Abstract | BACKGROUND: Despite the paucity of prospective evidence, stereotactic radiotherapy (SRT) is increasingly being considered in the setting of oligoprogression to delay the need to change systemic therapy. OBJECTIVE: DESIGN, SETTING, AND PARTICIPANTS: A prospective multicenter study was performed to evaluate the use of SRT in oligoprogressive mRCC patients. Patients with mRCC who had previous stability or response after ≥3 mo of TKI therapy were eligible if they developed progression of five of fewer metastases. Thirty-seven patients with 57 oligoprogressive tumors were enrolled. INTERVENTION: Oligoprogressive tumors were treated with SRT, and the same TKI therapy was continued afterward. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Competing risk analyses and the Kaplan-Meir methodology were used to report the outcomes of interest. RESULTS AND LIMITATIONS: The median duration of TKI therapy prior to study entry was 18.6 mo; 1-yr LC of the irradiated tumors was 93% (95% confidence interval [CI] 71-98%). The median PFS after SRT was 9.3 mo (95% CI 7.5-15.7 mo). The cumulative incidence of changing systemic therapy was 47% (95% CI 32-68%) at 1 yr, with a median time to change in systemic therapy of 12.6 mo (95% CI 9.6-17.4 mo). One-year OS was 92% (95% CI 82-100%). There were no grade 3-5 SRT-related toxicities. CONCLUSIONS: LC of irradiated oligoprogressive mRCC tumors was high, and the need to change systemic therapy was delayed for a median of >1 yr. PATIENT SUMMARY:
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Authors | Patrick Cheung, Samir Patel, Scott A North, Arjun Sahgal, William Chu, Hany Soliman, Belal Ahmad, Eric Winquist, Tamim Niazi, Francois Patenaude, Gerald Lim, Daniel Yick Chin Heng, Arbind Dubey, Piotr Czaykowski, Rebecca K S Wong, Anand Swaminath, Scott C Morgan, Rupi Mangat, Sareh Keshavarzi, Georg A Bjarnason |
Journal | European urology
(Eur Urol)
Vol. 80
Issue 6
Pg. 693-700
(Dec 2021)
ISSN: 1873-7560 [Electronic] Switzerland |
PMID | 34399998
(Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved. |
Chemical References |
- Protein Kinase Inhibitors
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Topics |
- Carcinoma, Renal Cell
(drug therapy, radiotherapy)
- Female
- Humans
- Kidney Neoplasms
(drug therapy, radiotherapy)
- Male
- Prospective Studies
- Protein Kinase Inhibitors
(therapeutic use)
- Radiosurgery
(adverse effects, methods)
- Retrospective Studies
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