The efficacy of external beam radiotherapy and stereotactic body radiotherapy for painful spinal metastases from renal cell carcinoma

Hunter, G.K.; Balagamwala, E.H.; Koyfman, Shlomo A.; Bledsoe, Turner; Sheplan, Lawrence; Reddy, Chandana A.; Chao, Samuel T.; Djemil, T.; Angelov, Lilyana; Videtic, Gregory M.M.

doi:10.1016/j.prro.2012.01.005

Cited by 47 publications

(35 citation statements)

References 14 publications

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“…We have described the best available contemporary evidence base, from which 12 Amiraliev et al (2012) 23 Brinkmann et al (2007) 29 Eggener et al (2008) 27 Fokas et al (2010) 36 Fuchs et al (2005) 35 Hunter et al (2012) 34 Ikushima et al (2000) 37 Kwak et al (2007) 30 Lee et al (2006) 32 Pretalia et al (2010) 24 Russo et al (2007) 31 Staehler et al (2009) 26 Staehler et al (2010) 25 Zelefsky et al (2012) 33 Zerbi et al (2008) Review some conclusions can be made, and identifi ed knowledge gaps that can only be addressed through well-designed, prospective comparative studies. However, there are several limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Findings from a multivariate analysis of cancer-specifi c survival, adjusting for previous nephrectomy, sex, and age, still favoured metastasectomy with curettage and intramedullary stabilisation compared with no surgical treatment (p=0·018). A third study 34 compared the effi cacy and durability of pain relief between single-dose SBRT and CRT in patients with bone metastases to the spinal column (C1 sacrum); no signifi cant diff erence between pain objective responses (p=0·67), time to pain relief (p=0·29), or duration of pain relief (p=0·095) was found (table 2).…”

Section: Complete Versus No or Incomplete Metastasectomymentioning

confidence: 99%

“…There was a moderate-to-high risk of confounding regarding previous treatment, tumour histology, grade, and size or volume of metastases, especially in studies on local treatments of bone and brain metastases. [33][34][35][36][37] Regarding diff erent sites treated in the same study, there was generally a moderate-to-high risk of confounding, especially for studies pertaining to treatment of metastases at various sites, 12,27,[30][31][32] because it was often unclear if these confounders were adjusted. Evidence quality was not assessed by GRADE because of the nature of the included studies (ie, retrospective comparative studies), and the high risk of bias across the studies.…”

Section: Local Therapies For Brain Metastasesmentioning

confidence: 99%

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Local treatments for metastases of renal cell carcinoma: a systematic review

Dabestani

Marconi

Hofmann

et al. 2014

The Lancet Oncology

283

205

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Local treatment of metastases such as metastasectomy or radiotherapy remains controversial in the treatment of metastatic renal cell carcinoma. To investigate the benefi ts and harms of various local treatments, we did a systematic review of all types of comparative studies on local treatment of metastases from renal cell carcinoma in any organ. Interventions included metastasectomy, radiotherapy modalities, and no local treatment. The results suggest that patients treated with complete metastasectomy have better survival and symptom control (including pain relief in bone metastases) than those treated with either incomplete or no metastasectomy. Nevertheless, the available evidence was marred by high risks of bias and confounding across all studies. Although the fi ndings presented here should be interpreted with caution, they and the identifi ed gaps in knowledge should provide guidance for clinicians and researchers, and directions for further research.

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Section: Discussionmentioning

confidence: 99%

Section: Complete Versus No or Incomplete Metastasectomymentioning

confidence: 99%

Section: Local Therapies For Brain Metastasesmentioning

confidence: 99%

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Local treatments for metastases of renal cell carcinoma: a systematic review

Dabestani

Marconi

Hofmann

et al. 2014

The Lancet Oncology

283

205

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“…More commonly it is used for the symptomatic treatment of painful osseous metastases, and several modalities have been shown to provide good relief of bone pain (Hunter et al 2012 ;Zelefsky et al 2012 ).…”

