Regression of non-irradiated metastases after extracranial stereotactic radiotherapy in metastatic renal cell carcinoma

Wersäll, Peter; Blomgren, Henric; Pisa, Pavel; Lax, Ingmar; Kälkner, Karl Mikael; Svedman, Christer

doi:10.1080/02841860600604611

Cited by 208 publications

(129 citation statements)

References 27 publications

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“…Immunotherapy with antibodies against the programmed cell death protein 1 (PD-1) or its ligand 1 (PD-L1) have demonstrated excellent preliminary results (48)(49)(50). Interestingly, SBRT might also be applied to enhance immunogenic the anti-tumor response via the abscopal effect: clinical studies have described regression of non-irradiated distant lesions following SBRT to an RCC metastasis (51)(52)(53). This effect is hypothesized to be immune RCC, renal cell carcinoma; OS, overall survival.…”

Section: Toxicitymentioning

confidence: 99%

Stereotactic body radiotherapy (SBRT) for pulmonary metastases from renal cell carcinoma—a multicenter analysis of the German working group “Stereotactic Radiotherapy”

Hoerner-Rieber¹,

Duma²,

Blanck³

et al. 2017

J. Thorac. Dis.

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Background: Renal cell carcinoma (RCC) is traditionally considered to be radioresistant. Radiotherapy response rates are believed to improve with hypofractionated, high dose stereotactic body radiotherapy (SBRT).However, limited data exist regarding the role of SBRT in the treatment of pulmonary metastases. Methods: The working group "Stereotactic Radiotherapy" of the German Society of Radiation Oncology analyzed its multi-institutional database of more than 700 patients who received SBRT for pulmonary metastases. Treatment was performed at 10 centers between 2001 and 2016. Patients with metastatic RCC were included in the study. Tumor characteristics, treatment details, and follow-up data including survival, local control (LC), distant metastases, and toxicity were evaluated. Results: A total of 46 RCC patients treated with SBRT for 67 lung metastases were identified, who received a median total biologically effective dose (BED iso ) at planning target volume (PTV) isocenter of 117.0 Gy (range, 48.0-189.0 Gy). A median fractional dose of 20.8 Gy at isocenter (range, 6.0-37.9 Gy) was administered in a median number of 3 fractions (1-8 fractions). After a median follow-up time of 28.3 months for all patients, 1-and 3-year LC rates were 98.1% and 91.9%, with corresponding 1-and 3-year overall survival (OS) of 84.3% and 43.8%, respectively. Pulmonary metastases treated with BEDiso ≥130 Gy showed a trend for superior LC (P=0.054). OS was significantly improved in both uni-and multivariate analysis for patients with higher Karnofsky performance scale, lower maximum pulmonary metastasis diameter and lack of post-SBRT systemic therapy due to progression (P=0.014; P=0.049; P=0.006). Only mild acute and late toxicity was reported.

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Section: Toxicitymentioning

confidence: 99%

Stereotactic body radiotherapy (SBRT) for pulmonary metastases from renal cell carcinoma—a multicenter analysis of the German working group “Stereotactic Radiotherapy”

Hoerner-Rieber¹,

Duma²,

Blanck³

et al. 2017

J. Thorac. Dis.

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“…According to our knowledge, the radiation therapy is not available in patients with multiple metastatic cancer. The abscopal effect is observed outside the treated field of radiation, but it is underrecognized in the clinical practice [2,3]. Recent studies have suggested that the Abscopal effect may result from radiotherapyinduced immune system-mediated cancer cell death [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

An Abscopal Response to Radiation Therapy in a Patient with Metastatic Non-Small Cell Lung Cancer: A Case Report

