Need for a new trial to evaluate postoperative radiotherapy in renal cell carcinoma: a meta-analysis of randomized controlled trials

Tunio, Mutahir A.; Hashmi, Altaf; Rafi, Mansoor

doi:10.1093/annonc/mdq028

Cited by 69 publications

(31 citation statements)

References 24 publications

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“…However, subsequent clinical trials throughout the 1970s and 1980s failed to demonstrate any increase in survival with external beam radiation delivered in the neoadjuvant or adjuvant setting [26–29]. A meta‐analysis of seven randomized controlled trials and 735 patients treated with postoperative radiotherapy was recently published [30]. Pooled results from these trials showed a significant reduction of locoregional failure in patients treated with postoperative radiotherapy ( P < 0.001) but no difference in overall survival ( P = 0.29).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of stereotactic radiotherapy ablation for primary renal cell carcinoma

et al. 2012

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Section: Discussionmentioning

confidence: 99%

A systematic review of stereotactic radiotherapy ablation for primary renal cell carcinoma

et al. 2012

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“…A meta-analysis of randomized trials of adjuvant CRT showed no significant improvement in overall or disease-free survival, although these trials were not performed in a modern RT era. 7 The main use of RT to date has been in the metastatic setting to palliate symptomatic bone and brain metastases, where short course RT doses have symptomatic benefit. 8,9 Over the past 10 to 15 years, there have been tremendous advances in RT practice, permitting use of high precision RT planning and delivery techniques.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic body radiotherapy for the treatment of medically inoperable primary renal cell carcinoma: Current evidence and future directions

Swaminath

Chu

2015

CUAJ

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The incidence of renal cell carcinoma (RCC) is steadily rising due to an aging population and more frequent imaging of the abdomen for other medical conditions. While surgery remains the standard of care treatment for localized disease, many patients are unfit due to their advanced age and medical comorbidities. In these patients, an active surveillance strategy or ablative therapies, including radiofrequency/microwave ablation or cryotherapy, can be offered. Such options have limitations particularly with fast growing, or larger tumors. A promising ablative therapy option to consider is stereotactic body radiotherapy (SBRT). SBRT refers to high dose, focally ablative radiation delivered in a short time (3-5 fractions), and is safe and effective in many other cancer sites, including lung, liver and spine. SBRT offers potential advantages in the primary kidney cancer setting due to its ablative dosing (overcoming the notion of "radio-resistance"), short treatment duration (important in an elderly population), low toxicity profile (enabling SBRT to treat larger RCCs than other ablative modalities), and non-invasiveness. To date, there is limited long-term prospective data on the outcomes of SBRT in primary RCC. However, early evidence is intriguing with respect to excellent local control and low toxicity; however, most studies vary in terms of technique and radiation dosing used. Welldesigned prospective cohort studies with clearly defined and standardized techniques, dosing, follow-up, and integration of quality of life outcomes will be essential to further establish the role of SBRT in management of inoperable, localized RCC.

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“…The incidence of RCC over last 20 years has progressively increased due to widespread use of modern imaging. 1 About 30%-50% of patients are found to have metastases at diagnosis. While bone, lymph nodes, lungs and brain constitute expected 'homing' sites, metastasis may turn up at the unusual locations (skin, testis, maxillary antrum and tongue).…”

Section: Introductionmentioning

confidence: 99%

Metastatic Renal Cell Carcinoma in Endometrial Cavity : A Rare Case Report

Nibhoria¹,

Tiwana²,

Monga³

2014

jemds

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Renal cell carcinoma (RCC) has unpredictable and diverse behaviour. The classic triad of hematuria, loin pain and abdominal mass is uncommon at time of presentation. About 30%-50% of patients are found to have metastases at the time of diagnosis. Bones, lungs, liver and brain are the frequent sites of metastases. RCC with metastasis to the endometrial cavity is rarest manifestation, as seen in our patient. Patient was a 40 year old female, G3P1, known case of renal cell carcinoma, presenting in emergency with bleeding per vaginum. She had no other co-morbidity. Endometrial curettage was done and specimen sent for histopathological examination, which revealed metastasis from clear cell type of renal cell carcinoma in endometrial cavity and was confirmed on IHC. KEYWORDS: Endometrial cavity, Metastasis, Renal cell carcinoma INTRODUCTION:Renal cell carcinoma (RCC) has unpredictable and diverse behaviour. The incidence of RCC over last 20 years has progressively increased due to widespread use of modern imaging. 1 About 30%-50% of patients are found to have metastases at diagnosis. While bone, lymph nodes, lungs and brain constitute expected 'homing' sites, metastasis may turn up at the unusual locations (skin, testis, maxillary antrum and tongue). 2-4 Uterus is a rare site of metastasis, because of dense stroma and less vascularity.Metastatic RCC to endometrial cavity of uterus is extremely rare and usually associated with left sided RCC; only four case reports have been published so far, that too in cervix uteri. [5][6][7][8] There is one report in the literature of metastatic oncocytic papillary RCC to the endometrium in an 89-yearold woman, who presented with vaginal bleeding. 9 The exact mechanism is not known; however retrograde venous flow of tumor cells from left renal vein to the left ovarian vein and cervical and vaginal venous plexus explains the spread of left sided RCC to uterus.

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Need for a new trial to evaluate postoperative radiotherapy in renal cell carcinoma: a meta-analysis of randomized controlled trials

Abstract: PORT significantly reduces LRF but has no effect on OS and DFS. However, due to poor patient accrual and older radiotherapy techniques in previous studies, there is a need for a new trial to evaluate PORT using conformal and intensity-modulated radiotherapy techniques.

Cited by 69 publications

References 24 publications

A systematic review of stereotactic radiotherapy ablation for primary renal cell carcinoma

A systematic review of stereotactic radiotherapy ablation for primary renal cell carcinoma

Stereotactic body radiotherapy for the treatment of medically inoperable primary renal cell carcinoma: Current evidence and future directions

Metastatic Renal Cell Carcinoma in Endometrial Cavity : A Rare Case Report

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