Section: Radiotherapymentioning

confidence: 99%

Female Pelvis: Genital Organs

Forstner

Cunha²

2015

Imaging of Complications and Toxicity Following Tumor Therapy

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Medical Radiology-Diagnostic Imaging is a unique series that aims to document the most innovative technologies in all fi elds within diagnostic imaging and interventional radiology, thereby informing the physician in practice of the latest advances in diagnostic imaging and percutaneous imageguided minimally invasive procedures. Th e contents are intended to cover all organs, and all modern imaging techniques and image-guided treatment modalities, with special emphasis on applications in clinical practice. Each volume is a comprehensive reference book on a topical theme, and the editors are always experts of high international standing. Contributions are included from both clinicians and researchers, ensuring wide appeal. Medical Radiology -Radiation Oncology is a unique series that aims to document the most innovative technologies in all fi elds within radiology, thereby informing the physician in practice of the latest advances in diagnostic and treatment techniques. Th e contents range from contemporary statements relating to management for various disease sites to explanations of the newest techniques for tumor identifi cation and of mechanisms for the enhancement of radiation eff ects, with the emphasis on maximizing cure and minimizing complications. Each volume is a comprehensive reference book on a topical theme, and the editors are always experts of high international standing. Contributions are included from both clinicians and researchers, ensuring wide appeal. This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. AbstractA precise knowledge of antineoplastic drugs is an indispensable basis for the care of patients with cancer. The mechanisms of action and resistance, cross-resistance patterns, pharmacodynamics and pharmacokinetics, pharmacological interaction, and last but not least potential adverse effects should be part of this knowledge. As contemporary cancer care requires interdisciplinary and multiprofessional structures, the radiologist is an important a...

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“…7 The main use of RT to date has been in the metastatic setting to palliate symptomatic bone and brain metastases, where short course RT doses have symptomatic benefit. 8,9 Over the past 10 to 15 years, there have been tremendous advances in RT practice, permitting use of high precision RT planning and delivery techniques. These achievements have culminated in the ability to prescribe high dose, ablative RT to tumour targets anywhere in the body, while creating steep dose gradients that minimize damage to nearby critical organs.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic body radiotherapy for the treatment of medically inoperable primary renal cell carcinoma: Current evidence and future directions

Swaminath

Chu

2015

CUAJ

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The incidence of renal cell carcinoma (RCC) is steadily rising due to an aging population and more frequent imaging of the abdomen for other medical conditions. While surgery remains the standard of care treatment for localized disease, many patients are unfit due to their advanced age and medical comorbidities. In these patients, an active surveillance strategy or ablative therapies, including radiofrequency/microwave ablation or cryotherapy, can be offered. Such options have limitations particularly with fast growing, or larger tumors. A promising ablative therapy option to consider is stereotactic body radiotherapy (SBRT). SBRT refers to high dose, focally ablative radiation delivered in a short time (3-5 fractions), and is safe and effective in many other cancer sites, including lung, liver and spine. SBRT offers potential advantages in the primary kidney cancer setting due to its ablative dosing (overcoming the notion of "radio-resistance"), short treatment duration (important in an elderly population), low toxicity profile (enabling SBRT to treat larger RCCs than other ablative modalities), and non-invasiveness. To date, there is limited long-term prospective data on the outcomes of SBRT in primary RCC. However, early evidence is intriguing with respect to excellent local control and low toxicity; however, most studies vary in terms of technique and radiation dosing used. Welldesigned prospective cohort studies with clearly defined and standardized techniques, dosing, follow-up, and integration of quality of life outcomes will be essential to further establish the role of SBRT in management of inoperable, localized RCC.

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The efficacy of external beam radiotherapy and stereotactic body radiotherapy for painful spinal metastases from renal cell carcinoma

Cited by 47 publications

References 14 publications

Local treatments for metastases of renal cell carcinoma: a systematic review

Local treatments for metastases of renal cell carcinoma: a systematic review

Female Pelvis: Genital Organs

Stereotactic body radiotherapy for the treatment of medically inoperable primary renal cell carcinoma: Current evidence and future directions

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