Department of Radiation Oncology and Department of Cancer Biology.
School of Medicine, Vanderbilt University Medical Center, Nashville, TN.
Am J Clin Oncol. 2022 Dec 1;45(12):501-505. doi: 10.1097/COC.0000000000000952. Epub 2022 Nov 14.
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.
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.
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).
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.
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。
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。
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)。
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。