Local Control Rates of Metastatic Renal Cell Carcinoma (RCC) to Thoracic, Abdominal, and Soft Tissue Lesions Using Stereotactic Body Radiotherapy (SBRT)

Radiation Oncology

Sana D. Karam³  Elaine T. Lam²  Brian D. Kavanagh³  Christine M. Fisher³  Thomas W. Flaig²  Elizabeth E. Kessler²  Maria T. Bourlon⁴  Muthanna Yacoub¹  Arya Amini³  Basel Altoos³ 

[1] University of Iowa Carver College of Medicine, Iowa City, Iowa, USA;Department of Medicine, Division of Medical Oncology, University of Colorado School of Medicine, Aurora, Colorado, USA;Department of Radiation Oncology, University of Colorado School of Medicine, 1665 Aurora Court, Room 1032, Aurora 80045, CO, USA;Medical Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

关键词: Conventional fractionation;    SBRT;    Local control;    Renal cell carcinoma;   

Others  :  1232601
DOI  :  10.1186/s13014-015-0528-z

 received in 2015-06-29, accepted in 2015-10-20,  发布年份 2015

【 摘 要 】

Background and purpose

We report the radiographic response rate of SBRT compared to conventional fractionated radiotherapy (CF-EBRT) for thoracic, abdominal, skin and soft tissue RCC lesions treated at our institution.

Material and methods

Fifty three lesions where included in the study (36 SBRT, 17 CF-EBRT), treated from 2004 to 2014 at our institution. We included patients that had thoracic, skin & soft tissue (SST), and abdominal metastases of histologically confirmed RCC. The most common SBRT fractionation was 50 Gy in 5 fractions.

Results

The median time of follow-up was 16 months (range 3–97 months). Median BED was 216.67 (range 66.67–460.0) for SBRT, and 60 (range 46.67–100.83) for CF-EBRT. Median radiographic local control rates at 12, 24, and 36 months were 100, 93.41, and 93.41 % for lesions treated with SBRT versus 62.02, 35.27 and 35.27 % for those treated with CF-EBRT (p < 0.001). Predictive factors for radiographic local control under univariate analysis included BED ≥ 100 Gy (HR, 0.048; 95 % CI, 0.006–0.382; p = 0.005), dose per fraction ≥ 9 Gy (HR, 0.631; 95 % CI, 0.429–0.931; p = 0.021), and gender (HR, 0.254; 95 % CI, 0.066–0.978; p = 0.048). Under multivariate analysis, there were no significant predictors for local control. Toxicity rates were low and equivalent in both groups, with no grade 4 or 5 side effects reported.

Conclusions

SBRT is safe and effective for the treatment of RCC metastases to thoracic, abdominal and integumentary soft tissues. Radiographic response rates were greater and more durable using SBRT compared to CF-EBRT. Further prospective trials are needed to evaluate efficacy and safety of SBRT for RCC metastases.

【 授权许可】

   
2015 Altoos et al.

【 图 表 】

Fig. 1.

Fig. 2.

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