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.
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.
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.
SRT is effective and safe for oligometastatic and oligoprogressive RCC patients and may delay introduction or change of systemic therapy.
European journal of cancer (Oxford, England : 1990). 2018 Jun 01 [Epub ahead of print]
Emmanuel Meyer, David Pasquier, Guillemette Bernadou, Gilles Calais, Pierre Maroun, Alberto Bossi, Christine Theodore, Laurence Albiges, Dinu Stefan, Renaud D E Crevoisier, Christophe Hennequin, Jean-Léon Lagrange, Jean-Michel Grellard, Bénédicte Clarisse, Idlir Licaj, Jean-Louis Habrand, Christian Carrie, Florence Joly
Centre François Baclesse, Department of Radiation Oncology, 14000, Caen, France; Centre François Baclesse, Department of Clinical Research, 14000, Caen, France. Electronic address: ., Centre Oscar Lambret, Academic Department of Radiation Oncology, Lille University, 59000, Lille, France; CRISTAL UMR CNRS 9189, Lille, France., Clinique d'Oncologie et de Radiothérapie, Department of Radiation Oncology, 37000, Tours, France., Institut Gustave Roussy, Department of Radiation Oncology, 94800, Villejuif, France., Hôpital Foch, Department of Clinical Oncology, 92151 Suresnes, France., Gustave Roussy, Department of Clinical Oncology, 94800, Villejuif, France., Centre François Baclesse, Department of Radiation Oncology, 14000, Caen, France; Centre François Baclesse, Department of Clinical Research, 14000, Caen, France., Centre Eugène Marquis, Department of Radiation Oncology, 35000, Rennes, France., Hôpital Saint-Louis, Department of Radiation Oncology, 75010, Paris, France., Hôpital Henri Mondor, Department of Radiation Oncology, 94010, Créteil, France., Centre François Baclesse, Department of Clinical Research, 14000, Caen, France., Centre François Baclesse, Department of Radiation Oncology, 14000, Caen, France., Centre Léon Bérard, Department of Radiation Oncology, 69008, Lyon, France., Centre François Baclesse, Department of Clinical Research, 14000, Caen, France; Centre François Baclesse, Department of Clinical Oncology, 14000, Caen, France.