Outcomes of Stereotactic Radiotherapy for Cranial and Extracranial Metastatic Renal Cell Carcinoma: a Systematic Review — YRD
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  3. Outcomes of Stereotactic Radiotherapy for Cranial and Extracranial Metastatic Renal Cell Carcinoma: a Systematic Review

Outcomes of Stereotactic Radiotherapy for Cranial and Extracranial Metastatic Renal Cell Carcinoma: a Systematic Review (#106)

Gargi Kothari 1 , Farshad Foroudi 1 2 3 , Niall M Corcoran 4 , Shankar Siva 1 3
  1. Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Vic, Australia
  2. Department of Pathology, University of Melbourne, Melbourne, Vic, Australia
  3. Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Vic, Australia
  4. Departments of Urology and Surgery, Royal Melbourne Hospital and the University of Melbourne, Parkville, Vic, Australia

Background/ Significance:

Intracranial stereotactic radiosurgery (SRS) and stereotactic ablative body radiotherapy (SABR) are non-invasive ablative techniques for metastatic disease, which may be particularly effective in treating metastatic RCC.

Objectives:

To critically assess SRS and SABR in metastatic RCC, focusing on associated outcomes and toxicity.

Methods:

A systematic review of the English literature was performed of Medline in March 2013 using structured search terms. Secondary manual searches were performed of major radiotherapy journals. Exclusion criteria included mixed histology studies and case series of less than 5 patients. Outcomes including local control (LC), overall survival (OS) and toxicities were analysed.

Results:

A total of 148 publications were identified, of which 16 publications for cranial and 9 publications for extracranial metastatic RCC met inclusion criteria. Two extracranial studies were prospective. The patient population was heterogeneous in terms of baseline characteristics, burden of metastatic disease, and prior treatment. In the intracranial literature, there were a total of 810 patients and 2296 targets. Data regarding LC was available for 14 studies, with a weighted LC of 92%. OS ranged from 6.7 to 25.6 months. Three studies reported toxicity according to common toxicity criteria, with Grade 3 to 4 toxicity ranging from 0% to 6%. The weighted rate of treatment related mortality was 0.6%, all secondary to intratumoral haemorrhage. In the extracranial literature, there were a total of 356 patients and 691 targets. Data regarding LC was available for 7 studies, with a weighted LC of 84%. Grade 3 to 4 toxicity ranged from 0% to 4%. There were 2 treatment related deaths.

Conclusion:

Stereotactic radiotherapy is associated with a high probability of LC and low rates of toxicity for both cranial and extracranial metastatic RCC. Further prospective studies are required to identify the group of patients, particularly in the extracranial setting, that would benefit the most from stereotactic radiotherapy.