Stereotactic radiation therapy in the strategy of treatment of metastatic renal cell carcinoma: A study of the Getug group

Meyer, E.; Pasquier, David; Bernadou, G.; Calais, G.; Maroun, Pierre; Bossi, Alberto; Théodore, C; Albigès, Laurence; Stefan, Dinu; Crevoisier, R. de; Hennequin, Christophe; Lagrange, Jean‐Léon; Grellard, Jean‐Michel; Clarisse, Bénédicte; Licaj, Idlir; Habrand, Jean‐Louis; Carrié, C.; Joly, Florence

doi:10.1016/j.ejca.2018.04.008

Cited by 66 publications

(63 citation statements)

References 28 publications

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“…Few lesions progress on a background of widespread but stable metastatic disease [83] + Link with other therapies Progression occurs in a limited number of tumors/metastases while the majority of other metastases are responding or stable while on a systemic treatment strategy [41,48,61] Progression occurs after a cytoreductive treatment [67] Progression while other sites including the primary disease remain stable on systemic treatment or observation [113] Resistant clones can result in isolated progression [42] + Disease load <5 enlarging metastases in an otherwise well-controlled disease state [39] <5 sites of metastatic disease progression while other sites including primary remain stable on systemic treatment [113] 3-5 slowly progressive metastases [36,48] Oligo-Persistence Persistent disease after systemic therapy [67] + Disease load <5 persistent lesions after systemic therapy [39] Statements 7 and 9:…”

Section: Oligo-progressionmentioning

confidence: 99%

Defining oligometastatic disease from a radiation oncology perspective: An ESTRO-ASTRO consensus document

Lievens

Gückenberger

Gomez

et al. 2020

Radiotherapy and Oncology

421

278

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Background: Recognizing the rapidly increasing interest and evidence in using metastasis-directed radiotherapy (MDRT) for oligometastatic disease (OMD), ESTRO and ASTRO convened a committee to establish consensus regarding definitions of OMD and define gaps in current evidence. Methods: A systematic literature review focused on curative intent MDRT was performed in Medline, Embase and Cochrane. Subsequent consensus opinion, using a Delphi process, highlighted the current state of evidence and the limitations in the available literature. Results: Available evidence regarding the use of MDRT for OMD mostly derives from retrospective, singlecentre series, with significant heterogeneity in patient inclusion criteria, definition of OMD, and outcomes reported. Consensus was reached that OMD is largely independent of primary tumour, metastatic location and the presence or length of a disease-free interval, supporting both synchronous and metachronous OMD. In the absence of clinical data supporting a maximum number of metastases and organs to define OMD, and of validated molecular biomarkers, consensus supported the ability to deliver safe and clinically meaningful radiotherapy with curative intent to all metastatic sites as a minimum requirement for defining OMD in the context of radiotherapy. Systemic therapy induced OMD was identified as a distinct state of OMD. High-resolution imaging to assess and confirm OMD is crucial, including brain imaging when indicated. Minimum common endpoints such as progression-free and overall survival, local control, toxicity and quality-of-life should be reported; uncommon endpoints as deferral of systemic therapy and cost were endorsed. Conclusion: While significant heterogeneity exists in the current OMD definitions in the literature, consensus was reached on multiple key questions. Based on available data, OMD can to date be defined as 1-5 metastatic lesions, a controlled primary tumor being optional, but where all metastatic sites must be safely treatable. Consistent definitions and reporting are warranted and encouraged in ongoing trials and reports generating further evidence to optimize patient benefits.

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Section: Oligo-progressionmentioning

confidence: 99%

Defining oligometastatic disease from a radiation oncology perspective: An ESTRO-ASTRO consensus document

Lievens

Gückenberger

Gomez

et al. 2020

Radiotherapy and Oncology

421

278

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“…Although local control rates of resection and SRT are better than WBRT, resection is restricted to a small number of lesions, and SRT is restricted to small lesions. 9,[14][15][16][17][18] In the present study, there were no patients who received craniotomy and more patients who received SRT in the "Routine head CT" group. Although not a strict criterion, we indicated >15 mm BM for craniotomy.…”

