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放疗联合唑来膦酸可降低骨转移肾癌患者的骨骼相关事件。

Radiotherapy combined with zoledronate can reduce skeletal-related events in renal cell carcinoma patients with bone metastasis.

机构信息

Division of Orthopedic Oncology, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Shuntou-gun, Shizuoka, 411-8777, Japan.

Division of Urology, Shizuoka Cancer Center Hospital, Shizuoka, 411-8777, Japan.

出版信息

Int J Clin Oncol. 2018 Dec;23(6):1127-1133. doi: 10.1007/s10147-018-1310-7. Epub 2018 Jun 29.

Abstract

BACKGROUND

Skeletal-related events (SRE) are common in patients with renal cell carcinoma (RCC) that includes bone metastasis. The purpose of this study was to clarify the effectiveness of zoledronate with and without sunitinib, combined with radiotherapy, for the treatment of bone metastasis from RCC.

METHODS

We retrospectively analyzed 62 RCC patients with bone metastasis, who had been treated with radiotherapy at our institution. We divided the study cohort into two groups: patients treated with radiotherapy alone (RT; n = 27) and those treated with radiotherapy combined with zoledronate (RT + Z; n = 35). We investigated the overall survival and post-irradiation (PI)-SRE-free rate for each group, as well as the effect of sunitinib in the RT + Z treatment group. In addition, we determined treatment effectiveness by imaging assessments and relative response rates.

RESULTS

There was no significant difference in the survival rates between the RT and RT + Z treatment groups (p = 0.11). However, the PI-SRE-free rate in the RT + Z group was significantly higher than that in the RT group (p = 0.02). The PI-SRE-free rate was significantly higher in patients who were treated with sunitinib after radiotherapy than in those who were treated without sunitinib (p = 0.03). However, there was no significant difference in the relative response rates, as assessed by imaging, in each group.

CONCLUSION

Radiotherapy combined with zoledronate is an effective treatment for RCC with bone metastasis to prevent PI-SRE. Sunitinib may reduce PI-SRE if used after radiotherapy and combined with zoledronate.

摘要

背景

骨骼相关事件(SRE)在包括骨转移的肾细胞癌(RCC)患者中很常见。本研究旨在阐明唑来膦酸联合或不联合舒尼替尼联合放疗治疗 RCC 骨转移的疗效。

方法

我们回顾性分析了在我院接受放疗的 62 例 RCC 伴骨转移患者。将研究队列分为两组:单纯放疗组(RT;n=27)和放疗联合唑来膦酸组(RT+Z;n=35)。我们调查了每组的总生存率和放疗后(PI)-SRE 无事件生存率,以及舒尼替尼在 RT+Z 治疗组中的作用。此外,我们通过影像学评估和相对缓解率来确定治疗效果。

结果

RT 和 RT+Z 治疗组的生存率无显著差异(p=0.11)。然而,RT+Z 组的 PI-SRE 无事件生存率显著高于 RT 组(p=0.02)。放疗后接受舒尼替尼治疗的患者 PI-SRE 无事件生存率显著高于未接受舒尼替尼治疗的患者(p=0.03)。然而,各组的相对缓解率(通过影像学评估)没有显著差异。

结论

放疗联合唑来膦酸是治疗 RCC 伴骨转移以预防 PI-SRE 的有效方法。舒尼替尼联合放疗和唑来膦酸可能会降低 PI-SRE 的发生。

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