Radiation therapy of renal cell carcinoma skeletal metastases – Does histologic subtype predict progression?
Introduction: This investigation assessed whether the following factors were associated with radiographic local progression in bone metastases from renal cell carcinoma (RCC): (1) high-risk histologic features (2) lesional surgery (3) biologically effective dose (BED) of radiation therapy. Methods a...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Clinical Surgical Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773160X24000084 |
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| author | Kavin Sundaram Joshua M. Lawrenz Precious C. Oyem Aditya Banerjee Shannon Wu Paras Shah Shireen Parsai Chirag Shah Nathan W. Mesko John Reith Lukas M. Nystrom |
| author_facet | Kavin Sundaram Joshua M. Lawrenz Precious C. Oyem Aditya Banerjee Shannon Wu Paras Shah Shireen Parsai Chirag Shah Nathan W. Mesko John Reith Lukas M. Nystrom |
| author_sort | Kavin Sundaram |
| collection | DOAJ |
| description | Introduction: This investigation assessed whether the following factors were associated with radiographic local progression in bone metastases from renal cell carcinoma (RCC): (1) high-risk histologic features (2) lesional surgery (3) biologically effective dose (BED) of radiation therapy. Methods and materials: A single-institution database identified all patients who underwent surgery and radiation therapy for bone metastases from RCC to the appendicular skeleton and pelvis from 2006 to 2016. Thirty-six patients underwent radiotherapy for 80 metastases. While all patients had surgical stabilization, 17/36 also had lesional surgery to address the metastatic lesion. Progression of each individual lesion was determined using the application of RECIST criteria to imaging at last follow-up. Results: The rate of progressive disease was 8/25 (32%) in the high-risk group versus 5/55 (9%) in the standard-risk group (p = 0.019). The rate of progression among high-risk metastases undergoing lesional surgery was 0/9 versus 8/16 (50%) having non-lesional surgery (p = 0.0218). The rate of progression among standard-risk metastases undergoing lesional surgery was 1/16 (6%) versus 4/39 (10%) with non-lesional surgery (p = 1.00). High-risk histologic features (OR: 10.592, 95% confidence interval: 1.347–83.271, p = 0.025) and as well as a reduction in risk with every additional Gray of BED (OR: 0.902, 95% confidence interval: 0.827–0.984, p = 0.021) were found to predict progressive disease. Conclusions: Bone metastases from renal cell carcinoma with high-risk histologic features are associated with less favorable response to radiotherapy than those with standard-risk histology. Delivery of a higher BED was associated with lower odds of progression. |
| format | Article |
| id | doaj-art-b3554a0033aa4eec8dc84952aa394c47 |
| institution | DOAJ |
| issn | 2773-160X |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Surgical Oncology |
| spelling | doaj-art-b3554a0033aa4eec8dc84952aa394c472025-08-20T02:50:29ZengElsevierClinical Surgical Oncology2773-160X2024-03-013110004010.1016/j.cson.2024.100040Radiation therapy of renal cell carcinoma skeletal metastases – Does histologic subtype predict progression?Kavin Sundaram0Joshua M. Lawrenz1Precious C. Oyem2Aditya Banerjee3Shannon Wu4Paras Shah5Shireen Parsai6Chirag Shah7Nathan W. Mesko8John Reith9Lukas M. Nystrom10Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA; University of Texas at Austin Dell Medical School, 1501 Red River St., Austin, TX 78712, USAVanderbilt University Medical Center, 1215 21st Ave S, Medical Center East, Suite 4200, Nashville, TN, 37232, USACleveland Clinic Lerner College of Medicine of Case Western University, 9501 Euclid Ave./EC10, Cleveland, OH, 44195, USACleveland Clinic Lerner College of Medicine of Case Western University, 9501 Euclid Ave./EC10, Cleveland, OH, 44195, USACleveland Clinic Lerner College of Medicine of Case Western University, 9501 Euclid Ave./EC10, Cleveland, OH, 44195, USACleveland Clinic Lerner College of Medicine of Case Western University, 9501 Euclid Ave./EC10, Cleveland, OH, 44195, USARiverside Radiation Onc Dept., 3535 Olentangy River Rd, Columbus, OH, 43214, USACleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USACleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USACleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USACleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA; Corresponding author.Introduction: This investigation assessed whether the following factors were associated with radiographic local progression in bone metastases from renal cell carcinoma (RCC): (1) high-risk histologic features (2) lesional surgery (3) biologically effective dose (BED) of radiation therapy. Methods and materials: A single-institution database identified all patients who underwent surgery and radiation therapy for bone metastases from RCC to the appendicular skeleton and pelvis from 2006 to 2016. Thirty-six patients underwent radiotherapy for 80 metastases. While all patients had surgical stabilization, 17/36 also had lesional surgery to address the metastatic lesion. Progression of each individual lesion was determined using the application of RECIST criteria to imaging at last follow-up. Results: The rate of progressive disease was 8/25 (32%) in the high-risk group versus 5/55 (9%) in the standard-risk group (p = 0.019). The rate of progression among high-risk metastases undergoing lesional surgery was 0/9 versus 8/16 (50%) having non-lesional surgery (p = 0.0218). The rate of progression among standard-risk metastases undergoing lesional surgery was 1/16 (6%) versus 4/39 (10%) with non-lesional surgery (p = 1.00). High-risk histologic features (OR: 10.592, 95% confidence interval: 1.347–83.271, p = 0.025) and as well as a reduction in risk with every additional Gray of BED (OR: 0.902, 95% confidence interval: 0.827–0.984, p = 0.021) were found to predict progressive disease. Conclusions: Bone metastases from renal cell carcinoma with high-risk histologic features are associated with less favorable response to radiotherapy than those with standard-risk histology. Delivery of a higher BED was associated with lower odds of progression.http://www.sciencedirect.com/science/article/pii/S2773160X24000084Renal cell carcinomaBony metastasisSarcomatoidRhabdoidHistologyRadiation |
| spellingShingle | Kavin Sundaram Joshua M. Lawrenz Precious C. Oyem Aditya Banerjee Shannon Wu Paras Shah Shireen Parsai Chirag Shah Nathan W. Mesko John Reith Lukas M. Nystrom Radiation therapy of renal cell carcinoma skeletal metastases – Does histologic subtype predict progression? Clinical Surgical Oncology Renal cell carcinoma Bony metastasis Sarcomatoid Rhabdoid Histology Radiation |
| title | Radiation therapy of renal cell carcinoma skeletal metastases – Does histologic subtype predict progression? |
| title_full | Radiation therapy of renal cell carcinoma skeletal metastases – Does histologic subtype predict progression? |
| title_fullStr | Radiation therapy of renal cell carcinoma skeletal metastases – Does histologic subtype predict progression? |
| title_full_unstemmed | Radiation therapy of renal cell carcinoma skeletal metastases – Does histologic subtype predict progression? |
| title_short | Radiation therapy of renal cell carcinoma skeletal metastases – Does histologic subtype predict progression? |
| title_sort | radiation therapy of renal cell carcinoma skeletal metastases does histologic subtype predict progression |
| topic | Renal cell carcinoma Bony metastasis Sarcomatoid Rhabdoid Histology Radiation |
| url | http://www.sciencedirect.com/science/article/pii/S2773160X24000084 |
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