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Zoledronic acid enhances the effect of radiotherapy for bone metastases from renal cell carcinomas: more than a 24-month median follow-up

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Renal cell carcinoma (RCC) is thought to respond unreliably to radiotherapy (RT). Zoledronic acid significantly reduces the risk of skeletal complications. This study investigated whether RT with zoledronic acid prolonged the time to bone-lesion progression in comparison with RT alone.

Method

Twenty-seven patients (34 lesions) with bone metastases secondary to RCC undergoing treatment with RT with or without zoledronic acid were retrospectively evaluated at two institutions between 1999 and 2009. Twelve patients were treated with RT alone from 1999 to 2008 (RT group). Fifteen patients were treated with RT and zoledronic acid from 2006 to 2009 (RT + Z group). The time to skeletal-related events and pain progression were assessed from patients’ medical records.

Results

The median (range) follow-up was 26 (3–75) and 24 (3–55) months in the RT and RT + Z groups, respectively. Three patients (three lesions) in the RT + Z group had skeletal-related events (SREs). In contrast, six patients (eight lesions) in the RT group had SREs. SREs comprised pathological fractures in five, additional surgeries in three, spinal cord or cauda equine compression in two, and repeat RT in one. There was a significant difference in SRE-free survival time and duration of site-specific pain response between groups.

Conclusions

RT combined with zoledronic acid significantly prolonged SRE-free survival and duration of pain response compared with RT alone in the treatment of osseous metastases from RCC.

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Conflict of interest

The authors did not receive and will not receive any benefits and funding from any commercial party related directly or indirectly to the subject of this article. This work is original, and authors meet the criteria for authorship, including acceptance of responsibility for the scientific content of the manuscript. There are no potential conflicts of interest.

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Authors and Affiliations

  1. Department of Rehabilitation Sciences and Hokuto Endowed Chair in Prevention of Joint Disease, Faculty of Health Sciences, Hokkaido University, Kita 12, Nishi 5, Kita-ku, