Stereotactic radiosurgery for brain metastasis from renal cell carcinoma

Mori, Yoshimasa; Kondziolka, Douglas; Flickinger, John C.; Logan, Theodore F.; Lunsford, L. Dade

doi:10.1002/(sici)1097-0142(19980715)83:2<344::aid-cncr19>3.0.co;2-t

Cited by 182 publications

(89 citation statements)

References 35 publications

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“…This median survival was less impressive than that achieved by the group who underwent SRS for BM from other primary cancers (lung, 10 months; renal cell, 11 months; breast, 13 months; melanoma, 7 months). [32][33][34][35] The local control rate was 84% and there were few side effects. However, the patients in that study who had active extracranial disease had a median survival of only 2 months after SRS.…”

Section: Discussionmentioning

confidence: 89%

Multidisciplinary management of colorectal brain metastases

Kruser

Chao

Elson

et al. 2008

Cancer

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BACKGROUND.The incidence of brain metastases (BM) from colorectal cancer (CRC) is increasing, and the management of this previously rare complication at a single institution is reported.METHODS.The records of all patients with BM from 1994 to 2005 were reviewed, and 49 patients (33 men, 16 women) with 102 BM from CRC were identified. Associations between patient and tumor characteristics, treatment modality, and survival were assessed.RESULTS.The median age at diagnosis of BM from CRC was 66 years. Forty patients (82%) had other systemic disease. The median survival after a diagnosis of BM from CRC was 5.1 months. Fifteen patients (31%) underwent surgery at some point, 14 patients (29%) underwent stereotactic radiosurgery (SRS), and 42 patients (86%) received whole‐brain radiotherapy during their management. Seven patients (14%) underwent upfront SRS. On multivariate analysis, a longer interval from diagnosis of CRC to diagnosis of BM was associated significantly with shorter survival (p = .01). Sex, Karnofsky performance status, tumor location, recursive partitioning analysis class, and initial treatment modality did not have an impact on survival.CONCLUSIONS.Because BM from CRC are a late‐stage phenomenon, the majority of patients in the current study had other systemic involvement, and survival after CNS involvement was poor. The results indicated that a high prevalence of systemic disease limits the proportion of patients who are strong candidates for upfront SRS, thereby limiting the impact that this modality has on outcomes in this population as a whole. Late development (>1 year after the primary tumor diagnosis) of CNS involvement may predict for poorer survival after therapy for patients with BM from CRC. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 89%

Multidisciplinary management of colorectal brain metastases

Kruser

Chao

Elson

et al. 2008

Cancer

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“…[23][24][25] The current study did not enroll any patients with brain metastases although this was not a specific reason for exclusion. Only three patients were treated for indications other than painful bony metastasis.…”

Section: Discussionmentioning

confidence: 99%

A phase II trial of palliative radiotherapy for metastatic renal cell carcinoma

Lee

Hodgson

Chow

et al. 2005

Cancer

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BACKGROUNDRenal cell carcinoma (RCC) has previously been described as being less responsive to radiotherapy (RT) than other tumor types. The authors conducted a prospective study to assess the effect of RT on symptoms and quality of life (QOL) in patients with metastatic RCC.METHODSBetween 1996 and 2002, patients with symptomatic metastatic RCC were entered into a prospective study in two cancer centers. Symptomatic sites of disease were treated with 30 grays (Gy) in 10 fractions. Patients reported pain, analgesic use, symptoms, and QOL using validated questionnaires before RT, 1 month and 3 months after treatment, and every 3 months to 1 year thereafter.RESULTSThirty‐one patients (19 males and 12 females) were entered into the trial. The median age of the patients was 61 years (range, 35–81 yrs). The most common indication for RT was bone pain (n = 24). The median duration of follow‐up was 4.3 months (range, 1–15 mos). Of 23 evaluable patients treated for pain, 83% (n = 19) experienced site‐specific pain relief after RT, and 48% (n = 11) did not have an associated increase in analgesic medication use. The median duration of site‐specific pain response was 3 months (range, 1–15 mos). The global pain response rate was only 15% (n = 3) because many patients developed other painful metastases. Global QOL was found to improve in 33% (n = 8) of the evaluable patients.CONCLUSIONSA palliative radiotherapy dose of 30Gy in 10 fractions can result in a significant response rate and the relief of local symptoms in patients with bone metastases from RCC. Improvements in global pain and QOL appear to be limited by the effects of progressive systemic disease. Cancer 2005. © 2005 American Cancer Society.

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“…On the other hand, the effect of fractionated SRT on metastatic lesions from RCC is unclear, since primary RCC has traditionally been considered as a``radiationresistant'' tumor. 10,23) A smaller tumor reduction rate (27%) 33) and a lower complete response rate (11%) 21) were found in patients with RCC brain metastases. Conversely, stereotactic radiosurgery showed similar or better effectiveness (local control rate, 81.5-100%) on RCC brain metastasis than on other histologies.…”

Section: Discussionmentioning

confidence: 97%

“…However, only 4% to 13% of patients develop brain metastases during the course of RCC. 17,23) We describe a case of symptomatic pituitary metastasis secondary to RCC treated by imageguided fractionated stereotactic radiotherapy (SRT).…”

Section: Introductionmentioning

confidence: 99%

Metastatic Pituitary Tumor From Renal Cell Carcinoma Treated by Fractionated Stereotactic Radiotherapy-Case Report-

Yokoyama

Yoshino

Katayama

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 63-year-old man presented with rapidly progressive visual field deficit and hypopituitarism including diabetes insipidus, 8 years after treatment for a renal cell carcinoma. Neuroimaging studies revealed a dumbbell-shaped pituitary mass that had destroyed the sellar floor and abutted against the optic apparatus. Fractionated stereotactic radiotherapy (SRT), employing computer-image integration techniques and a frame that could be relocated to facilitate a fractionated dosing scheme, was carried out under a plan for reducing the treatment risk to the optic apparatus. Three months later, the patient exhibited marked improvement in the visual field deficit and visual acuity concomitant with a reduction in tumor volume. Magnetic resonance imaging of the sellar region confirmed striking shrinkage of the metastasis. His neurological status remained stable at 12 months after the SRT with no complications. Fractionated SRT appears to be effective for preserving or improving the residual vision in patients with visual loss secondary to metastatic tumor of the pituitary gland, and may result in a longer and better quality of life.

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Stereotactic radiosurgery for brain metastasis from renal cell carcinoma

Abstract: SR for brain metastasis from RCC results in brain disease control in the majority of patients and was associated with few complications. Early detection of brain metastases and treatment with SR provides extended quality survival.

Cited by 182 publications

References 35 publications

Multidisciplinary management of colorectal brain metastases

Multidisciplinary management of colorectal brain metastases

A phase II trial of palliative radiotherapy for metastatic renal cell carcinoma

Metastatic Pituitary Tumor From Renal Cell Carcinoma Treated by Fractionated Stereotactic Radiotherapy-Case Report-

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