RT Journal Article
SR Electronic
T1 Stereotactic Radiotherapy for the Treatment of Patients With Oligo-progressive Metastatic Renal Cell Carcinoma Receiving Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor: Data From the Real World
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 7037
OP 7043
DO 10.21873/anticanres.14730
VO 40
IS 12
A1 GEBBIA, VITTORIO
A1 GIRLANDO, ANDREA
A1 DI GRAZIA, ALFIO
A1 FAZIO, IVAN
A1 BORSELLINO, NICOLÒ
A1 PIAZZA, DARIO
A1 SERRETTA, VINCENZO
A1 PERGOLIZZI, STEFANO
A1 PONTORIERO, ANTONIO
A1 FIRENZE, ALBERTO
A1 VALERIO, MARIA ROSARIA
YR 2020
UL http://ar.iiarjournals.org/content/40/12/7037.abstract
AB Aim: This retrospective observational study evaluated the role of hypo-fractionated stereotactic radiotherapy (SRT) in patients with oligo-progressive metastatic renal cell carcinoma (mRCC) treated with first-line oral tyrosine kinase inhibitors (TKI). Data on local control, delay of further progression, and safety are reported. Patients and Methods: Between January 2010 and December 2016, 28 patients with mRCC who showed oligo-progressive disease while receiving first-line pazopanib were treated with hypofractionated SRT to progressive metastatic sites to delay the change of systemic therapy. First and second progression-free survival (PFS-1 and PFS-2) were recorded, as well as objective response and toxicity. Results: After pazopanib therapy, nine partial remissions (32%), 12 stable disease (43%) and seven progressions (25%) were recorded. The median time to progression from first-line pazopanib until oligo-progression was 9.45 months (PFS-1 range=2-30 months). Seventeen patients (61%) showed progression at pre-existing tumor sites, and 11 patients (39%) showed the appearance of new metastases. Progression-free survival after radiation therapy was 4.55 months (PFS-2 range=1-11 months). PFS-1 plus PFS-2 was 14.0 months (range=3-41 months). Severe grade 3-4 toxicities were seen only occasionally. Conclusion: Patients with oligo-progressive mRCC treated with first-line pazopanib may benefit from hypo-fractionated high-dose SRT at progressing sites achieving a further increase in median progression-free survival. Further studies and prospective validation are required to establish if this minimally invasive approach may have a positive impact on overall survival and reported outcomes.