Emmanuel Meyer1, David Pasquier2, Guillemette Bernadou3, Gilles Calais3, Pierre Maroun4, Alberto Bossi4, Christine Theodore5, Laurence Albiges6, Dinu Stefan7, Renaud de Crevoisier8, Christophe Hennequin9, Jean-Léon Lagrange10, Jean-Michel Grellard11, Bénédicte Clarisse11, Idlir Licaj11, Jean-Louis Habrand12, Christian Carrie13, Florence Joly14. 1. Centre François Baclesse, Department of Radiation Oncology, 14000, Caen, France; Centre François Baclesse, Department of Clinical Research, 14000, Caen, France. Electronic address: e.meyer@live.fr. 2. Centre Oscar Lambret, Academic Department of Radiation Oncology, Lille University, 59000, Lille, France; CRISTAL UMR CNRS 9189, Lille, France. 3. Clinique d'Oncologie et de Radiothérapie, Department of Radiation Oncology, 37000, Tours, France. 4. Institut Gustave Roussy, Department of Radiation Oncology, 94800, Villejuif, France. 5. Hôpital Foch, Department of Clinical Oncology, 92151 Suresnes, France. 6. Gustave Roussy, Department of Clinical Oncology, 94800, Villejuif, France. 7. Centre François Baclesse, Department of Radiation Oncology, 14000, Caen, France; Centre François Baclesse, Department of Clinical Research, 14000, Caen, France. 8. Centre Eugène Marquis, Department of Radiation Oncology, 35000, Rennes, France. 9. Hôpital Saint-Louis, Department of Radiation Oncology, 75010, Paris, France. 10. Hôpital Henri Mondor, Department of Radiation Oncology, 94010, Créteil, France. 11. Centre François Baclesse, Department of Clinical Research, 14000, Caen, France. 12. Centre François Baclesse, Department of Radiation Oncology, 14000, Caen, France. 13. Centre Léon Bérard, Department of Radiation Oncology, 69008, Lyon, France. 14. Centre François Baclesse, Department of Clinical Research, 14000, Caen, France; Centre François Baclesse, Department of Clinical Oncology, 14000, Caen, France.
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.
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 RCCpatients. METHODS: Data of all RCCpatients 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 RCCpatients and may delay introduction or change of systemic therapy.
Authors: Jonathan E Schoenhals; Osama Mohamad; Alana Christie; Yuanyuan Zhang; Daniel Li; Nirmish Singla; Isaac Bowman; Waddah Arafat; Hans Hammers; Kevin Courtney; Suzanne Cole; Aditya Bagrodia; Vitaly Margulis; Neil Desai; Aurelie Garant; Hak Choy; Robert Timmerman; James Brugarolas; Raquibul Hannan Journal: Adv Radiat Oncol Date: 2021-05-26