Predictive Factors for Long-Term Disease Control in Systemic Treatment-Naïve Oligorecurrent Renal Cell Carcinoma Treated with Up-Front Stereotactic Ablative Radiotherapy (SABR)

• Published in: Cancers Vol. 16; no. 17; p. 2963
• Main Authors: Franzese, Ciro, Vernier, Veronica, Badalamenti, Marco, Lucchini, Raffaella, Stefanini, Sara, Bertolini, Anna, Ilieva, Maryia, Di Cristina, Luciana, Marini, Beatrice, Franceschini, Davide, Comito, Tiziana, Spoto, Ruggero, Dominici, Luca, Galdieri, Carmela, Mancosu, Pietro, Tomatis, Stefano, Scorsetti, Marta
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 25.08.2024
• Subjects: Disease control; Kidney cancer; Medical prognosis; Metastases; Metastasis; Patients; Radiation therapy; Renal cell carcinoma; Toxicity; oligorecurrence; SABR; radiotherapy; renal cell carcinoma; predictive factors
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers16172963

Stereotactic ablative radiotherapy (SABR) is emerging as a potential local treatment option for oligometastatic RCC. This study aims to evaluate the efficacy of SABR in patients with oligorecurrent RCC. A total of 50 patients with histologically confirmed RCC underwent SABR for oligorecurrence between 2006 and 2022. Eligible patients had up to five extracranial metastases and were systemic treatment-naïve at the time of irradiation. The primary endpoints of the analysis were overall survival (OS), local control (LC), distant metastasis-free survival (DMFS), and time to systemic therapy initiation. The median OS was not reached, with 1- and 3-year OS rates of 93.8% and 77.5%, respectively. LC rates at one and three years were 95.8% and 86.5%, respectively. The median time to systemic therapy initiation was 63.8 months, and the median DMFS was 17.9 months, with one- and three-year rates of 63.4% and 36.6%, respectively. Multiple metastases were a negative predictive factor for DMFS (HR 2.39, = 0.023), whereas lung metastases were associated with a more favorable outcome (HR 0.38, = 0.011). SABR offers a valuable treatment option for oligometastatic RCC, demonstrating significant potential for achieving long-term disease control and delaying the need for systemic therapy.