Stereotactic gamma-ray body radiation therapy for asynchronous bilateral renal cell carcinoma

Wang, Yijun; Han, Tingting; Xue, Jing; Chang, D.; Li, Hongqi; Li, Ping; Wang, Jidong; Wang, Yingjie; Xia, Tingyi

doi:10.1007/s11547-014-0402-3

Cited by 11 publications

(6 citation statements)

References 15 publications

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“…Such dose dependency is commonly observed for SABR in other disease sites. It is also illustrated in RCC by the findings of Wang et al [41] demonstrating LC rates as low as 43.5% at 5 yr when using fractional doses of 3-5 Gy (total: 36-51 Gy) for mostly large or locally invasive T3/4 RCC. The LC rate demonstrated here for primary RCC SABR compares favorably with TA with consideration of tumor size and follow-up duration.…”

Section: Local Controlmentioning

confidence: 88%

The Emerging Role of Stereotactic Ablative Radiotherapy for Primary Renal Cell Carcinoma: A Systematic Review and Meta-Analysis

Correa

Louie

Zaorsky

et al. 2019

European Urology Focus

108

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Context: Stereotactic ablative radiotherapy (SABR) is an emerging treatment option for primary renal cell carcinoma (RCC). Objective: To systematically review the literature on SABR for primary RCC and perform a meta-analysis evaluating local control (LC), toxicity, and renal function. Evidence acquisition: A PROSPERO-registered (#115573), Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA)-based systematic review of the literature was conducted (1995-2019). Studies of SABR targeting primary RCC tumors were included, while those targeting only metastases were excluded. The primary outcome was LC defined as tumor size reduction and/or absence of local progression. Secondary outcomes included toxicity (Common Terminology Criteria for Adverse Events) and renal function (change in estimated glomerular filtration rate [eGFR]). Weighted random-effect meta-analyses using the DerSimonian and Laird method were conducted for primary and secondary outcomes. The I 2 statistic and Cochran's Q test were used to assess heterogeneity. Evidence synthesis: From 2386 PubMed entries and 924 meeting abstracts, 26 studies were identified (11 prospective trials), including 383 tumors in 372 patients, most of whom were deemed inoperable. Weighted averages (ranges) of median follow-up, median age, and mean tumor size were 28.0 (5.8-79.2) mo, 70.4 (62-83) yr, and 4.6 (2.3-9.5) cm, respectively. RCC histology was confirmed in 78.9% of patients who

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Section: Local Controlmentioning

confidence: 88%

The Emerging Role of Stereotactic Ablative Radiotherapy for Primary Renal Cell Carcinoma: A Systematic Review and Meta-Analysis

Correa

Louie

Zaorsky

et al. 2019

European Urology Focus

108

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“…This device has Co 60 sources which can be utilized to form the sharp dose gradient and focused radiation to achieve target coverage while maintaining normal tissue tolerances in a rotating mechanism. Previous literatures have demonstrated inspiring outcome of patients suffered from lung and renal cancer treated with this advanced treatment protocol and device 34 – 37 . A retrospective study with a 2-years follow-up in our institute showed that in osteosarcoma patients with pulmonary metastases, stereotactic radiosurgery was effective and safe compared with surgical resection 38 .…”

Section: Introductionmentioning

confidence: 95%

Efficacy and safety of stereotactic radiosurgery for pulmonary metastases from osteosarcoma: Experience in 73 patients

Liu

Tang

et al. 2017

Sci Rep

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Osteosarcoma pulmonary metastases are typically treated with resection and/or chemotherapy. We hypothesize that stereotactic radiosurgery (SRS) can be an alternative to surgery that can achieve high rates of local control with limited toxicity. From January 2005 to December 2013, 73 patients who developed pulmonary metastasis during period of adjuvant chemotherapy or follow-up were analyzed. 33 patients were treated by stereotactic radiosurgery using the body gamma-knife system. A total dose of 50 Gy was delivered at 5 Gy/fraction to the 50% isodose line covering the planning target volume, whereas a total dose of 70 Gy was delivered at 7 Gy/fraction to the gross target volume. The other 40 patients were treated by surgical resection. Four-year progression-free survival rate, four-year survival rate, median time of PRPFS (post-relapse progress-free survival) and PROS (post-relapse overall survival) in SRS group were parallel to that in surgical group. Patients tolerated gamma knife radiosurgery well. Our study demonstrates that SRS is well-tolerated with excellent local control and less complications. SRS should be considered as a potential option in patients with pulmonary metastases from osteosarcoma, especially in those who are medically inoperable, refuse surgery.

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“…Inadequate single doses (≤7 Gy) in this prospective study could be the reason for these moderate results. For asynchronous bilateral RCC ( N = 9), SBRT resulted in an ORR of 55.6%, and the 1-, 3-, and 5-year OS rates were 66.7%, 53.3%, and 35.6%, respectively [40]. Among patients with localized RCC who were not suitable for surgery, a phase I study using SBRT (24–48 Gy/4f) showed three partial responses and 12 patients with stable disease among those with an evaluable response ( N = 15) [41].…”

Section: Efficacy Of Sbrt In Patients With Advanced Rccmentioning

confidence: 99%

Combination with Stereotactic Body Radiotherapy Offers a Promising Strategy to Overcome Resistance to Immunotherapy in Advanced Renal Cell Cancer

Sun

Gan

Aru

et al. 2019

Journal of Oncology

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Immunotherapy for renal cell cancer (RCC) has witnessed several developments for more than two decades. Checkpoint inhibitors, including anti-CTLA-4 and anti-PD-1/PD-L1 blockers, have changed the treatment landscape for patients with advanced RCC in the past 3 years. Despite these advances, more than 55% RCC patients become resistant to different immunotherapies without other treatment combination. Among various attempts at overcoming resistance to immunotherapy, stereotactic body radiotherapy (SBRT) has been found to potentiate the activity of immunotherapy agents through several potential mechanisms, including normalization of microvessels to alleviate tumor hypoxia, improvement in efficient delivery of drugs, abundant neoantigen exposure, and recruitment of antitumor immune cells to alter the immunosuppressive tumor microenvironment. Preclinical studies and clinical case reports have predicted that the combination of SBRT, an immunotherapy, may lead to remarkable results. This review aims to provide the biological basis for the feasibility of combining SBRT to overcome immunotherapy resistance and to review the currently available clinical evidence of this combination therapy in patients with advanced RCC.

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Stereotactic gamma-ray body radiation therapy for asynchronous bilateral renal cell carcinoma

Abstract: Stereotactic gamma-ray body radiation therapy was found to be safe and effective in the treatment of asynchronous bRCC. Improved prognosis will require individualised treatment and a combination of multiple therapeutic approaches; this will be a primary research trend in the future.

Cited by 11 publications

References 15 publications

The Emerging Role of Stereotactic Ablative Radiotherapy for Primary Renal Cell Carcinoma: A Systematic Review and Meta-Analysis

The Emerging Role of Stereotactic Ablative Radiotherapy for Primary Renal Cell Carcinoma: A Systematic Review and Meta-Analysis

Efficacy and safety of stereotactic radiosurgery for pulmonary metastases from osteosarcoma: Experience in 73 patients

Combination with Stereotactic Body Radiotherapy Offers a Promising Strategy to Overcome Resistance to Immunotherapy in Advanced Renal Cell Cancer

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