Tumor Control Outcomes After Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases From Renal Cell Carcinoma
Purpose To report tumor local progression-free outcomes after treatment with single-dose, image-guided, intensity-modulated radiotherapy and hypofractionated regimens for extracranial metastases from renal cell primary tumors. Patients and Methods Between 2004 and 2010, 105 lesions from renal cell c...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2012-04, Vol.82 (5), p.1744-1748 |
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| creator | Zelefsky, Michael J., M.D Greco, Carlo, M.D Motzer, Robert, M.D Magsanoc, Juan Martin, M.D Pei, Xin, Ph.D Lovelock, Michael, Ph.D Mechalakos, Jim, Ph.D Zatcky, Joan, N.P., R.N Fuks, Zvi, M.D Yamada, Yoshiya, M.D |
| description | Purpose To report tumor local progression-free outcomes after treatment with single-dose, image-guided, intensity-modulated radiotherapy and hypofractionated regimens for extracranial metastases from renal cell primary tumors. Patients and Methods Between 2004 and 2010, 105 lesions from renal cell carcinoma were treated with either single-dose, image-guided, intensity-modulated radiotherapy to a prescription dose of 18–24 Gy (median, 24) or hypofractionation (three or five fractions) with a prescription dose of 20–30 Gy. The median follow-up was 12 months (range, 1–48). Results The overall 3-year actuarial local progression-free survival for all lesions was 44%. The 3-year local progression-free survival for those who received a high single-dose (24 Gy; n = 45), a low single-dose ( |
| doi_str_mv | 10.1016/j.ijrobp.2011.02.040 |
| format | Article |
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Patients and Methods Between 2004 and 2010, 105 lesions from renal cell carcinoma were treated with either single-dose, image-guided, intensity-modulated radiotherapy to a prescription dose of 18–24 Gy (median, 24) or hypofractionation (three or five fractions) with a prescription dose of 20–30 Gy. The median follow-up was 12 months (range, 1–48). Results The overall 3-year actuarial local progression-free survival for all lesions was 44%. The 3-year local progression-free survival for those who received a high single-dose (24 Gy; n = 45), a low single-dose (<24 Gy; n = 14), or hypofractionation regimens ( n = 46) was 88%, 21%, and 17%, respectively (high single dose vs. low single dose, p = .001; high single dose vs. hypofractionation, p < .001). Multivariate analysis revealed the following variables were significant predictors of improved local progression-free survival: 24 Gy dose compared with a lower dose ( p = .009) and a single dose vs. hypofractionation ( p = .008). Conclusion High single-dose, image-guided, intensity-modulated radiotherapy is a noninvasive procedure resulting in high probability of local tumor control for metastatic renal cell cancer generally considered radioresistant according to the classic radiobiologic ranking.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2011.02.040</identifier><identifier>PMID: 21596489</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Bone Neoplasms - mortality ; Bone Neoplasms - radiotherapy ; Bone Neoplasms - secondary ; Carcinoma, Renal Cell - mortality ; Carcinoma, Renal Cell - radiotherapy ; Carcinoma, Renal Cell - secondary ; CARCINOMAS ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hematology, Oncology and Palliative Medicine ; Humans ; Hypofractionation ; Image-guided radiotherapy ; Kidney Neoplasms ; KIDNEYS ; Male ; Medical sciences ; METASTASES ; MULTIVARIATE ANALYSIS ; Nephrology. Urinary tract diseases ; PATIENTS ; PROBABILITY ; RADIATION DOSES ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy Dosage ; Radiotherapy, Image-Guided - methods ; Radiotherapy, Intensity-Modulated - methods ; Renal cell cancer ; Single fraction ; Tumor Burden ; Tumors of the urinary system</subject><ispartof>International journal of radiation oncology, biology, physics, 2012-04, Vol.82 (5), p.1744-1748</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c553t-cbf6ffef0f580cab44a0081fbf919eb57d83273051082ccdbc3e150b6b9933bb3</citedby><cites>FETCH-LOGICAL-c553t-cbf6ffef0f580cab44a0081fbf919eb57d83273051082ccdbc3e150b6b9933bb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301611003609$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25768449$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21596489$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22056224$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Zelefsky, Michael J., M.D</creatorcontrib><creatorcontrib>Greco, Carlo, M.D</creatorcontrib><creatorcontrib>Motzer, Robert, M.D</creatorcontrib><creatorcontrib>Magsanoc, Juan Martin, M.D</creatorcontrib><creatorcontrib>Pei, Xin, Ph.D</creatorcontrib><creatorcontrib>Lovelock, Michael, Ph.D</creatorcontrib><creatorcontrib>Mechalakos, Jim, Ph.D</creatorcontrib><creatorcontrib>Zatcky, Joan, N.P., R.N</creatorcontrib><creatorcontrib>Fuks, Zvi, M.D</creatorcontrib><creatorcontrib>Yamada, Yoshiya, M.D</creatorcontrib><title>Tumor Control Outcomes After Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases From Renal Cell Carcinoma</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To report tumor local progression-free outcomes after treatment with single-dose, image-guided, intensity-modulated radiotherapy and hypofractionated regimens for extracranial metastases from renal cell primary tumors. Patients and Methods Between 2004 and 2010, 105 lesions from renal cell carcinoma were treated with either single-dose, image-guided, intensity-modulated radiotherapy to a prescription dose of 18–24 Gy (median, 24) or hypofractionation (three or five fractions) with a prescription dose of 20–30 Gy. The median follow-up was 12 months (range, 1–48). Results The overall 3-year actuarial local progression-free survival for all lesions was 44%. The 3-year local progression-free survival for those who received a high single-dose (24 Gy; n = 45), a low single-dose (<24 Gy; n = 14), or hypofractionation regimens ( n = 46) was 88%, 21%, and 17%, respectively (high single dose vs. low single dose, p = .001; high single dose vs. hypofractionation, p < .001). Multivariate analysis revealed the following variables were significant predictors of improved local progression-free survival: 24 Gy dose compared with a lower dose ( p = .009) and a single dose vs. hypofractionation ( p = .008). Conclusion High single-dose, image-guided, intensity-modulated radiotherapy is a noninvasive procedure resulting in high probability of local tumor control for metastatic renal cell cancer generally considered radioresistant according to the classic radiobiologic ranking.</description><subject>Biological and medical sciences</subject><subject>Bone Neoplasms - mortality</subject><subject>Bone Neoplasms - radiotherapy</subject><subject>Bone Neoplasms - secondary</subject><subject>Carcinoma, Renal Cell - mortality</subject><subject>Carcinoma, Renal Cell - radiotherapy</subject><subject>Carcinoma, Renal Cell - secondary</subject><subject>CARCINOMAS</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Hypofractionation</subject><subject>Image-guided radiotherapy</subject><subject>Kidney Neoplasms</subject><subject>KIDNEYS</subject><subject>Male</subject><subject>Medical sciences</subject><subject>METASTASES</subject><subject>MULTIVARIATE ANALYSIS</subject><subject>Nephrology. Urinary tract diseases</subject><subject>PATIENTS</subject><subject>PROBABILITY</subject><subject>RADIATION DOSES</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Image-Guided - methods</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><subject>Renal cell cancer</subject><subject>Single fraction</subject><subject>Tumor Burden</subject><subject>Tumors of the urinary system</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl1rFDEUhgdR7Fr9ByIDInozazJJ5uOmUNZ-QUuhW8G7kMmctFlnkjXJiPun_I2ecauCFwohCeE55z0n78myl5QsKaHV-83SboLvtsuSULok5ZJw8ihb0KZuCybEp8fZgrCKFAzhg-xZjBtCkKz50-ygpKKteNMusu-30-hDvvIuBT_k11PSfoSYH5sEIT_fbb0JSifrnUrQ58r1-dq6uwGKDz5CvkYKfJoJnV-M6g6Ks8n2SF64BC7atCuufD8NP6NvVG99uoegtrvcoOzJt4TZg3JWDfkVJBVxofpp8GN-Aw5fVzDgpoK2zo_qefbEqCHCi4fzMPt4enK7Oi8ur88uVseXhRaCpUJ3pjIGDDGiIVp1nCtCGmo609IWOlH3DStrRgQlTal132kGVJCu6tqWsa5jh9nrfV4fk5VR2wT6XnvnQCdZlkRUZcmReruntsF_mSAmOdqosWDlwE9RtmUrCOeUIvnunyStmrqqGKc1onyP6uBjDGDkNthRhZ2kRM7Oy43cOy9n5yUpJTqPYa8eFKZuhP530C-rEXjzAKio1YC2Om3jH07UVcP5zB3tOcD__WohzO2D09DbMHffe_u_Sv5OoAfrLGp-hh3EjZ8CGos9y4gBcj1P6TyklJL52rIfPGHmCQ</recordid><startdate>20120401</startdate><enddate>20120401</enddate><creator>Zelefsky, Michael J., M.D</creator><creator>Greco, Carlo, M.D</creator><creator>Motzer, Robert, M.D</creator><creator>Magsanoc, Juan Martin, M.D</creator><creator>Pei, Xin, Ph.D</creator><creator>Lovelock, Michael, Ph.D</creator><creator>Mechalakos, Jim, Ph.D</creator><creator>Zatcky, Joan, N.P., R.N</creator><creator>Fuks, Zvi, M.D</creator><creator>Yamada, Yoshiya, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20120401</creationdate><title>Tumor Control Outcomes After Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases From Renal Cell Carcinoma</title><author>Zelefsky, Michael J., M.D ; Greco, Carlo, M.D ; Motzer, Robert, M.D ; Magsanoc, Juan Martin, M.D ; Pei, Xin, Ph.D ; Lovelock, Michael, Ph.D ; Mechalakos, Jim, Ph.D ; Zatcky, Joan, N.P., R.N ; Fuks, Zvi, M.D ; Yamada, Yoshiya, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c553t-cbf6ffef0f580cab44a0081fbf919eb57d83273051082ccdbc3e150b6b9933bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Biological and