Extracranial stereotactic radiotherapy for primary and metastatic renal cell carcinoma.
OBJECTIVE
We investigated the results of using stereotactic radiotherapy (SRT) for 58 patients with renal cell carcinomas (RCC) who were evaluated restrospectively for response rates, local control rates and side effects.


METHODS
From October 1997 to January 2003, 50 patients suffering from metastatic RCC and eight patients with inoperable primary RCC received high-dose fraction SRT while placed in a stereotactic body-frame. The most common dose/fractionation schedules used were 8 Gyx4, 10 Gyx4 and 15 Gyx3 during approximately 1 week.


RESULTS
SRT-treated tumor lesions regressed totally in 30% of the patients at 3-36 months, whereas 60% of the patients had a partial volume reduction or no change after a median follow-up of 37 months (SD 17.4) for censored and 13 months (SD 12.9) for uncensored patients. Side effects were generally mild. Of 162 treated tumors, only three recurred, yielding a local control rate of 90-98%, considering the 8% non-evaluable sites as defined here. For patients with one to three metastases, the time to new spread was 9 months.


CONCLUSIONS
Our use of SRT for patients with primary and metastatic RCC yielded a high local control rate with low toxicity. Patients with one to three metastases, local recurrences after nephrectomy or inoperable primary tumors benefited the most, i.e. had fewer distant recurrences (13/23) and longer survival times compared to patients with >3 metastases (24/27 recurrences).
Department of General Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden. peter.wersall@ks.se
Peter J
PJ
Wersäll
Henric
H
Blomgren
Ingmar
I
Lax
Karl-Mikael
KM
Kälkner
Christina
C
Linder
Göran
G
Lundell
Bo
B
Nilsson
Sten
S
Nilsson
Ingemar
I
Näslund
Pavel
P
Pisa
Christer
C
Svedman
D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011832:Radiation Injuries; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D016896:Treatment Outcome