Role of Stereotactic Body Radiation Therapy for the Management of Oligometastatic Renal Cell Carcinoma

No AccessJournal of UrologyAdult Urology1 Jan 2019Role of Stereotactic Body Radiation Therapy for the Management of Oligometastatic Renal Cell Carcinoma Ciro Franzese, Davide Franceschini, Lucia Di Brina, Giuseppe Roberto D'Agostino, Pierina Navarria, Tiziana Comito, Pietro Mancosu, Stefano Tomatis, and Marta Scorsetti Ciro FranzeseCiro Franzese *Correspondence: Humanitas Clinical and Research Hospital, Via Manzoni 56, Rozzano (MI), Italy, +39-0282247454 (e-mail: E-mail Address: [email protected]). Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy , Davide FranceschiniDavide Franceschini Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy , Lucia Di BrinaLucia Di Brina Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy , Giuseppe Roberto D'AgostinoGiuseppe Roberto D'Agostino Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy , Pierina NavarriaPierina Navarria Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy , Tiziana ComitoTiziana Comito Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy , Pietro MancosuPietro Mancosu Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy , Stefano TomatisStefano Tomatis Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy , and Marta ScorsettiMarta Scorsetti Department of Biomedical Sciences, Humanitas University, Milan, Italy View All Author Informationhttps://doi.org/10.1016/j.juro.2018.08.049AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Kidney cancer has been increasing 1.7% annually. Renal cell carcinoma is the most common kidney cancer and it can metastasize. Our aim was to analyze patients treated with stereotactic body radiation therapy of renal cell carcinoma metastases. Materials and Methods: A total of 58 patients (73 lesions) were treated from 2004 to 2016. Patients were candidates for analysis if a maximum of 3 metastases were diagnosed and the primary tumor was resected. Toxicity was classified according to Common Terminology Criteria for Adverse Events version 3. Results: All patients had renal cell carcinoma, in particular the clear cell type in 82.7%. A total of 39 metastases (53.4%) were located in the lungs and 19 (26%) were in the lymph nodes. Less common were metastases to bone (9.5% of cases), the liver (4.1%) and the adrenal gland (6.8%). Median followup was 16.1 months (range 3.5 to 157.1). The local control rate at 12 and 18 months was 90.2% and 90.2%, respectively. The progression-free survival rate at 12 and 18 months was 46.2% (95% CI 32.2–59) and 35% (95% CI 21.4–48.9), respectively. On univariate and multivariable analyses metachronous and single metastases predicted better progression-free survival. Systemic therapy before stereotactic body radiation therapy predicted improved local control in clear cell cases. Conclusions: Stereotactic body radiation therapy can be considered a safe approach and it provides effective local control of oligometastatic renal cell carcinoma. However, future prospective studies are necessary to evaluate the impact on survival and quality of life. References 1. : Kidney cancer, version 2.2014. J Natl Compr Canc Netw 2014; 12: 175. Google Scholar 2. : Skeletal complications and survival in renal cancer patients with bone metastases. Bone 2011; 48: 160. Google Scholar 3. : Extracranial stereotactic radiotherapy for primary and metastatic renal cell carcinoma. Radiother Oncol 2005; 77: 88. 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No direct or indirect commercial incentive associated with publishing this article. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLawrentschuk N (2019) Editorial CommentJournal of Urology, VOL. 201, NO. 6, (1104-1104), Online publication date: 1-Jun-2019. Volume 201Issue 1January 2019Page: 70-76 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordsrenal cellkidney neoplasmsneoplasm metastasisstereotactic techniquesradiosurgerycarcinomaMetricsAuthor Information Ciro Franzese Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy *Correspondence: Humanitas Clinical and Research Hospital, Via Manzoni 56, Rozzano (MI), Italy, +39-0282247454 (e-mail: E-mail Address: [email protected]). More articles by this author Davide Franceschini Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy More articles by this author Lucia Di Brina Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy More articles by this author Giuseppe Roberto D'Agostino Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy More articles by this author Pierina Navarria Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy More articles by this author Tiziana Comito Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy More articles by this author Pietro Mancosu Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy More articles by this author Stefano Tomatis Radiotherapy and Radiosurgery Unit, Humanitas Clinical and Research Center, Milan, Italy More articles by this author Marta Scorsetti Department of Biomedical Sciences, Humanitas University, Milan, Italy More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. 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