The role of stereotactic body radiation therapy and its integration with systemic therapies in metastatic kidney cancer: a multicenter study on behalf of the AIRO (Italian Association of Radiotherapy and Clinical Oncology) genitourinary study group.
Adult
Aged
Aged, 80 and over
Antineoplastic Agents
/ adverse effects
Carcinoma, Renal Cell
/ mortality
Chemotherapy, Adjuvant
Disease Progression
Female
Humans
Italy
Kidney Neoplasms
/ mortality
Male
Middle Aged
Progression-Free Survival
Radiosurgery
/ adverse effects
Retrospective Studies
Time Factors
Kidney cancer
Oligometastases
Oligoprogressive
Oligorecurrent
Renal cell carcinoma
Sabr
Sbrt
Stereotactic body radiation therapy
Journal
Clinical & experimental metastasis
ISSN: 1573-7276
Titre abrégé: Clin Exp Metastasis
Pays: Netherlands
ID NLM: 8409970
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
06
09
2021
accepted:
03
11
2021
pubmed:
9
11
2021
medline:
30
11
2021
entrez:
8
11
2021
Statut:
ppublish
Résumé
Although systemic therapy represents the standard of care for polymetastatic kidney cancer, stereotactic body radiation therapy (SBRT) may play a relevant role in the oligometastatic setting. We conducted a multicenter study including oligometastatic kidney cancer treated with SBRT. We retrospectively analyzed 207 patients who underwent 245 SBRT treatments on 385 lesions, including 165 (42.9%) oligorecurrent (OR) and 220 (57.1%) oligoprogressive (OP) lesions. Most common sites were lung (30.9%) for OR group, and bone (32.7%) for OP group. Among 78 (31.8%) patients receiving concomitant systemic therapy, sunitinib (61.5%) and pazopanib (15.4%) were the most common for OR patients, while sunitinib (49.2%) and nivolumab (20.0%) for OP patients. End points were local control (LC), progression free survival (PFS), overall survival (OS), time to next systemic therapy (TTNS) and toxicity. Median follow-up was 18.6 months. 1, 2 and 3-year LC rates were 89.4%, 80.1% and 76.6% in OR patients, and 82.7%, 76.9% and 64.3% in those with OP, respectively. LC for OP group was influenced by clear cell histology (p = 0.000), total number of lesions (p = 0.004), systemic therapy during SBRT (p = 0.012), and SBRT dose (p = 0.012). Median PFS was 37.9 months. 1, 2- and 3-year OS was 92.7%, 86.4% and 81.8%, respectively. Median TTNS was 15.8 months for OR patients, and 13.9 months for OP patients. No grade 3 or higher toxicities were reported for both groups. SBRT may be considered an effective safe option in the multidisciplinary management of both OR and OP metastases from kidney cancer.
Identifiants
pubmed: 34748125
doi: 10.1007/s10585-021-10131-w
pii: 10.1007/s10585-021-10131-w
doi:
Substances chimiques
Antineoplastic Agents
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
527-537Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature B.V.
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