Park Sangjoon, Kim Kyung Hwan, Rhee Woo Joong, Lee Jeongshim, Cho Yeona, Koom Woong Sub
Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
Radiat Oncol J. 2016 Jun;34(2):128-34. doi: 10.3857/roj.2016.01718. Epub 2016 Jun 17.
To evaluate the clinical outcomes of patients who underwent radiation therapy with or without targeted molecular therapy for the treatment of spinal metastasis from renal cell carcinoma (RCC).
A total of 28 spinal metastatic lesions from RCC patients treated with radiotherapy between June 2009 and June 2015 were retrospectively reviewed. Thirteen lesions were treated concurrently with targeted molecular therapy (concurrent group) and 15 lesions were not (nonconcurrent group). Local control was defined as lack of radiographically evident local progression and neurological deterioration.
At a median follow-up of 11 months (range, 2 to 58 months), the 1-year local progression-free rate (LPFR) was 67.0%. The patients with concurrent targeted molecular therapy showed significantly higher LPFR than those without (p = 0.019). After multivariate analysis, use of concurrent targeted molecular therapy showed a tendency towards improved LPFR (hazard ratio, 0.13; 95% confidence interval, 0.01 to 1.16). There was no difference in the incidence of systemic progression between concurrent and nonconcurrent groups. No grade ≥2 toxicities were observed during or after radiotherapy.
Our study suggests the possibility that concurrent use of targeted molecular therapy during radiotherapy may improve LPFR. Further study with a large population is required to confirm these results.
评估接受或未接受靶向分子治疗的放射治疗患者在治疗肾细胞癌（RCC）脊柱转移方面的临床结局。
回顾性分析2009年6月至2015年6月期间接受放射治疗的28例RCC患者的脊柱转移病灶。13个病灶接受了靶向分子治疗（联合组），15个病灶未接受（非联合组）。局部控制定义为影像学上无明显局部进展和神经功能恶化。
中位随访11个月（范围2至58个月），1年局部无进展率（LPFR）为67.0%。接受联合靶向分子治疗的患者LPFR显著高于未接受者（p = 0.019）。多因素分析后，联合使用靶向分子治疗显示出LPFR改善的趋势（风险比，0.13；95%置信区间，0.01至1.16）。联合组和非联合组全身进展发生率无差异。放疗期间或放疗后未观察到≥2级毒性反应。
我们的研究提示放疗期间联合使用靶向分子治疗可能改善LPFR。需要进行更大规模人群的进一步研究以证实这些结果。
