Radiotherapy for renal-cell carcinoma

Meerleer, Gert De; Khoo, Vincent; Escudier, Bernard; Joniau, Steven; Bossi, Alberto; Ost, Piet; Briganti, Alberto; Fonteyne, Valérie; Vulpen, Marco van; Lumen, Nicolaas; Spahn, Martin; Mareel, Marcus

doi:10.1016/s1470-2045(13)70569-2

Cited by 237 publications

(181 citation statements)

References 53 publications

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“…As mentioned above, also very little is known how radiotherapy affects the tumor bed and in particular the ECM, that can promote tumor angiogenesis and metastasis. [80][81][82] Given that ECM is rather stable and will persist after the end of radiotherapy it is important to understand what radiotherapy is doing to the ECM. Questions are arising whether there is a limited number of ECM molecules that are induced by radiotherapy and what their identity and role during and after radiotherapy is.…”

Section: Tenascin-c In Radiotherapy: Friend or Foe?mentioning

confidence: 99%

“…18,24 Irradiation also has an impact on the immune response and can trigger "cellular immunology." 82 In particular, a high-dose and few-fraction schedule had been reported to trigger inflammation associated apoptosis that was characterized by the recruitment of dendritic cells to the irradiated site. Tumor specific immunity seems to be enhanced by radiotherapy but apparently only when large-fraction doses were applied.…”

Section: Induction Of Tenascin-c Upon Radiotherapymentioning

confidence: 99%

“…Endothelial cell apoptosis occurs within the first hour, peaks at 4 hours and ends at 6 hours after a single fraction of 5 Gy ( 100 , reviewed in 82 ). This process is started within seconds after irradiation not yet involving a DNA damage response but the production of ceramide through ASMase (sphingomyelinase), which is a proapoptotic messenger (reviewed in 82 ).…”

Section: Induction Of Tenascin-c Upon Radiotherapymentioning

confidence: 99%

“…This process is started within seconds after irradiation not yet involving a DNA damage response but the production of ceramide through ASMase (sphingomyelinase), which is a proapoptotic messenger (reviewed in 82 ). Ionizing irradiation also appears to interfere with vascular endothelial growth factor (VEGFA) and fibroblast growth factor-2 (FGF-2) -induced angiogenesis in vivo, and suppresses endothelial cell proliferation, migration and sprouting in vitro.…”

Section: Induction Of Tenascin-c Upon Radiotherapymentioning

confidence: 99%

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Tenascin-C: Exploitation and collateral damage in cancer management

Spenlé

Saupe

Midwood³

et al. 2015

Cell Adhesion & Migration

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Section: Tenascin-c In Radiotherapy: Friend or Foe?mentioning

confidence: 99%

Section: Induction Of Tenascin-c Upon Radiotherapymentioning

confidence: 99%

Section: Induction Of Tenascin-c Upon Radiotherapymentioning

confidence: 99%

Section: Induction Of Tenascin-c Upon Radiotherapymentioning

confidence: 99%

See 2 more Smart Citations

Tenascin-C: Exploitation and collateral damage in cancer management

Spenlé

Saupe

Midwood³

et al. 2015

Cell Adhesion & Migration

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“…By contrast, higher RT fractions efficiently destroy tumor vessels (microvasculature) (11) and are, therefore, expected to achieve better results in tumors that are highly dependent on angiogenesis. The majority of clear-cell RCCs are highly vascularized.…”

Section: Discussionmentioning

confidence: 99%

Radiation therapy following targeted therapy in oligometastatic renal cell carcinoma

