scholarly journals Hybrid Therapy (Surgery and Radiosurgery) for the Treatment of Renal Cell Carcinoma Spinal Metastases

Neurosurgery ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ibrahim Hussain ◽  
Jacob L. Goldberg ◽  
Joseph A. Carnevale ◽  
Samuel Z. Hanz ◽  
Anne S. Reiner ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Spinal Metastases ◽  
Hybrid Therapy

scholarly journals Single-fraction versus multifraction spinal stereotactic radiosurgery for spinal metastases from renal cell carcinoma: secondary analysis of Phase I/II trials

2016 ◽  
Vol 24 (5) ◽  
pp. 829-836 ◽  
Author(s):  
Amol J. Ghia ◽  
Eric L. Chang ◽  
Andrew J. Bishop ◽  
Hubert Y. Pan ◽  
Nicholas S. Boehling ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Stereotactic Radiosurgery ◽  
Renal Cell ◽  
Tumor Volume ◽  
Secondary Analysis ◽  
Spinal Metastases ◽  
Survival Duration ◽  
Single Fraction ◽  
Entire Cohort

OBJECTIVE The objective of this study was to compare fractionation schemes and outcomes of patients with renal cell carcinoma (RCC) treated in institutional prospective spinal stereotactic radiosurgery (SSRS) trials who did not previously undergo radiation treatment at the site of the SSRS. METHODS Patients enrolled in 2 separate institutional prospective protocols and treated with SSRS between 2002 and 2011 were included. A secondary analysis was performed on patients with previously nonirradiated RCC spinal metastases treated with either single-fraction (SF) or multifraction (MF) SSRS. RESULTS SSRS was performed in 47 spinal sites on 43 patients. The median age of the patients was 62 years (range 38–75 years). The most common histological subtype was clear cell (n = 30). Fifteen sites underwent surgery prior to the SSRS, with laminectomy the most common procedure performed (n = 10). All SF SSRS was delivered to a dose of 24 Gy (n = 21) while MF regiments were either 27 Gy in 3 fractions (n = 20) or 30 Gy in 5 fractions (n = 6). The median overall survival duration for the entire cohort was 22.8 months. The median local control (LC) for the entire cohort was 80.6 months with 1-year and 2-year actuarial LC rates of 82% and 68%, respectively. Single-fraction SSRS correlated with improved 1- and 2-year actuarial LC relative to MF SSRS (95% vs 71% and 86% vs 55%, respectively; p = 0.009). On competing risk analysis, SF SSRS showed superior LC to MF SSRS (subhazard ratio [SHR] 6.57, p = 0.014). On multivariate analysis for LC with tumor volume (p = 0.272), number of treated levels (p = 0.819), gross tumor volume (GTV) coverage (p = 0.225), and GTV minimum point dose (p = 0.97) as covariates, MF SSRS remained inferior to SF SSRS (SHR 5.26, p = 0.033) CONCLUSIONS SSRS offers durable LC for spinal metastases from RCC. Single-fraction SSRS is associated with improved LC over MF SSRS for previously nonirradiated RCC spinal metastases.

scholarly journals Survival After Surgery for Renal Cell Carcinoma Metastatic to the Spine: Impact of Modern Systemic Therapies on Outcomes

Neurosurgery ◽  
2020 ◽  
Author(s):  
Ganesh M Shankar ◽  
Laura A Van Beaver ◽  
Bryan D Choi ◽  
Muhamed Hadzipasic ◽  
Ahilan Sivaganesan ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Systemic Therapy ◽  
Renal Cell ◽  
Systemic Disease ◽  
Cohort Analysis ◽  
Spinal Metastases ◽  
Immune Checkpoints ◽  
Metastatic Rcc ◽  
Systemic Therapies

