For patients with widespread bony metastases from prostate cancer, do you ever consider treating with beta-emitters such as Samarium-153 or Strontium-89 over Radium-223?

I use radium 223 in all patients unless thier performance staus is poor ECOG-2 or they have significant visceral disease. In those cases it may difficult to get authorization for Radium 223. In terms Cost effectiveness there is data now from the ALSYMPCA trial updates that patient's who received Rad...