立体定向体部放疗用于老年原发性肾细胞癌患者：4年经验后的初步结果
Stereotactic Body Radiotherapy for Frail Patients with Primary Renal Cell Carcinoma: Preliminary Results after 4 Years of Experience.
作者信息
Grelier Laure, Baboudjian Michael, Gondran-Tellier Bastien, Couderc Anne-Laure, McManus Robin, Deville Jean-Laurent, Carballeira Ana, Delonca Raphaelle, Delaporte Veronique, Padovani Laetitia, Boissier Romain, Lechevallier Eric, Muracciole Xavier
机构信息
Department of Urology and Kidney Transplantation, Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille (AP-HM), Conception Academic Hospital, 13005 Marseille, France.
Department of Radiotherapy, La Timone Hospital, Assistance Publique-Hopitaux de Marseille (AP-HM), 13005 Marseille, France.
出版信息
Cancers (Basel). 2021 Jun 23;13(13):3129. doi: 10.3390/cancers13133129.
INTRODUCTION
The aim of this study was to report the oncological outcomes and toxicity of stereotactic body radiotherapy (SBRT) to treat primary renal cell carcinoma (RCC) in frail patients unfit for surgery or standard alternative ablative therapies.
METHODS
We retrospectively enrolled 23 patients who had SBRT for primary, biopsy-proven RCC at our tertiary center between October 2016 and March 2020. Treatment-related toxicities were defined using CTCAE, version 4.0. The primary outcome was local control which was defined using the Response Evaluation Criteria in Solid Tumors.
RESULTS
The median age, Charlson score and tumor size were 81 (IQR 79-85) years, 7 (IQR 5-8) and 40 (IQR 28-48) mm, respectively. The most used dose fractionation schedule was 35 Gy (78.3%) in five or seven fractions. The median duration of follow-up for all living patients was 22 (IQR 10-39) months. Local recurrence-free survival, event-free survival, cancer-specific survival and overall survival were 96 (22/23), 74 (18/23), 96 (22/23) and 83% (19/23), respectively. There were no grade 3-4 side effects. No patients required dialysis during the study period. No treatment-related deaths or late complications were reported.
CONCLUSION
SBRT appears to be a promising alternative to surgery or ablative therapy to treat primary RCC in frail patients.
引言
本研究的目的是报告立体定向体部放疗（SBRT）治疗不适于手术或标准替代消融治疗的体弱患者原发性肾细胞癌（RCC）的肿瘤学结局和毒性。
方法
我们回顾性纳入了2016年10月至2020年3月期间在我们的三级中心接受SBRT治疗原发性、经活检证实的RCC的23例患者。使用CTCAE 4.0版定义治疗相关毒性。主要结局是局部控制，使用实体瘤疗效评价标准进行定义。
结果
中位年龄、Charlson评分和肿瘤大小分别为81（四分位间距79 - 85）岁、7（四分位间距5 - 8）和40（四分位间距28 - 48）mm。最常用的剂量分割方案是35 Gy（78.3%），分5次或7次。所有存活患者的中位随访时间为22（四分位间距10 - 39）个月。局部无复发生存率、无事件生存率、癌症特异性生存率和总生存率分别为96%（22/23）、74%（18/23）、96%（22/23）和83%（19/23）。无3 - 4级副作用。研究期间无患者需要透析。未报告与治疗相关的死亡或晚期并发症。
结论
SBRT似乎是治疗体弱患者原发性RCC的一种有前景的替代手术或消融治疗的方法。
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