Abstract BACKGROUND Modern medical management of metastatic renal cell carcinoma (RCC) includes therapies targeting tyrosine kinases, growth pathways (mammalian target of rapamycin (mTOR)), and immune checkpoints. OBJECTIVE To test our hypothesis that patients with spinal metastases would benefit from postoperative systemic therapy despite presenting with disease that, in many cases, was resistant to prior systemic therapy. METHODS This is an Institutional Review Board-approved clinical retrospective cohort analysis. A sample of adult patients with RCC metastatic to the spine who underwent operative intervention between January 2010 and December 2017 at 2 large academic medical centers was used in this study. RESULTS We identified 78 patients with metastatic RCC in whom instrumented stabilization was performed in 79% and postoperative stereotactic radiosurgery was performed in 41% of patients. Of patients presenting with weakness or myelopathy, 93% noted postoperative improvement and 78% reported improvement in radicular and axial paraspinal pain severity. Increased overall survival (OS) (913 d (95% CI: 633-1975 d, n = 49) vs 222 d (95% CI: 143-1005 d, n = 29), P = .003) following surgery was noted in patients who received postoperative systemic therapy a median of 80 d (interquartile range 48-227 d) following the surgical intervention. CONCLUSION Postoperative outcomes and palliation of symptoms for metastatic RCC without targeted therapies in this cohort are similar to those reported in earlier series prior to the adoption of these systemic therapies. We observed a significantly longer OS among patients who received modern systemic therapies postoperatively. These findings have implications for the preoperative evaluation of patients with systemic disease who may have been deemed poor surgical candidates prior to the availability of these systemic therapies.

Endovascular embolization with Onyx of spinal metastases from renal cell carcinoma

2011 ◽  
Vol 78 (3) ◽  
pp. e135-e138
Author(s):  
Daniel López ◽  
Elvira Jiménez Gómez ◽  
María José Méndez Vidal ◽  
Rafael Oteros Fernández ◽  
Fernando Delgado Acosta
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Spinal Metastases ◽  
Endovascular Embolization

scholarly journals Spinal metastases from renal cell carcinoma: Case note with an overview

2021 ◽  
Vol 23 ◽  
pp. 100994
Author(s):  
Shailesh Hadgaonkar ◽  
Amogh Zawar ◽  
Sahil Sanghavi ◽  
Ajay Kothari ◽  
Parag Sancheti ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Spinal Metastases ◽  
Case Note ◽  
Renal Cell Carcinoma Case

Stereotactic radiosurgery for spinal metastases from renal cell carcinoma

2005 ◽  
Vol 3 (4) ◽  
pp. 288-295 ◽  
Author(s):  
Peter C. Gerszten ◽  
Steven A. Burton ◽  
Cihat Ozhasoglu ◽  
William J. Vogel ◽  
William C. Welch ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Tumor Progression ◽  
Cell Carcinoma ◽  
Stereotactic Radiosurgery ◽  
Renal Cell ◽  
Spinal Metastases ◽  
External Beam Radiation ◽  
Content Type ◽  
Single Fraction ◽  
Fine Print

Object. The role of stereotactic radiosurgery in treating renal cell carcinoma (RCC) metastases to the spine has previously been limited. In this study the authors evaluated the clinical outcome in patients with spinal RCC who underwent single-fraction radiosurgery. Methods. Forty-eight patients with 60 RCC metastases to the spine (six cervical, 26 thoracic, 18 lumbar, and 10 sacral) were treated with a single-fraction radiosurgery technique and were followed for a period of 14 to 48 months (median 37 months). All patients were successfully treated in an outpatient setting. The tumor volume ranged from 5.5 to 203 cm3 (mean 61.9 cm3). Forty-two of the total 60 lesions had been previously treated with external-beam radiation therapy (EBRT). The maximum tumor dose was maintained at 17.5 to 25 Gy (mean 20 Gy). The volume of the spinal cord exposed to greater than 8 Gy ranged from 0.01 to 3 cm3 (mean 0.64 cm3); the volume of the spinal canal at the cauda equina level exposed to greater than 8 Gy ranged from 0.01 to 2.2 cm3 (mean 0.65 cm3). No radiation-induced toxicity occurred during the follow-up period. Axial and radicular pain improved in 34 (89%) of 38 patients who were treated primarily for pain. Tumor control was demonstrated in seven of eight patients treated primarily for radiographically documented tumor progression. In time six patients required open surgical intervention for tumor progression that had caused neurological dysfunction after radiosurgery. Conclusions. Spinal radiosurgery can be a successful therapeutic modality for the delivery of large-dose single-fraction radiation to RCC spinal metastases that are often poorly controlled with conventional EBRT modalities.

Outcome of surgical management of spinal metastases secondary to renal cell carcinoma in a district general hospital

2016 ◽  
Vol 16 (4) ◽  
pp. S91
Author(s):  
James N. Hadfield ◽  
A.-M. Hill ◽  
L. Jagonase ◽  
S. England ◽  
A.T. Cross ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
General Hospital ◽  
Surgical Management ◽  
Renal Cell ◽  
Spinal Metastases ◽  
District General Hospital
Sign in / Sign up

Export Citation Format

Share Document