Conclusion
The survival gain in patients with bone metastases from CRPC treated with 223Ra is well established, but the identification of baseline variables that may predict the individual response to treatment is a continuous challenge. In our analysis, the baseline QoL assessed through the EORTC QLQ-C30 and the EORTC QLQ-BM22, showed a significant correlation with OS, meaning that patients with better baseline QoL are more likely to obtain a marked survival prolonging effect from 223Ra-therapy. These findings suggest that patient-reported QoL measures, in addition to clinic-pathological factors, may improve prognostic stratification in mCRPC patients undergoing 223Ra-therapy, thus influencing clinical decision-making process and patient-doctor communication about prognosis.