The Effect of Biological Effective Dose on Time to Symptom Progression in Metastatic Renal Cell Carcinoma

Wilson, David B.; Hiller, Louise; Gray, L; Grainger, Melvin; Stirling, Allan; James, Nicholas D.

doi:10.1016/s0936-6555(03)00164-x

Cited by 41 publications

(25 citation statements)

References 27 publications

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“…Choosing an ␣/␤ ratio of 10 for RCC, DiBiase et al reported an overall symptomatic response rate of 86% and concluded that a BED 10 Ͼ 50 (equivalent to 36 Gy in 9 fractions) was associated with significantly higher CR rates. In contrast, Wilson et al 9 utilized lower ␣/␤ ratios of 3 and 7 and found an overall response rate of 73% with no significant relation between BED and response. These 4 studies examined a wide range of RT doses (range, 8 -64 Gy) and used primarily physician-based, retrospective analysis of response.…”

Section: Discussionmentioning

confidence: 94%

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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Section: Discussionmentioning

confidence: 94%

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

Lee

Hodgson

Chow

et al. 2005

Cancer

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“…In prospective studies for patients with metastatic RCC, palliative radiotherapy can result in significant relief of local symptoms and improved quality of life [17,18]. Therefore, external beam radiation therapy has been standard palliative treatment for symptomatic bone metastases.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcome and prognostic factors in renal cell cancer patients with bone metastasis

Yuasa

Urakami

Yamamoto

et al. 2011

Clin Exp Metastasis

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We retrospectively analyzed treatment outcomes and factors for poor prognosis for patients with renal cell cancer (RCC) bone metastases. Patients with bone metastases at initial diagnosis of metastasis secondary from RCC, treated at our hospital between 1984 and 2009, were retrospectively reviewed and statistically analyzed. Among 214 RCC patients with metastasis, 71 patients (33%) were found to have bone metastases at initial diagnosis of metastasis. The median follow-up was 21.1 months (intra-quartile range: IQR, 9.1-47.4 months). The estimated median overall survival time from the diagnosis of bone metastasis was 27.7 months. The probability of patients surviving at 1, 2, and 5 years was 63.7, 52.2, and 19.3%, respectively. When they were stratified by MSKCC scores, the probability of the median overall survival of the populations classified as favorable, intermediate, and poor was not reached, 32.9, and 10.5 months, respectively (P = 0.002). In addition, poor performance status (PS) (hazard ratio [HR]: 1.938, P = 0.035) and no prior nephrectomy (HR: 3.008, P = 0.004) were extracted as independent poor prognostic factors by multivariate analysis. All treatment modalities-including radical en bloc surgery, radiation therapy, cytokine therapy, molecular targeted therapy, and administration of zoledronic acid-seemed to contribute to favorable survival. More than half of the patients with bone metastases secondary from RCC were predicted to survive more than 24 months. In this population, MSKCC scores were valid predictors of survival. With increased treatment options, RCC patients with bone metastasis may benefit further from subsequent modalities and/or agents.

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“…In a retrospective study of 78 patients with metastases at different sites from renal cell carcinoma, a higher biologically effective dose was not a predictor of response to radiotherapy [24]. In another retrospective study of patients with MSCC from colorectal cancer, median survival was better after doses > 30 Gy than after ≤ 30 Gy (7 vs. 3.1 months) [1].…”

Section: Resultsmentioning

confidence: 99%