Stereotactic radiation therapy in the strategy of treatment of metastatic renal cell carcinoma: A study of the Getug group. (July 2018)

• Record Type: Journal Article
• Authors: Meyer, Emmanuel; Pasquier, David; Bernadou, Guillemette; Calais, Gilles; Maroun, Pierre; Bossi, Alberto; Theodore, Christine; Albiges, Laurence; Stefan, Dinu; de Crevoisier, Renaud; Hennequin, Christophe; Lagrange, Jean-Léon; Grellard, Jean-Michel; Clarisse, Bénédicte; Licaj, Idlir; Habrand, Jean-Louis; Carrie, Christian; Joly, Florence
• Is Part Of: European journal of cancer. Volume 98(2018)
• Page Start: 38
• Page End: 47
• Publication Date: 2018-07
• Subjects: Renal cell carcinoma -- Stereotactic radiation therapy -- Oligometastatic disease -- Oligoprogressive disease; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2018.04.008
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Background: Renal cell carcinoma (RCC) is usually considered radioresistant, but stereotactic radiation therapy (SRT) may increase local disease control. This study aimed to assess the benefit of SRT in the management of metastatic RCC patients. Methods: Data of all RCC patients who received SRT between 2008 and 2015 with curative intent were retrospectively collected in six French referral centres. Local control (LC), progression-free survival (PFS), local recurrence-free survival (LRFS), time to systemic therapy (TTS) and overall survival (OS) were assessed. Results: One hundred and eighty-eight patients treated with SRT for 252 RCC metastases (brain [n = 120]; spine [n = 75]; and others [n = 57]) were recensed. SRT was performed for oligoprogressive disease (101 patients), oligometastatic disease (80 patients) or residual tumour after a partial response to systemic treatment (7 patients). The median biologically effective dose was 78 Gy. For the whole population, local control rates at 6, 12 and 24 months were 87.5%, 82.9% and 77.6%, respectively; median PFS, LRFS, TTS and OS were 8.5, 23.2, 13.2 and 29.2 months, respectively. Among patients treated for oligoprogressive/oligometastatic disease, the median PFS, TTS, and OS were 8.6/7.6, 10.5/14.2 and 23.2/33.9 months, respectively. Among the 7 patients treated with SRT after partial response to systemic treatment, no relapse occurred for 3 of them after a median follow-up of 22 months. Acute and late severe toxicities were noted in 5 (2.6%) patients. Conclusions: SRT is effective and safe for oligometastatic and oligoprogressive RCC patients and may delay introduction or change of systemic therapy. Highlights: Stereotactic radiotherapy (SRT) is effective and safe in oligometastatic and oligoprogressive mRCC. 6- and 12-month local control rate of metastases treated with SRT were 87.5% and 82.9%, respectively. 25% of oligometastatic patients did not relapse, and 40% did not need systemic treatment. Median PFS and TTS were 8.6 and 10.5 months, respectively, in oligoprogressive setting.