Although systemic therapy represents the standard of care for polymetastatic kidney cancer, stereotactic body radiation therapy (SBRT) may play a relevant role in the oligometastatic setting. We conducted a multicenter study including oligometastatic kidney cancer treated with SBRT. We retrospectively analyzed 207 patients who underwent 245 SBRT treatments on 385 lesions, including 165 (42.9%) oligorecurrent (OR) and 220 (57.1%) oligoprogressive (OP) lesions. Most common sites were lung (30.9%) for OR group, and bone (32.7%) for OP group. Among 78 (31.8%) patients receiving concomitant systemic therapy, sunitinib (61.5%) and pazopanib (15.4%) were the most common for OR patients, while sunitinib (49.2%) and nivolumab (20.0%) for OP patients. End points were local control (LC), progression free survival (PFS), overall survival (OS), time to next systemic therapy (TTNS) and toxicity. Median follow-up was 18.6 months. 1, 2 and 3-year LC rates were 89.4%, 80.1% and 76.6% in OR patients, and 82.7%, 76.9% and 64.3% in those with OP, respectively. LC for OP group was influenced by clear cell histology (p = 0.000), total number of lesions (p = 0.004), systemic therapy during SBRT (p = 0.012), and SBRT dose (p = 0.012). Median PFS was 37.9 months. 1, 2- and 3-year OS was 92.7%, 86.4% and 81.8%, respectively. Median TTNS was 15.8 months for OR patients, and 13.9 months for OP patients. No grade 3 or higher toxicities were reported for both groups. SBRT may be considered an effective safe option in the multidisciplinary management of both OR and OP metastases from kidney cancer.
Clinical & experimental metastasis. 2021 Nov 08 [Epub ahead of print]
Ciro Franzese, Giulia Marvaso, Giulio Francolini, Paolo Borghetti, Luca Eolo Trodella, Matteo Sepulcri, Fabio Matrone, Luca Nicosia, Giorgia Timon, Lucia Ognibene, Annamaria Vinciguerra, Filippo Alongi, Roberto Bortolus, Luigi Corti, Sara Ramella, Stefano Maria Magrini, Lorenzo Livi, Barbara Alicja Jereczek-Fossa, Marta Scorsetti, Stefano Arcangeli
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele-Milan, Italy. ., Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milano, Italy., Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy., Radiation Oncology Unit, Department of Medical and Surgical Specialties, Radiological Science and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy., Radiation Oncology, Campus Bio-Medico University, University of Rome, Rome, Italy., Department of Radiation Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy., Department of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy., Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar, Italy., Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy., Radiotherapy Unit, San Gaetano Radiotherapy and Nuclear Medicine Center, Palermo, Italy., Department of Radiation Oncology "G. D'Annunzio", University of Chieti, SS. Annunziata Hospital, Chieti, Italy., Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele-Milan, Italy., UOC Radioterapia ASST Monza, Università di Milano, Bicocca, Italy.