Department of Radiology, Section of Radiation Oncology, Baylor College of Medicine, 6565 Fannin, Houston, TX 77030, USA
Acta Oncol. 2012 May;51(5):584-8. doi: 10.3109/0284186X.2011.652741. Epub 2012 Jan 17.
To investigate the utility of stereotactic body radiotherapy (SBRT) in the treatment of painful renal cell carcinoma (RCC) bone metastases, and for a possible dose effect on time to symptom relief.
Eighteen patients with 24 painful osseous lesions from metastatic RCC were treated with SBRT. The most common treatment regimens were 24 Gy in 3 fractions and 40 Gy in 5 fractions. The times from treatment to first reported pain relief and time to symptom recurrence were evaluated. Median follow-up was 38 weeks (1-156 weeks).
Seventy-eight percent of all patients had pain relief. Patients treated with a BED > 85 Gy achieved faster and more durable pain relief compared to those treated with a BED < 85 Gy. There was decrease in time to pain relief after a change in treatment regimen to 8 Gy × 5 fractions (BED = 86). There was only one patient with grade 1 skin toxicity. No neurological or other toxicity was observed.
SBRT can safely and effectively treat painful RCC bony metastases. There appears to be a relationship between radiation dose and time to stable pain relief.
研究立体定向体部放疗（SBRT）治疗疼痛性肾细胞癌（RCC）骨转移的效果，以及对缓解症状时间可能存在的剂量效应。
18 例转移性 RCC 患者的 24 个骨转移病灶接受 SBRT 治疗。最常见的治疗方案是 24Gy 分 3 次和 40Gy 分 5 次。评估从治疗到首次报告疼痛缓解和症状复发的时间。中位随访时间为 38 周（1-156 周）。
所有患者中有 78%的疼痛得到缓解。与 BED<85Gy 的患者相比，BED>85Gy 的患者获得更快和更持久的疼痛缓解。改变治疗方案为 8Gy×5 次（BED=86）后，缓解疼痛的时间缩短。只有 1 例患者出现 1 级皮肤毒性。未观察到神经毒性或其他毒性。
SBRT 可安全有效地治疗疼痛性 RCC 骨转移。似乎存在放射剂量与稳定缓解症状时间之间的关系。