Section: Discussionmentioning

confidence: 55%

Clinical utility of head computed tomography scan during systemic therapy for metastatic renal cell carcinoma

et al. 2021

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The utility of brain metastasis screening in asymptomatic metastatic renal cell carcinoma is controversial. Our study evaluated the utility of routine head computed tomography during systemic therapy. Methods: We retrospectively investigated 152 metastatic renal cell carcinoma patients who did not initially have brain metastasis at Yamagata University Hospital from January 2008 to July 2019. Patients who routinely received head computed tomography scan together with routine contrast-enhanced chest/abdominal/pelvic computed tomography scan every 2-4 months during systemic therapy ("Routine head computed tomography" group, n = 95) and patients without routine head computed tomography ("No routine head computed tomography" group, n = 57) were compared. Results: Brain metastasis occurred in 16 patients in the "Routine head computed tomography" group and six patients in the "No routine head computed tomography" group. There was no statistical difference in overall survival after metastatic renal cell carcinoma diagnosis between groups (53.4 vs 37.3 months, respectively, P = 0.357) and neurological symptom-free survival after metastatic renal cell carcinoma diagnosis (53.4 vs 36.6 months, P = 0.336). Although there was no statistical difference on incidence of unrecovered neurological symptom (25.0% vs 50.0%, P = 0.334), fewer patients in the "Routine head computed tomography" group required craniotomy (0% vs 66.7%, P = 0.002). In the "No routine head computed tomography" group, the neurological symptom resolved for all patients without craniotomy. Conclusions: Routine head computed tomography during systemic therapy for metastatic renal cell carcinoma is not significantly associated with improved brain metastasis prognosis. However, routine head computed tomography enables brain metastasis diagnosis in the asymptomatic phase, which can avoid craniotomy.

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“…1 Memorial Sloan Kettering Cancer Center; 2 The University of Texas MD Anderson Cancer Center; 3 Massachusetts General Hospital Cancer Center; 4 O'Neal Comprehensive Cancer Center at UAB; 5 Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance; 6 Roswell Park Comprehensive Cancer Center; 7 University of Michigan Rogel Cancer Center; 8 Abramson Cancer Center at the University of Pennsylvania; 9 Duke Cancer Institute; 10 Fox Chase Cancer Center; 11 Robert H. Lurie Comprehensive Cancer Center of Northwestern University; 12 Huntsman Cancer Institute at the University of Utah; 13 Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; 14 Dana-Farber/Brigham and Women's Cancer Center; 15 Mayo Clinic Cancer Center; 16 UC San Diego Moores Cancer Center; 17 Stanford Cancer Institute; 18 University of Wisconsin Carbone Cancer Center; 19 Fred & Pamela Buffett Cancer Center; 20 University of Colorado Cancer Center; 21 City of Hope National Medical Center; 22 Kidney Cancer Coalition; 23 Moffitt Cancer Center; 24 The Ohio State University Comprehensive Cancer Center -James Cancer Hospital and Solove Research Institute; 25 The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; 26…”

Section: Please Notementioning

confidence: 99%

“…Patients with excellent performance status and small-volume distant metastases could be considered for cytoreductive nephrectomy followed by systemic treatment. A subset of patients with a resectable primary RCC and synchronous oligometastatic disease can be managed with either surgical metastasectomy, stereotactic body radiation therapy, [13][14][15] or ablative techniques (see KID-3, page 1282). In patients with stage IV disease whose tumors are surgically unresectable, the panel recommends performing tissue sampling to determine histology and guide subsequent management.…”

Section: Initial Management Of Stage IV Diseasementioning

confidence: 99%

NCCN Guidelines Insights: Kidney Cancer, Version 2.2020

Motzer

Jonasch

Michaelson

et al. 2019

Journal of the National Comprehensive Cancer Network

204

176

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The NCCN Guidelines for Kidney Cancer provide multidisciplinary recommendations for the clinical management of patients with clear cell and non–clear cell renal cell carcinoma, and are intended to assist with clinical decision-making. These NCCN Guidelines Insights summarize the NCCN Kidney Cancer Panel discussions for the 2020 update to the guidelines regarding initial management and first-line systemic therapy options for patients with advanced clear cell renal cell carcinoma.

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Stereotactic radiation therapy in the strategy of treatment of metastatic renal cell carcinoma: A study of the Getug group

Cited by 66 publications

References 28 publications

Defining oligometastatic disease from a radiation oncology perspective: An ESTRO-ASTRO consensus document

Defining oligometastatic disease from a radiation oncology perspective: An ESTRO-ASTRO consensus document

Clinical utility of head computed tomography scan during systemic therapy for metastatic renal cell carcinoma

NCCN Guidelines Insights: Kidney Cancer, Version 2.2020

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