medical sciences</topic><topic>Bone Neoplasms - mortality</topic><topic>Bone Neoplasms - radiotherapy</topic><topic>Bone Neoplasms - secondary</topic><topic>Carcinoma, Renal Cell - mortality</topic><topic>Carcinoma, Renal Cell - radiotherapy</topic><topic>Carcinoma, Renal Cell - secondary</topic><topic>CARCINOMAS</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Hypofractionation</topic><topic>Image-guided radiotherapy</topic><topic>Kidney Neoplasms</topic><topic>KIDNEYS</topic><topic>Male</topic><topic>Medical sciences</topic><topic>METASTASES</topic><topic>MULTIVARIATE ANALYSIS</topic><topic>Nephrology. Urinary tract diseases</topic><topic>PATIENTS</topic><topic>PROBABILITY</topic><topic>RADIATION DOSES</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Image-Guided - methods</topic><topic>Radiotherapy, Intensity-Modulated - methods</topic><topic>Renal cell cancer</topic><topic>Single fraction</topic><topic>Tumor Burden</topic><topic>Tumors of the urinary system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zelefsky, Michael J., M.D</creatorcontrib><creatorcontrib>Greco, Carlo, M.D</creatorcontrib><creatorcontrib>Motzer, Robert, M.D</creatorcontrib><creatorcontrib>Magsanoc, Juan Martin, M.D</creatorcontrib><creatorcontrib>Pei, Xin, Ph.D</creatorcontrib><creatorcontrib>Lovelock, Michael, Ph.D</creatorcontrib><creatorcontrib>Mechalakos, Jim, Ph.D</creatorcontrib><creatorcontrib>Zatcky, Joan, N.P., R.N</creatorcontrib><creatorcontrib>Fuks, Zvi, M.D</creatorcontrib><creatorcontrib>Yamada, Yoshiya, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zelefsky, Michael J., M.D</au><au>Greco, Carlo, M.D</au><au>Motzer, Robert, M.D</au><au>Magsanoc, Juan Martin, M.D</au><au>Pei, Xin, Ph.D</au><au>Lovelock, Michael, Ph.D</au><au>Mechalakos, Jim, Ph.D</au><au>Zatcky, Joan, N.P., R.N</au><au>Fuks, Zvi, M.D</au><au>Yamada, Yoshiya, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tumor Control Outcomes After Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases From Renal Cell Carcinoma</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>82</volume><issue>5</issue><spage>1744</spage><epage>1748</epage><pages>1744-1748</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose To report tumor local progression-free outcomes after treatment with single-dose, image-guided, intensity-modulated radiotherapy and hypofractionated regimens for extracranial metastases from renal cell primary tumors. Patients and Methods Between 2004 and 2010, 105 lesions from renal cell carcinoma were treated with either single-dose, image-guided, intensity-modulated radiotherapy to a prescription dose of 18–24 Gy (median, 24) or hypofractionation (three or five fractions) with a prescription dose of 20–30 Gy. The median follow-up was 12 months (range, 1–48). Results The overall 3-year actuarial local progression-free survival for all lesions was 44%. The 3-year local progression-free survival for those who received a high single-dose (24 Gy; n = 45), a low single-dose (<24 Gy; n = 14), or hypofractionation regimens ( n = 46) was 88%, 21%, and 17%, respectively (high single dose vs. low single dose, p = .001; high single dose vs. hypofractionation, p < .001). Multivariate analysis revealed the following variables were significant predictors of improved local progression-free survival: 24 Gy dose compared with a lower dose ( p = .009) and a single dose vs. hypofractionation ( p = .008). Conclusion High single-dose, image-guided, intensity-modulated radiotherapy is a noninvasive procedure resulting in high probability of local tumor control for metastatic renal cell cancer generally considered radioresistant according to the classic radiobiologic ranking.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21596489</pmid><doi>10.1016/j.ijrobp.2011.02.040</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biological and medical sciences Bone Neoplasms - mortality Bone Neoplasms - radiotherapy Bone Neoplasms - secondary Carcinoma, Renal Cell - mortality Carcinoma, Renal Cell - radiotherapy Carcinoma, Renal Cell - secondary CARCINOMAS Disease-Free Survival Female Follow-Up Studies Hematology, Oncology and Palliative Medicine Humans Hypofractionation Image-guided radiotherapy Kidney Neoplasms KIDNEYS Male Medical sciences METASTASES MULTIVARIATE ANALYSIS Nephrology. Urinary tract diseases PATIENTS PROBABILITY RADIATION DOSES Radiology RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy Dosage Radiotherapy, Image-Guided - methods Radiotherapy, Intensity-Modulated - methods Renal cell cancer Single fraction Tumor Burden Tumors of the urinary system |
| title | Tumor Control Outcomes After Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases From Renal Cell Carcinoma |
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