Gravis

Faure

Rybikowski

et al. 2015

Molecular and Clinical Oncology

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Abstract. Up to 40% of patients with renal cell carcinoma (RCC) with initially localized disease eventually develop metastasis following nephrectomy. The current standard of care for metastatic RCC (mRCC) is targeted therapy. However, complete response remains rare. A state of oligometastatic disease may exist, in which metastases are present in a limited number of locations; such cases may benefit from metastasis-directed local therapy, based on the evidence supporting resection of limited-volume metastases, allowing for improved disease control. We retrospectively analyzed 7 cases of response of RCC metastases, in patients treated with targeted therapies followed by radiation therapy (RT) of residual metastatic lesions in Paoli-Calmettes Institute (Marseille, France). We analyzed disease response rates, response to sequential strategy, relapse at the irradiated locations and disease evolution. The median follow-up was 34.1 months (range, 19.2-54.5 months). No progression at the irradiated sites was observed. A total of 5 patients had stable disease at the irradiated locations at the last follow-up; 3 remained in complete remission at the assessment, and 2 were stable. Excellent local response and clinical benefit may be achieved without added toxicity. In conclusion, sequential therapeutic strategies with RT following systemic treatment using sunitinib appear to be highly effective in patients with progressive mRCC and prompt the conduction of further confirmatory trials. IntroductionOne-third of patients diagnosed with renal cell carcinoma (RCC) present with metastasis at initial diagnosis and up to 40% of patients with initially localized RCC eventually develop metastasis following radical or partial nephrectomy (1). The current standard of care for patients with metastatic RCC (mRCC) is targeted therapy, which may reduce tumor burden and improve survival rates compared with historical treatments (2). However, complete response to systemic therapy alone remains extremely rare (3). mRCC has long been a disease for which the resection of metastatic deposits has been considered for patient treatment (4). Patients who undergo metastasectomy tend to exhibit a better outcome, independently of their risk score (5).However, in several cases, patients with metastatic disease are either unfit for surgery or have technically unresectable disease and, therefore, non-invasive metastasis-directed therapy for selected patients may be recommended.For patients with metastatic disease progression and for those who present with distant disease, the median survival is ~20 months, with an expected 5-year survival rate of 30% (6).Among patients with mRCC, certain subgroups have been identified with improved prognosis and a prolonged disease course (7). For these patients, management of limited metastatic disease may be beneficial. A state of oligometastasis may exist, in which metastases are present in a limited number of locations and may benefit from metastasis-directed local therapy, based on the evidence supporting resection ...

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Stereotactic Body and Conventional Radiotherapy for Painful Bone Metastases

Bindels,

Mercier,

Gal

et al. 2024

JAMA Netw Open

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ImportanceConventional external beam radiotherapy (cEBRT) and stereotactic body radiotherapy (SBRT) are commonly used treatment options for relieving metastatic bone pain. The effectiveness of SBRT compared with cEBRT in pain relief has been a subject of debate, and conflicting results have been reported.ObjectiveTo compare the effectiveness associated with SBRT vs cEBRT for relieving metastatic bone pain.Data SourcesA structured search was performed in the PubMed, Embase, and Cochrane databases on June 5, 2023. Additionally, results were added from a new randomized clinical trial (RCT) and additional unpublished data from an already published RCT.Study SelectionComparative studies reporting pain response after SBRT vs cEBRT in patients with painful bone metastases.Data Extraction and SynthesisTwo independent reviewers extracted data from eligible studies. Data were extracted for the intention-to-treat (ITT) and per-protocol (PP) populations. The study is reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.Main Outcomes and MeasuresOverall and complete pain response at 1, 3, and 6 months after radiotherapy, according to the study’s definition. Relative risk ratios (RRs) with 95% CIs were calculated for each study. A random-effects model using a restricted maximum likelihood estimator was applied for meta-analysis.ResultsThere were 18 studies with 1685 patients included in the systematic review and 8 RCTs with 1090 patients were included in the meta-analysis. In 7 RCTs, overall pain response was defined according to the International Consensus on Palliative Radiotherapy Endpoints in clinical trials (ICPRE). The complete pain response was reported in 6 RCTs, all defined according to the ICPRE. The ITT meta-analyses showed that the overall pain response rates did not differ between cEBRT and SBRT at 1 (RR, 1.14; 95% CI, 0.99-1.30), 3 (RR, 1.19; 95% CI, 0.96-1.47), or 6 (RR, 1.22; 95% CI, 0.96-1.54) months. However, SBRT was associated with a higher complete pain response at 1 (RR, 1.43; 95% CI, 1.02-2.01), 3 (RR, 1.80; 95% CI, 1.16-2.78), and 6 (RR, 2.47; 95% CI, 1.24-4.91) months after radiotherapy. The PP meta-analyses showed comparable results.Conclusions and RelevanceIn this systematic review and meta-analysis, patients with painful bone metastases experienced similar overall pain response after SBRT compared with cEBRT. More patients had complete pain alleviation after SBRT, suggesting that selected subgroups will benefit from SBRT.

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Radiotherapy for renal-cell carcinoma

Cited by 237 publications

References 53 publications

Tenascin-C: Exploitation and collateral damage in cancer management

Tenascin-C: Exploitation and collateral damage in cancer management

Radiation therapy following targeted therapy in oligometastatic renal cell carcinoma

Stereotactic Body and Conventional Radiotherapy for Painful Bone Metastases

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