Hybrid Therapy (Surgery and Radiosurgery) for the Treatment of Renal Cell Carcinoma Spinal Metastases.
Neurosurgery
; 90(2): 199-206, 2022 02 01.
Article
em En
| MEDLINE
| ID: mdl-35023875
ABSTRACT
BACKGROUND:
The management of spinal metastatic renal cell carcinoma (mRCC) is controversial regarding extent of resection and radiation dosing.OBJECTIVE:
To determine outcomes in patients treated with hybrid therapy (separation surgery plus adjuvant stereotactic body radiation therapy [SBRT]) for mRCC.METHODS:
A retrospective study of a prospectively collected cohort of patients undergoing hybrid therapy for mRCC between 2003 and 2017 was performed. SBRT was delivered as high-dose single-fraction, high-dose hypofractionated, or low-dose hypofractionated. Extent of disease, clinical and operative outcomes, and complications data were collected, and associations with overall survival (OS) and progression-free survival were determined.RESULTS:
Ninety patients with mRCC with high-grade epidural spinal cord compression (ESCC grades 2 and 3) were treated. Metastases were widespread, oligometastatic, and solitary in 56%, 33%, and 11% of patients, respectively. SBRT delivered was high-dose single-fraction, high-dose hypofractionated, and low-dose hypofractionated in 24%, 56%, and 20% of patients, respectively. The 1-yr cumulative incidence of major complications was 3.4% (95% confidence interval [CI] 0.0%-7.2%). The median follow-up was 14.2 mo for the entire cohort and 38.3 mo for survivors. The 1-yr cumulative incidence of progression was 4.6% (95% CI 0.2%-9.0%), which translates to a local control rate of 95.4% (95% CI 91.0%-99.8%) 1 yr after surgery. The median OS for the cohort was 14.8 mo.CONCLUSION:
These data support the use of hybrid therapy as a safe and effective strategy for the treatment of renal cell spine metastases.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Coluna Vertebral
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Carcinoma de Células Renais
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Radiocirurgia
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Neoplasias Renais
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article