Katayama¹,

Tamiya²,

Koba³

et al. 2017

J Cancer Sci Ther

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IntroductionThe Abscopal effect refers to radiation-induced tumor regression in lesions that are distant from a targeted site, and has been recognized for six decades as a rare, unexplained phenomenon in patients receiving local radiotherapy [1]. According to our knowledge, the radiation therapy is not available in patients with multiple metastatic cancer. The abscopal effect is observed outside the treated field of radiation, but it is underrecognized in the clinical practice [2,3]. Recent studies have suggested that the Abscopal effect may result from radiotherapyinduced immune system-mediated cancer cell death [4][5][6]. In support of this hypothesis, the Abscopal effect was reported in a patient who was treated with ipilimumab and fractionated radiotherapy [7]. However, the possibility that ipilimumab alone might be responsible for the patient's response cannot be ruled out, because some non-small cell lung cancer (NSCLC) patients receiving immunotherapeutic agents such as nivolumab achieved good responses and longer progressionfree survival rates [8,9].We encountered a patient with metastatic NSCLC who experienced the Abscopal effect after whole-brain radiotherapy (WBRT) and palliative radiation for vertebral metastasis in a patient. Case PresentationA 63-year-old man who was a current smoker (40 cigarettes a day for 43 years) presented with worsening dysgraphia and memory impairment. Chest radiography and computed tomography (CT) revealed a 4 cm solitary tumor in the upper lobe of the left lung with mediastinal lymphadenopathy, and magnetic resonance imaging (MRI) revealed a 3 cm solitary tumor, assumed to be a metastatic lesion, with cerebral edema extending from the left temporal lobe to the occipital lobe. Bronchoscopic cytology from the lung tumor revealed malignant cells that were consistent with NSCLC. Bone scintigraphy with AbstractIntroduction: The Abscopal effect refers to radiotherapy-induced tumor regression in lesions distant from a targeted site, and is a rare phenomenon in patients receiving local radiotherapy. This report is the first to describe an Abscopal response in a chemotherapy-naïve non-small cell lung cancer (NSCLC) patient following whole-brain radiotherapy as well as palliative radiotherapy.

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“…Effects of radiation therapy on tumors outside of the radiation field have, however, been reported in many malignancies [1,2,[21][22][23][24][25][26][27][28][29][30]. This phenomenon was originally described as abscopal effect by Mole in 1953 [31].…”

Section: Introductionmentioning

confidence: 97%

“Abscopal” Effect of Radiation Therapy Combined with Immune-Therapy Using IFN-γ Gene Transfected Syngeneic Tumor Cells, in Rats with Bilateral Implanted N29 Tumors

et al. 2011

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The tumor growth rate response was studied on N29 rat glioma tumor cells subcutaneously implanted on both hind legs of Fischer-344 rats. At around 30 days after inoculation, RT was given with 60 Co gamma radiation with 4 daily fractions of 5 Gy only to the right-lateral tumors. At days 26, 42, and 54 after inoculation, immunization was performed with irradiated syngeneic IFNγ-gene transfected cells. Tumor growth rate (TGR % per day) of the right-lateral irradiated tumor was significantly decreased (P < 0.01) after RT alone and with the combination of RT and immunization. But immunization alone gave no significant decrease of the TGR but significantly increased time of survival. The TGR of the unirradiated left-lateral tumors was significantly decreased (P < 0.02) only in the group of rats treated with RT alone. It is apparent that tumor cells killed by the radiation mediate suppression of tumor cells outside the target area. This effect is called the abscopal effect.

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Regression of non-irradiated metastases after extracranial stereotactic radiotherapy in metastatic renal cell carcinoma

Cited by 208 publications

References 27 publications

Stereotactic body radiotherapy (SBRT) for pulmonary metastases from renal cell carcinoma—a multicenter analysis of the German working group “Stereotactic Radiotherapy”

Stereotactic body radiotherapy (SBRT) for pulmonary metastases from renal cell carcinoma—a multicenter analysis of the German working group “Stereotactic Radiotherapy”

An Abscopal Response to Radiation Therapy in a Patient with Metastatic Non-Small Cell Lung Cancer: A Case Report

“Abscopal” Effect of Radiation Therapy Combined with Immune-Therapy Using IFN-γ Gene Transfected Syngeneic Tumor Cells, in Rats with Bilateral Implanted N29 Tumors

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