title: Contemporary Trends in the Utilization of Radiotherapy in Patients With Renal Cell Carcinoma.
abstract: OBJECTIVE
  To examine the utilization of radiation therapy (RT) in patients with renal cell carcinoma (RCC) using a large national tumor registry.
  
  
  METHODS
  Patients diagnosed with RCC were identified using the National Cancer Data Base. Our primary objective was to assess temporal trends in the utilization of RT. Our secondary objective was to identify patient and treatment factors associated with receipt of RT. The Cochran-Armitage test was used for trend analysis. Multivariable logistic regression was performed to identify factors associated with RT use.
  
  
  RESULTS
  A total of 279,427 patients were diagnosed with RCC from 1998 to 2010. A total of 233,572 (83.6%) had localized or locally advanced disease, whereas the remaining 45,855 (16.4%) had metastatic disease. There was a decrease in radiotherapy across all patients during this period (1.5%-0.6%, P <.001); as salvage or adjuvant therapy with surgery (1.3%-0.3%, P <.001), and in patients with metastatic disease (33.3%-28.5%, P <.001). Factors associated with increased RT use in patients with nonmetastatic RCC included male gender, receipt of systemic therapy, higher stage, higher grade, nonacademic treatment facility, facility location, and sarcomatoid or other histology.
  
  
  CONCLUSIONS
  In the National Cancer Data Base, we observed a decrease in the use of RT for patients with RCC from 1998 to 2010. Patients with more aggressive disease characteristics were more likely to receive RT. Well-designed clinical trials are needed to clarify the role of RT in the management of these patients.
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Talha
authors.initials: T
authors.lastname: Shaikh
authors.affiliation: Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Handorf
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Colin T
authors.initials: CT
authors.lastname: Murphy
authors.affiliation: Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kutikov
authors.affiliation: Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Uzzo
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Mark
authors.initials: M
authors.lastname: Hallman
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Horwitz
authors.affiliation: Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA. Electronic address: Marc.Smaldone@fccc.edu.
authors.forename: Marc C
authors.initials: MC
authors.lastname: Smaldone
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000532:radiotherapy* / Q000556:secondary / Q000628:therapy; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000706:statistics & numerical data / Q000639:trends; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D012042:Registries; D016879:Salvage Therapy; D012737:Sex Factors; D014481:United States
chemical_list: D000970:Antineoplastic Agents