title: A phase II trial of palliative radiotherapy for metastatic renal cell carcinoma.
abstract: BACKGROUND
  Renal cell carcinoma (RCC) has previously been described as being less responsive to radiotherapy (RT) than other tumor types. The authors conducted a prospective study to assess the effect of RT on symptoms and quality of life (QOL) in patients with metastatic RCC.
  
  
  METHODS
  Between 1996 and 2002, patients with symptomatic metastatic RCC were entered into a prospective study in two cancer centers. Symptomatic sites of disease were treated with 30 grays (Gy) in 10 fractions. Patients reported pain, analgesic use, symptoms, and QOL using validated questionnaires before RT, 1 month and 3 months after treatment, and every 3 months to 1 year thereafter.
  
  
  RESULTS
  Thirty-one patients (19 males and 12 females) were entered into the trial. The median age of the patients was 61 years (range, 35-81 yrs). The most common indication for RT was bone pain (n = 24). The median duration of follow-up was 4.3 months (range, 1-15 mos). Of 23 evaluable patients treated for pain, 83% (n = 19) experienced site-specific pain relief after RT, and 48% (n = 11) did not have an associated increase in analgesic medication use. The median duration of site-specific pain response was 3 months (range, 1-15 mos). The global pain response rate was only 15% (n = 3) because many patients developed other painful metastases. Global QOL was found to improve in 33% (n = 8) of the evaluable patients.
  
  
  CONCLUSIONS
  A palliative radiotherapy dose of 30 Gy in 10 fractions can result in a significant response rate and the relief of local symptoms in patients with bone metastases from RCC. Improvements in global pain and QOL appear to be limited by the effects of progressive systemic disease.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Justin
authors.initials: J
authors.lastname: Lee
authors.forename: David
authors.initials: D
authors.lastname: Hodgson
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
authors.forename: Andrea
authors.initials: A
authors.lastname: Bezjak
authors.forename: Pamela
authors.initials: P
authors.lastname: Catton
authors.forename: Debbie
authors.initials: D
authors.lastname: Tsuji
authors.forename: Mary
authors.initials: M
authors.lastname: O'Brien
authors.forename: Cyril
authors.initials: C
authors.lastname: Danjoux
authors.forename: Charles
authors.initials: C
authors.lastname: Hayter
authors.forename: Padraig
authors.initials: P
authors.lastname: Warde
authors.forename: Mary K
authors.initials: MK
authors.lastname: Gospodarowicz
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010148:Intractable Pain / Q000532:radiotherapy*; D010166:Palliative Care; D011788:Quality of Life; D016896:Treatment Outcome