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

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.

Beyond the Knife in Renal Cell Carcinoma: A Systematic Review—To Ablate or Not to Ablate?

“…Within this review, median LC at 12 months was 84.4%, (range 82.5–93) with a median LC rate of 87% (79–100%). This is comparable to a considerable number of retrospective mRCC SBRT studies, where the 12-month LC ranges from 70% to 98.2% [ 74 , 87 , 88 , 89 , 90 , 91 ]. Similar LC rates are also seen within a few retrospective studies of RFA in mRCC [ 92 ] and cryoablation studies [ 93 ].…”