Management of spinal metastases from renal cell carcinoma using stereotactic body radiotherapy.
OBJECTIVE
To evaluate the outcomes associated with stereotactic body radiotherapy (SBRT) in the management of spinal metastases from renal cell carcinoma (RCC).


METHODS
SBRT was used in the treatment of patients with spinal metastases from RCC. Patients received either 24 Gy in a single fraction, 27 Gy in three fractions, or 30 Gy delivered in five fractions. Effectiveness of SBRT with respect to tumor control and palliation of pain was assessed using patient-reported outcomes.


RESULTS
A total of 48 patients with 55 spinal metastases were treated with SBRT with a median follow-up time of 13.1 months (range, 3.3-54.5 months). The actuarial 1-year spine tumor progression free survival was 82.1%. At pretreatment baseline, 23% patients were pain free; at 1 month and 12 months post-SBRT, 44% and 52% patients were pain free, respectively. No Grade 3-4 neurologic toxicity was observed.


CONCLUSIONS
The data support SBRT as a safe and effective treatment modality that can be used to achieve good tumor control and palliation of pain associated with RCC spinal metastases. Further evaluation with randomized trials comparing SBRT to conventional radiotherapy may be warranted.
Nguyen
Quynh-Nhu
QN
Department of Radiation Oncology, The University of Texas, M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Shiu
Almon S
AS
Rhines
Laurence D
LD
Wang
He
H
Allen
Pamela K
PK
Wang
Xin Shelley
XS
Chang
Eric L
EL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000601:surgery; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D013125:Spinal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*