Background: Patients with advanced-stage ovarian cancer face a poor prognosis because
of recurrent peritoneal cavity metastases following surgery and chemotherapy. Alpha-emitters
may enable the efficient treatment of such disseminated diseases because of their short range
and highly energetic radiation. Radium-224 is a candidate α-emitter due to its convenient 3.6-day
half-life, with more than 90% of the decay energy originating from α-particles. However, its inherent
skeletal accumulation must be overcome to facilitate intraperitoneal delivery of the radiation
dose. Therefore, 224Ra-labeled CaCO3 microparticles have been developed.
Objective: The antitumor effect of CaCO3 microparticles as a carrier for 224Ra was investigated,
with an emphasis on the ratio of activity to mass dose of CaCO3, that is, specific activity.
Methods: Nude athymic mice were inoculated intraperitoneally with human ovarian cancer cells
(ES-2) and treated with a single intraperitoneal injection of 224Ra-labeled CaCO3 microparticles
with varying combinations of mass and activity dose, or cationic 224Ra in solution. Survival and
ascites volume at sacrifice were evaluated.
Results: Significant therapeutic effect was achieved for all tested specific activities ranging from
0.4 to 4.6 kBq/mg. Although treatment with a mean activity dose of 1305 kBq/kg of cationic 224Ra
prolonged the survival compared with the control, equivalent median survival could be achieved
with 224Ra-labeled microparticles with a mean dose of only 420 kBq/kg. The best outcome was
achieved with the highest specific activities (2.6 and 4.6 kBq/mg).
Conclusion: Radium-224-labeled CaCO3 microparticles present a promising therapy against cancer
dissemination in body cavities.