OBJECTIVE

To evaluate the clinical efficacy and safety of specialized therapeutic detoxifying enteral nutrition in patients with metastatic castration-resistant prostate cancer (mCRPC) with bone metastases, receiving radionuclide therapy with radium chloride [²²³Ra].

MATERIALS AND METHODS

The clinical study was conducted at the A.F. Tsyb Medical Research Center, a branch of the National Medical Research Center of Radiology of the Ministry of Health of the Russian Federation. Patients were randomized into two groups similar in age, stage and severity of the disease: Group 1 (main) — 20 patients with mCRPC with bone metastases, receiving treatment with radium chloride [²²³Ra] in combination with nutritional support with specialized products for dietary therapeutic and dietary prophylactic, including enteral nutrition for detoxification: “Detoxification drink” 1 time/day in the morning, “Protein detoxification cocktail” at lunch and in the evening 2 times/day). Group 2 (control, comparison group) — 20 patients received standard radionuclide therapy with radium chloride [²²³Ra] without nutritional support.

RESULTS

The use of therapeutic detoxifying enteral nutrition in patients with mCRPC with bone metastases made it possible to reduce the severity of intoxication. The patients experienced a decrease in the frequency and intensity of symptoms of nausea, vomiting, bowel disorders, flatulence, stopped losing weight, improved appetite and digestion, decreased fatigue and general weakness, and improved physical activity parameters and quality of life (improved the physical condition of patients, increased muscle strength and physical performance, decreased pain, improved sleep quality). In patients taking the LEOVIT ONCO therapeutic nutrition, blood tests showed an increase in protein and albumin levels, normalization of platelet levels, hemoglobin, and blood glucose, a significant decrease in the main inflammation marker — CRP, a decrease in the level of creatinine and urea in the blood, as well as total bilirubin and AST, which reflects the detoxification function of the studied therapeutic nutrition.

CONCLUSIONS

The use of specialized therapeutic food products “Protein Detoxification Cocktail” and “Detoxification Drink” made it possible to reduce toxic manifestations associated with both the course of the oncological disease and the antitumor therapy in patients with mCRPC receiving radionuclide therapy with radium chloride [²²³Ra], reduce the frequency of adverse events and improve the tolerability of the therapy. Potentially conducted nutritional detoxification therapy can be considered as a factor reducing the likelihood of missing or canceling the next administration of radium chloride [²²³Ra]. And full implementation of the entire course of therapy from 6 administrations is a factor positively influencing the overall survival of patients. It should also be noted that the data obtained in this work can form the basis for the use of therapeutic nutrition not only in patients receiving radionuclide therapy with radium chloride [²²³Ra]. Similar approaches can be used in therapy with other radionuclide drugs, including new radiotargeted drugs based on ¹⁷⁷Lu and ²²⁵Ac, both in prostate cancer and in other diseases.