. About two cases]. / Cancers du sein associes a la grossesse. A propos de deux cas.

The association between breast cancer and pregnancy is a rare but not exceptional. The authors reports two cases of patients aged 29 and 30 years respectively. Both patients had single pregnancis. The first patient, third delivery, had a gestational age of 30 weeks of amenorrhea and a stadify T 3NIM0. The second patent was second delivery and had during her first prenatal consultation at 38 weeks of amenorrhea a developing but not extending statify T4. Cytology suggest the diagnosis whicle was confirmed by histology in both cases. Treatment consisted in an immediate Pathey for the first patient who underwent a cesarean section at 36 weeks of gestation giving birth to a newborn without distinctive features. She died after the second course of chemotherapy type FAC. The second patient had an induced labour and gave birth to a newborn without distinctive features. Chemotherapy was started after delivery but the patient died after the first course which did not improve her condition. Late diagnosis and poor prognosis are common in literature. This is confirmed by our study in which we also stress the severity of the disease and the problems related to treatment.