Lee John H, Linzey Joseph R, Strong Michael J, Kathawate Varun G, Goethe Peyton E, Tudrick Lila R, Tripathy Arushi, Koduri Sravanthi, Gagnet Paul, Ward Ayobami L, Ogunsola Oludotun, Zaki Mark M, Joshi Rushikesh S, Evans Joseph, Jackson William C, Szerlip Nicholas J
School of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
World Neurosurg. 2023 Oct;178:e403-e409. doi: 10.1016/j.wneu.2023.07.079. Epub 2023 Jul 22.
The outcomes for patients with metastatic renal cell carcinoma (RCC) to the spine who underwent stereotactic body radiotherapy (SBRT) through a multidisciplinary spine oncology program are not well described. We sought to describe the clinical course and local control rates at 1 and 2 years for these patients.
A retrospective analysis of a prospectively maintained database of adult oncologic patients receiving SBRT to the spine through a multidisciplinary spine oncology program at a single institution from 2010 to 2021 was performed. Patients with a pathologic diagnosis of RCC were included.
A total of 75 spinal sites were treated in 60 patients. Of the 60 patients, 75.0% were men, and the mean patient age was 59.2 ± 11.3 years. At 1 year after treatment, 6 of the 60 patients were lost to follow-up. Of the remaining 54 patients, 18 were censored by death and 7 treatment sites showed local recurrence, for 37 of 44 treatment sites with local control (87.8%). At 2 years, 1 additional local recurrence had developed, 15 patients were censored by death, and no additional patients had been lost to follow-up, resulting in 28 of 36 treatment sites with local control (83.2%). None of the patients who had undergone repeat SBRT had local recurrence at 1 or 2 years. For those with local recurrence, the average time from treatment to progression was 6.6 ± 6.5 months.
In this cohort, one of the largest reported studies of spine SBRT for metastatic RCC, local control was high at 1 and 2 years. Our findings support the role of coordinated, algorithmic treatment for these patients.
通过多学科脊柱肿瘤项目接受立体定向体部放疗（SBRT）的脊柱转移性肾细胞癌（RCC）患者的治疗结果尚未得到充分描述。我们试图描述这些患者1年和2年时的临床病程及局部控制率。
对2010年至2021年在单一机构通过多学科脊柱肿瘤项目接受脊柱SBRT的成年肿瘤患者的前瞻性维护数据库进行回顾性分析。纳入病理诊断为RCC的患者。
60例患者共75个脊柱部位接受了治疗。60例患者中，75.0%为男性，平均患者年龄为59.2±11.3岁。治疗后1年，60例患者中有6例失访。其余54例患者中，18例因死亡被 censored，7个治疗部位出现局部复发，44个治疗部位中有37个实现局部控制（87.8%）。2年时，又出现1例局部复发，15例患者因死亡被 censored，无额外患者失访，36个治疗部位中有28个实现局部控制（83.2%）。接受重复SBRT的患者在1年或2年时均无局部复发。对于出现局部复发的患者，从治疗到进展的平均时间为6.6±6.5个月。
在这个队列中，这是已报道的关于脊柱SBRT治疗转移性RCC的最大规模研究之一，1年和2年时的局部控制率较高。我们的研究结果支持对这些患者进行协调的、按算法治疗的作用。
