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Concomitant radiotherapy and transarterial chemoembolization reduce skeletal-related events related to bone metastases from renal cell carcinoma

  • Joichi HeiannaEmail author
  • Wataru Makino
  • Takuro Ariga
  • Kazuki Ishikawa
  • Takeaki Kusada
  • Hitoshi Maemoto
  • Masafumi Toguchi
  • Junji Ito
  • Masato Goya
  • Minoru Miyazato
  • Yuko Iraha
  • Sadayuki Murayama
Musculoskeletal

Abstract

Objectives

The purpose of this study was to compare the efficacy of radiotherapy (RT) combined with transcatheter arterial chemoembolization (TACE) with RT alone for the treatment of bone metastases from renal cell carcinoma (RCC).

Methods

We included in this retrospective study 25 RCC patients (28 bone metastases), who were treated with RT at our institution. Patients were divided into two groups: patients treated with RT alone (monotherapy group; n = 17) and those treated with RT combined with TACE (combined therapy group; n = 11). The administered median RT dose was 30 Gy in 10 fractions. Anti-cancer agents used in TACE were cisplatin (median dose, 50 mg) and carboplatin (median dose, 240 mg) for patients with reduced renal function. We evaluated the objective response, post-RT-skeletal-related event (PR-SRE)–free rate, and adverse events associated with treatment for each group.

Results

The objective response rates for bone metastases in the monotherapy and combined therapy groups were 33% and 82%, respectively (p = 0.009). The 2-year PR-SRE-free rate in the monotherapy and combined therapy groups was 41.8% and 100%, respectively (p = 0.009). The objective response and PR-SRE-free rates were significantly superior in the combined therapy than in the monotherapy group. There were no significant differences in adverse events or survival between the two groups.

Conclusion

RT combined with TACE is a promising treatment for bone metastases from RCC, as it results in higher objective response, and PR-SRE-free rates compared with RT alone.

Key Points

• Skeletal-related events (SREs) are common in patients with bone metastases from renal cell carcinoma (RCC).

• Radiotherapy (RT) provides pain relief in patients with bone metastases from RCC, but rarely achieves objective response.

• Combination of RT with transcatheter arterial chemoembolization results in higher objective response and post-RT-SRE-free rates compared with RT alone and is a promising treatment for bone metastases from RCC, as it.

Keywords

Renal cell carcinoma Bone neoplasm Therapeutic embolization Radiotherapy 

Abbreviations

BMA

Bone-modifying agent

CR

Complete response

CT

Computed tomography

ICI

Immune checkpoint inhibitor

MRI

Magnetic resonance imaging

MTT

Molecularly targeted therapy

PD

Progressive disease

PR

Partial response

PR-SRE

Post-radiotherapy-skeletal-related event

QOL

Quality of life

RCC

Renal cell carcinoma

RT

Radiotherapy

SR

Stable response

SRE

Skeletal-related event

TACE

Transcatheter arterial chemoembolization

TAE

Transcatheter arterial embolization

Notes

Funding information

This study was supported by a grant-in-aid of the Uruma Fund for the Promotion of Science.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Sadayuki Murayama.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Joichi Heianna
    • 1
    Email author
  • Wataru Makino
    • 1
  • Takuro Ariga
    • 1
  • Kazuki Ishikawa
    • 1
  • Takeaki Kusada
    • 1
  • Hitoshi Maemoto
    • 1
  • Masafumi Toguchi
    • 1
  • Junji Ito
    • 1
  • Masato Goya
    • 2
  • Minoru Miyazato
    • 2
  • Yuko Iraha
    • 1
  • Sadayuki Murayama
    • 1
  1. 1.Department of RadiologyGraduate School of Medical Science University of The RyukyusNishiharaJapan
  2. 2.Department of UrologyGraduate School of Medical Science University of The RyukyusNishiharaJapan

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