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评估 5 次立体定向体部放射治疗(SBRT)治疗骨转移肾细胞癌。

Evaluation of 5 Fraction Stereotactic Body Radiation Therapy (SBRT) for Osseous Renal Cell Carcinoma Metastases.

机构信息

Department of Radiation Oncology and Department of Cancer Biology.

School of Medicine, Vanderbilt University Medical Center, Nashville, TN.

出版信息

Am J Clin Oncol. 2022 Dec 1;45(12):501-505. doi: 10.1097/COC.0000000000000952. Epub 2022 Nov 14.

Abstract

OBJECTIVES

The best fractionation for stereotactic body radiotherapy (SBRT) in renal cell carcinoma (RCC) metastases has not been well defined. In addition, the literature on outcomes using 5-fraction SBRT in the setting of osseous metastases has not been well reported.

MATERIALS AND METHODS

Thirty-nine patients with 69 RCC osseous metastases were treated using 5-fraction SBRT at a single institution using 2 dose-fractionation schemes. Overall survival and local-control (LC) outcomes of the 2 fractionation schemes were studied using Kaplan-Meier curves.

RESULTS

Of the 69 lesions included in the study, 20 were treated with 30 grays (Gy) in 5 fractions and 49 were treated with 40 Gy in 5 fractions. The median age of patients at diagnosis was 58.4 years. The 1-year LC rate for all treated lesions was 85.5% (59/69) with an LC of 90% (18/20) for lesions receiving 30 Gy and 83.7% (41/49) in lesions receiving 40 Gy. There was no statistically significant difference in 1-year LC rate between the 2 fractionation schemes (P-value, 0.553).

CONCLUSIONS

Patients with osseous RCC metastases undergoing 5 fractions of SBRT had favorable LC outcomes. There was no difference in survival or LC between the 40 Gy and 30 Gy treatment arms.

摘要

目的

立体定向体放射治疗(SBRT)治疗肾细胞癌(RCC)转移的最佳分割尚未明确。此外,关于 5 次分割 SBRT 在骨转移患者中应用的结果的文献报道也很少。

材料与方法

在一家机构中,39 例 69 个 RCC 骨转移灶采用 5 次分割 SBRT 治疗,使用 2 种剂量分割方案。使用 Kaplan-Meier 曲线研究了这 2 种分割方案的总生存率和局部控制(LC)结果。

结果

在本研究纳入的 69 个病灶中,20 个病灶接受 30 戈瑞(Gy)5 次分割治疗,49 个病灶接受 40 Gy 5 次分割治疗。患者诊断时的中位年龄为 58.4 岁。所有治疗病灶的 1 年 LC 率为 85.5%(59/69),30 Gy 组的 LC 率为 90%(18/20),40 Gy 组的 LC 率为 83.7%(41/49)。两种分割方案的 1 年 LC 率无统计学差异(P 值为 0.553)。

结论

接受 5 次分割 SBRT 的 RCC 骨转移患者的 LC 结果良好。40 Gy 与 30 Gy 治疗组在生存和 LC 方面无差异。

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