Calcium Carbonate Microparticles as Carriers of 224Ra: Impact of Specific Activity in Mice with Intraperitoneal Ovarian Cancer

Curr Radiopharm. 2021;14(2):145-153. doi: 10.2174/1874471013666201201102056.


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.

Keywords: 224Ra; Alpha therapy; calcium carbonate; intraperitoneal; microparticles; ovarian cancer; peritoneal carcinomatosis; radium-224.

MeSH terms

  • Alpha Particles / therapeutic use
  • Animals
  • Calcium Carbonate / pharmacology*
  • Drug Delivery Systems
  • Female
  • Mice
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / radiotherapy*
  • Particle Size
  • Radiopharmaceuticals / pharmacology*
  • Radiotherapy Dosage
  • Radium / pharmacology*
  • Thorium / pharmacology*


  • Radiopharmaceuticals
  • thorium X
  • Thorium
  • Calcium Carbonate
  • Radium