Kijima Toshiki, Fujii Yasuhisa, Suyama Taisuke, Okubo Yuhei, Yamamoto Shinya, Masuda Hitoshi, Yonese Junji, Fukui Iwao
Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, Tokyo, Japan.
BJU Int. 2009 Mar;103(5):620-4. doi: 10.1111/j.1464-410X.2008.08124.x. Epub 2008 Oct 16.
To investigate the rate of objective response and the skeletal-related event (SRE)-free survival after combined therapy with radiotherapy (RT) and zoledronate in patients with bone metastases from renal cell carcinoma (RCC).
In all, 23 patients with RCC metastatic to bone were included in this retrospective study, of whom 13 had RT to bone metastases with no bisphosphonate therapy between 2000 and 2006, while the remaining 10 had combined therapy with RT and zoledronate (RT + Z) in 2006 and 2007. Significant calcifications of osteolytic metastases and/or shrinkage of bone lesions, as measured by computed tomography, were defined as a partial response. SREs were defined as any of pathological fracture, spinal cord compression, bone surgery, or additional RT to the bone.
In the RT + Z group, six patients had a partial response, showing evidence of calcification of their osteolytic bone metastases, while in the RT group, only one patient did (P = 0.019). One patient in the RT + Z group had an SRE, while 10 in the RT group had SREs (P = 0.003). The median SRE-free survival time was not reached in the RT + Z group, but in the RT group it was 18.7 months (P = 0.046).
Combined therapy as RT + Z achieved a higher objective response rate (six of 10) and prolonged SRE-free survival than RT alone in patients with bone metastases from RCC.
探讨放射治疗(RT)联合唑来膦酸治疗肾细胞癌(RCC)骨转移患者的客观缓解率及无骨相关事件(SRE)生存期。
本回顾性研究共纳入23例RCC骨转移患者,其中13例在2000年至2006年间接受了骨转移灶的放射治疗,未接受双膦酸盐治疗,其余10例在2006年至2007年间接受了放射治疗与唑来膦酸的联合治疗(RT + Z)。通过计算机断层扫描测量,溶骨性转移灶的显著钙化和/或骨病变缩小被定义为部分缓解。SREs定义为病理性骨折、脊髓压迫、骨手术或对骨进行额外的放射治疗中的任何一种。
在RT + Z组中,6例患者有部分缓解,显示其溶骨性骨转移有钙化迹象,而在RT组中只有1例(P = 0.019)。RT + Z组中有1例患者发生SRE,而RT组中有10例发生SRE(P = 0.003)。RT + Z组未达到无SRE生存期的中位数,但RT组为18.7个月(P = 0.046)。
对于RCC骨转移患者,RT + Z联合治疗比单纯放射治疗具有更高的客观缓解率(10例中有6例)和更长的无SRE生存期。