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

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,...

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Autores principales: Altoos, Basel, Amini, Arya, Yacoub, Muthanna, Bourlon, Maria T., Kessler, Elizabeth E., Flaig, Thomas W., Fisher, Christine M., Kavanagh, Brian D., Lam, Elaine T., Karam, Sana D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625576/
https://www.ncbi.nlm.nih.gov/pubmed/26510665
http://dx.doi.org/10.1186/s13014-015-0528-z
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author Altoos, Basel
Amini, Arya
Yacoub, Muthanna
Bourlon, Maria T.
Kessler, Elizabeth E.
Flaig, Thomas W.
Fisher, Christine M.
Kavanagh, Brian D.
Lam, Elaine T.
Karam, Sana D.
author_facet Altoos, Basel
Amini, Arya
Yacoub, Muthanna
Bourlon, Maria T.
Kessler, Elizabeth E.
Flaig, Thomas W.
Fisher, Christine M.
Kavanagh, Brian D.
Lam, Elaine T.
Karam, Sana D.
author_sort Altoos, Basel
collection PubMed
description 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.
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spelling pubmed-46255762015-10-30 Local Control Rates of Metastatic Renal Cell Carcinoma (RCC) to Thoracic, Abdominal, and Soft Tissue Lesions Using Stereotactic Body Radiotherapy (SBRT) Altoos, Basel Amini, Arya Yacoub, Muthanna Bourlon, Maria T. Kessler, Elizabeth E. Flaig, Thomas W. Fisher, Christine M. Kavanagh, Brian D. Lam, Elaine T. Karam, Sana D. Radiat Oncol Research 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. BioMed Central 2015-10-28 /pmc/articles/PMC4625576/ /pubmed/26510665 http://dx.doi.org/10.1186/s13014-015-0528-z Text en © Altoos et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Altoos, Basel
Amini, Arya
Yacoub, Muthanna
Bourlon, Maria T.
Kessler, Elizabeth E.
Flaig, Thomas W.
Fisher, Christine M.
Kavanagh, Brian D.
Lam, Elaine T.
Karam, Sana D.
Local Control Rates of Metastatic Renal Cell Carcinoma (RCC) to Thoracic, Abdominal, and Soft Tissue Lesions Using Stereotactic Body Radiotherapy (SBRT)
title Local Control Rates of Metastatic Renal Cell Carcinoma (RCC) to Thoracic, Abdominal, and Soft Tissue Lesions Using Stereotactic Body Radiotherapy (SBRT)
title_full Local Control Rates of Metastatic Renal Cell Carcinoma (RCC) to Thoracic, Abdominal, and Soft Tissue Lesions Using Stereotactic Body Radiotherapy (SBRT)
title_fullStr Local Control Rates of Metastatic Renal Cell Carcinoma (RCC) to Thoracic, Abdominal, and Soft Tissue Lesions Using Stereotactic Body Radiotherapy (SBRT)
title_full_unstemmed Local Control Rates of Metastatic Renal Cell Carcinoma (RCC) to Thoracic, Abdominal, and Soft Tissue Lesions Using Stereotactic Body Radiotherapy (SBRT)
title_short Local Control Rates of Metastatic Renal Cell Carcinoma (RCC) to Thoracic, Abdominal, and Soft Tissue Lesions Using Stereotactic Body Radiotherapy (SBRT)
title_sort local control rates of metastatic renal cell carcinoma (rcc) to thoracic, abdominal, and soft tissue lesions using stereotactic body radiotherapy (sbrt)
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625576/
https://www.ncbi.nlm.nih.gov/pubmed/26510665
http://dx.doi.org/10.1186/s13014-015-0528-z
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