Locally advanced renal cell carcinoma: low complication rate and efficacy of postnephrectomy radiation therapy planned with CT.

Kao, Gary D.; Malkowicz, S. Bruce; Whittington, Richard; D’Amico, A.V.; Wein, Alan J.

doi:10.1148/radiology.193.3.7972814

Cited by 43 publications

(16 citation statements)

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“…Some studies show a tendency to increased overall survival, but without statistical significance [5,9,15].…”

Section: Discussionmentioning

confidence: 99%

“…It has been difficult to compare the results of studies because of a variety of dose fractionation schedules, different total doses, irradiation techniques and patient selection [5,6,9,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…This trial was in because of a high rate of complication in the irradiated group, caused probably by high dose per fraction 22.5 Gy (to a total dose 50 Gy). According to the linear quadratic model, the total dose used in this study would be equivalent to 70 Gy [5].…”

Section: Discussionmentioning

confidence: 99%

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The Characteristics of Renal Cell Carcinoma Patients, Who may Benefit from Radiotherapy and Post-Nephrectomy

et al. 2003

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Objective: A retrospective analysis of 251 patients with advanced renal cell carcinoma from 1985 to 1998 is presented.Purpose: The aim of this study was to assess the influence of post-operative radiotherapy on overall survival in renal cell carcinoma patients with pathological features and to determine a group of patients with the best results after nephrectomy and radiotherapy.Materials and methods: The medical records of 148 patients with stage B and 103 patients with stage C treated according to the Robson system were reviewed. Post-operative radiotherapy with megavoltage was given to 136 patients group II-R [þ]. Patients who underwent nephrectomy, but did not receive radiation therapy, were the control group I-R [2]. This group consisted of 115 patients, with indications to post-operative radiotherapy. Overall survival for patients with: capsular infiltration, perinephric fat, renal pelvis, renal pedicle and renal vein invasion, lymph node involvement and three tumor sizes: 1-5, 6 -10, . 10 cm, histological grade G1, G2, G3 were evaluated. Actuarial curves for overall survival were calculated using the Kaplan -Meier method. Survival curves were compared using the log rank test.Results: The following parameters were statistically significant: the capsular infiltration ðp ¼ 0:0352Þ and renal pelvis infiltration ð p ¼ 0:001Þ; renal pedicle invasion ð p ¼ 0:014Þ; tumor .5 cm ð p ¼ 0:0101Þ: The others: perinephric fat and renal vein invasion, lymph node involvement, tumor size # 5 cm, histological grade G2, G3 were not statistically significant ð p . 0:05Þ.Conclusions: We found post-operative radiotherapy to be the greatest benefit in patients with invasion of the capsule infiltration, renal pelvis, renal pedicle invasion and tumor .5 cm.

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“…Some studies show a tendency to increased overall survival, but without statistical significance [5,9,15].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Characteristics of Renal Cell Carcinoma Patients, Who may Benefit from Radiotherapy and Post-Nephrectomy

et al. 2003

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“…Earlier studies have been limited by relatively low postoperative doses used secondary to concerns of late radiation sequelae. Recent studies using more sophisticated radiation techniques have reported fewer treatment-related complications [11,12]. Using CT-based treatment planning, Kao et al [11] retrospectively reported the outcome of postoperative radiotherapy for selected patients with positive surgical margins or perinephric disease extension.…”

Section: Discussionmentioning

confidence: 99%

Renal Cell Carcinoma: The Experience of Kuwait Cancer Control Center, Kuwait

Thotathil

Varghese²,

Ragheb³

2004

Med Princ Pract

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Objectives: This retrospective study was undertaken to analyze the profile of patients presenting with renal cell carcinoma (RCC) and treatment outcomes. Subjects and Methods: Records of 49 patients (36 male, 16 female, 21–75 years) treated at the Kuwait Cancer Control Center, Kuwait for RCC during the period 1993–1998 were analyzed. Forty-one patients had a nephrectomy, 18 postoperative radiotherapy and 1 patient also received adjuvant immunotherapy with interferon. Patients with metastatic disease were treated with a variety of agents including interferon, chemotherapy (vinblastine) or a hormonal agent (megestrol acetate). Data analysis was performed using SPSS statistical software package. Overall survival and disease-free survival were calculated using the Kaplan-Meier method. Results: Twenty-nine patients presented with symptoms classically associated with RCC. Metastases at diagnosis were seen in 9 patients (18%), with lung being the most frequent site. The commonest tumor subtype was clear cell carcinoma (32.6%). Thirty-nine patients (80%) achieved a complete response to treatment and relapse was documented in 10 patients (26%). The majority of failures were distant, with lung metastases being the most common. Response to salvage treatment was poor. Overall survival was 83% at 2 years. The disease-free survival was 68 and 45% at 2 and 5 years, respectively. Conclusions: Although many patients presented with advanced local disease, a majority achieved complete response after radical surgery with or without postoperative radiation therapy. Salvage of metastatic disease proved difficult with interferon, chemotherapy.

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“…Using CT-based treatment planning, the outcome of postoperative radiotherapy has been retrospectively reported for selected patients with positive surgical margins or perinephric disease extension. The overall local failure rate was 100% as compared to 30% for similar patients who underwent nephrectomy alone [132]. Nevertheless, randomized trials limited to high-risk patients will be required to fully assess the benefit of postoperative radiotherapy in local control.…”

Section: Radiotherapymentioning

confidence: 99%

Renal cancer

Corgna¹,

Betti²,

Gatta³

et al. 2007

Critical Reviews in Oncology/Hematology

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In Europe, renal cancer (that is neoplasia of the kidney, renal pelvis or ureter (ICD-9 189 and ICD-10 C64-C66)) ranks as the seventh most common malignancy in men amongst whom there are 29,600 new cases each year (3.5% of all cancers). Tobacco, obesity and a diet poor in vegetables are all acknowledged risk factors, along with specific occupational and environmental factors. A familial history of renal carcinoma is also likely to increase the risk. Renal carcinoma may remain clinically occult for most of its course. The classic presentation of pain, haematuria, and flank mass occurs in only 9% of patients and is often indicative of advanced disease. Approximately 30% of patients with renal carcinoma present with metastatic disease, 25% with locally advanced renal carcinoma and 45% with localized disease. Metastases are typically found in the lung, soft tissue, bone, liver, cutaneous sites, and central nervous system. The most important staging technique is a computed tomography (CT) scan of the whole abdomen. Survival rates are more favourable for patients with tumours confined to the kidney. Five-year survival for patients with metastatic renal carcinoma is comprised between 0 and 20%. Radical nephrectomy is the standard intervention for renal cancer. Intrinsic resistance to chemotherapy has long been a hallmark of renal carcinoma. Limited options are available for the systemic therapy, and no chemotherapeutic regimen is accepted as a standard of care. Biologic agents represent the major effective therapies for widespread metastatic renal cancer. An antiangiogenic strategy, the neutralization of VEGF, can slow the growth rate of advanced cancer.

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Locally advanced renal cell carcinoma: low complication rate and efficacy of postnephrectomy radiation therapy planned with CT.

Cited by 43 publications

References 0 publications

The Characteristics of Renal Cell Carcinoma Patients, Who may Benefit from Radiotherapy and Post-Nephrectomy

The Characteristics of Renal Cell Carcinoma Patients, Who may Benefit from Radiotherapy and Post-Nephrectomy

Renal Cell Carcinoma: The Experience of Kuwait Cancer Control Center, Kuwait

Renal cancer

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