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Preliminary clinical observation of efficacy and safety of stereotactic body radiation therapy in combination with targeted therapy for metastatic renal cell carcinoma
Liu Yang1, Dong Pei2, Huang Sijuan1, Cao Wufei1, Liu Boji1, Lin Maosheng1, Jiang Xiaobo1, Lin Chengguang1, Liu Zhuowei2, Han Hui2, Li Yonghong2, Liu Mengzhong1, Zhou Fangjian2, He Liru1
1Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; 2Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
AbstractObjective To evaluate the preliminary clinical efficacy and safety of stereotactic body radiation therapy (SBRT) in combination with targeted therapy for metastatic renal cell carcinoma (mRCC). Methods Clinical data of 58 patients with mRCC who were treated with SBRT in combination with targeted therapy in Sun Yat-sen University Cancer Center from June 2013 to December 2018 were retrospectively analyzed. Among them, 79.3% patients were classified as intermediate or high risk according to International Metastatic Renal Cell Carcinoma Database Consortium Criteria. The median biologically equivalent dose (BED) was 147 Gy (67 to 238 Gy). Results Overall, 32, 13, 7, 5 and 1 patients received SBRT for 1, 2, 3, 4 and 6 metastatic sites (105 lesions) and 71.4% of them were bone lesions. Targeted therapy was continued during SBRT. With a median follow-up of 9.4 months (range 2.7 to 40.1 months), 18 patients died. The 1-year local control rate was 97.4%. The 1-year progression-free survival was 50.3%. The 1-and 2-year overall survival was 72% and 53%. Approximately 85% patients experienced pain relief after SBRT. Patients who achieved complete or partial response after SBRT obtained better overall survival than those with stable disease or disease progression (1-year overall survival:83% vs. 48%,P=0.021). In the whole cohort, 6 cases developed Grade Ⅲ adverse events, 4 of which were Grade Ⅲ myelosuppression, 1 case of Grade Ⅲ neuropathy and 1 case of radiation-induced skin injury. Conclusion Preliminary study reveals that combined use of targeted therapy and SBRT is an efficacious and safe treatment of advanced mRCC.
Corresponding Authors:
He Liru, Email:helir@sysucc.org.cn
Cite this article:
Liu Yang,Dong Pei,Huang Sijuan et al. Preliminary clinical observation of efficacy and safety of stereotactic body radiation therapy in combination with targeted therapy for metastatic renal cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2020, 29(10): 855-858.
Liu Yang,Dong Pei,Huang Sijuan et al. Preliminary clinical observation of efficacy and safety of stereotactic body radiation therapy in combination with targeted therapy for metastatic renal cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2020, 29(10): 855-858.
[1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017[J]. Ca Cancer J Clin, 2017, 67(1):7. DOI:10.3322/caac.21387.
[2] Coppin C, Kollmannsberger C, Le L, et al. Targeted therapy for advanced renal cell cancer (RCC):a cochrane systematic review of published randomised trials[J]. BJU Int, 2011, 108(10):1556-1563. DOI:10.1111/j.1464-410X.2011.10629.x.
[3] Dabestani S, Marconi L, Hofmann F, et al. Local treatments for metastases of renal cell carcinoma:a systematic review[J]. Lancet Oncol, 2014, 15(12):e549-e561. DOI:10.1016/S1470-2045(14)70235-9.
[4] Ranck MC, Golden DW, Corbin KS, et al. Stereotactic body radiotherapy for the treatment of oligometastatic renal cell carcinoma[J]. Am J Clin Oncol, 2013, 36(6):589-595. DOI:10.1097/COC.0b013e31825d52b2.
[5] Scorsetti M, Clerici E, Navarria P, et al. The role of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in the elderly[J]. Br J Radiol, 2015, 88(1053):20150111. DOI:10.1259/bjr.20150111.
[6] Hanna GG, Murray L, Patel R, et al. UK consensus on normal tissue dose constraints for stereotactic radiotherapy[J]. Clin Oncol, 2017, 30(1):S093665551730434X. DOI:10.1016/j.clon.2018.03.012.
[7] Costelloe CM, Chuang HH, Madewell JE, et al. Cancer Response Criteria and Bone Metastases:RECIST 1.1, MDA and PERCIST[J]. J Cancer, 2010, 1(1):80-92. DOI:10.7150/jca.1.80.
[8] Turajlic S, Xu H, Litchfield K, et al. Tracking cancer evolution reveals constrained routes to metastases:TRACERx Renal[J]. Cell, 2018, 173(3):581. DOI:10.1016/j.cell.2018.03.057.
[9] Meyer CP, Sun M, Karam JA, et al. Complications after metastasectomy for renal cell carcinoma-a population-based assessment[J]. Eur Urol, 2017, 72(2):171. DOI:10.1016/j.eururo.2017.03.005.
[10] Stenman M, Sinclair G, Paavola P, et al. Overall survival after stereotactic radiotherapy or surgical metastasectomy in oligometastatic renal cell carcinoma patients treated at two Swedish centres 2005-2014[J]. Radiother Oncol, 2018, 127(3):501-506. DOI:10.1016/j.radonc.2018.04.028.
[11] NCCN. The NCCN kidney cancer clinical practice guidelines in oncology (version 1. 2020). Washington:NCCN, 2019[EB/OL][2019-06-07].http://www.nccn.org/professionals/physician_gls/f_guidelines.asp.
[12] Smith BW, Joseph JR, Saadeh YS, et al. Radiosurgery for treatment of renal cell metastases to spine:a systematic review of the literature[J]. World Neurosurg, 2017, 109:S1878875017317382. DOI:10.1016/j.wneu.2017.10.011.
[13] Gargi K, Farshad F, Suki G, et al. Outcomes of stereotactic radiotherapy for cranial and extracranial metastatic renal cell carcinoma:a systematic review[J]. Acta Oncol, 2014, 54(2):1. DOI:10.3109/0284186X.2014.939298.
[14] Iacovelli R, Lanoy E, Albiges L, et al. Tumour burden is an independent prognostic factor in metastatic renal cell carcinoma[J]. BJU Int, 2012, 110(11):1747-1753. DOI:10.1111/j.1464-410X.2012.11518.x.
[15] Barbastefano J, Garcia JA, Elson P, et al. Association of percentage of tumour burden removed with debulking nephrectomy and progression-free survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy[J]. BJU Int, 2010, 106(9):1266-1269. DOI:10.1111/j.1464-410X.2010.09323.x.
[16] Meyer E, Pasquier D, Bernadou G, et al. Stereotactic radiation therapy in the strategy of treatment of metastatic renal cell carcinoma:a study of the Getug group[J]. Eur J Cancer, 2018, 98:38. DOI:10.1016/j.ejca.2018.04.008.
[17] Miller JA, Balagamwala EH, Angelov L, et al. Spine stereotactic radiosurgery with concurrent tyrosine kinase inhibitors for metastatic renal cell carcinoma[J]. J Neurosurg Spine, 2016, 25(6):766-774. DOI:10.3171/2016.4. SPINE16229.
[18] Meerleer GD, Khoo V, Escudier B, et al. Radiotherapy for renal-cell carcinoma[J]. Lancet Oncol, 2014, 15:e170-177. DOI:10.1016/S1470-2045(13)70569-2.
2020, Vol. 29 
