title: Tumor control outcomes after hypofractionated and single-dose stereotactic image-guided intensity-modulated radiotherapy for extracranial metastases from renal cell carcinoma.
abstract: OBJECTIVE
  To report tumor local progression-free outcomes after treatment with single-dose, image-guided, intensity-modulated radiotherapy and hypofractionated regimens for extracranial metastases from renal cell primary tumors.
  
  
  METHODS
  Between 2004 and 2010, 105 lesions from renal cell carcinoma were treated with either single-dose, image-guided, intensity-modulated radiotherapy to a prescription dose of 18-24 Gy (median, 24) or hypofractionation (three or five fractions) with a prescription dose of 20-30 Gy. The median follow-up was 12 months (range, 1-48).
  
  
  RESULTS
  The overall 3-year actuarial local progression-free survival for all lesions was 44%. The 3-year local progression-free survival for those who received a high single-dose (24 Gy; n = 45), a low single-dose (<24 Gy; n = 14), or hypofractionation regimens (n = 46) was 88%, 21%, and 17%, respectively (high single dose vs. low single dose, p = .001; high single dose vs. hypofractionation, p < .001). Multivariate analysis revealed the following variables were significant predictors of improved local progression-free survival: 24 Gy dose compared with a lower dose (p = .009) and a single dose vs. hypofractionation (p = .008).
  
  
  CONCLUSIONS
  High single-dose, image-guided, intensity-modulated radiotherapy is a noninvasive procedure resulting in high probability of local tumor control for metastatic renal cell cancer generally considered radioresistant according to the classic radiobiologic ranking.
authors: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. zelefskm@mskcc.org
authors: Michael J
authors: MJ
authors: Zelefsky
authors: Carlo
authors: C
authors: Greco
authors: Robert
authors: R
authors: Motzer
authors: Juan Martin
authors: JM
authors: Magsanoc
authors: Xin
authors: X
authors: Pei
authors: Michael
authors: M
authors: Lovelock
authors: Jim
authors: J
authors: Mechalakos
authors: Joan
authors: J
authors: Zatcky
authors: Zvi
authors: Z
authors: Fuks
authors: Yoshiya
authors: Y
authors: Yamada
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