Department of Urology.
Department of Radiation Oncology, Rush University, Chicago, Illinois, USA.
Curr Opin Urol. 2023 Sep 1;33(5):375-382. doi: 10.1097/MOU.0000000000001111. Epub 2023 Jul 5.
To provide a critical overview of the latest evidence on the role of metastasis-direct treatment (MDT) in the management of metastatic renal cell carcinoma (mRCC).
This is a nonsystematic review of the English language literature published since January 2021. A PubMed/MEDLINE search using various search terms was conducted, including only original studies. After title and abstract screening, selected articles were grouped into two main areas which mirror the main treatment options in this setting: surgical metastasectomy (MS) and stereotactic radiotherapy (SRT). While a limited number of retrospective studies have been reported on surgical MS, the consensus of these reports is that extirpation of metastasis should be part of a multimodal management strategy for carefully selected cases. In contrast, there have been both retrospective studies and a small number of prospective studies on the use of SRT of metastatic sites.
As the management of mRCC rapidly evolves, and evidence on MDT - both in the form of MS and SRT - has continued to build over the past 2 years. Overall, there is growing interest in this therapeutic option, which is increasingly being implemented and seems to be safe and potentially beneficial in well selected disease scenarios.
提供转移性肾细胞癌(mRCC)治疗中转移灶定向治疗(MDT)作用的最新证据的批判性概述。
这是对 2021 年 1 月以来发表的英文文献的非系统性综述。使用各种搜索词进行了 PubMed/MEDLINE 搜索,仅包括原始研究。经过标题和摘要筛选,选择的文章分为两个主要领域,反映了该领域的主要治疗选择:手术转移灶切除术(MS)和立体定向放疗(SRT)。虽然已经有一些关于手术 MS 的有限回顾性研究,但这些报告的共识是,对于精心挑选的病例,应将转移灶切除作为多模式管理策略的一部分。相比之下,对于转移性部位 SRT 的使用,既有回顾性研究,也有少数前瞻性研究。
随着 mRCC 治疗的快速发展,过去 2 年来,关于 MDT 的证据——包括 MS 和 SRT 形式——不断增加。总的来说,人们对这一治疗选择的兴趣越来越大,这种治疗选择越来越多地被实施,并且在选择良好的疾病情况下似乎是安全且可能有益的。