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Dear Editor,rnApproximately 90% of men with metastatic castration-resistant prostate cancer (mCRPC) have bone metastases that can cause excruciating pain,bone fractures,disability,and death.1-3 Radium-223 is a radioactive isotope that mimics calcium and emits alpha particle radiation that selectively targets bone metastases.4,5 The results from the Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA) study,a phase 3 randomized controlled trial,showed that radium-223 improved overall survival (OS) and time to symptomatic skeletalrelated events (SRE) in men with mCRPC and bone metastases compared to placebo6 Despite the FDA approval,radium-223 appears to be less utilized for the treatment of mCRPC compared to oral agents that target the androgen receptor pathway.We report our initial experience and outcomes of men with mCRPC and bone metastases treated with radium-223.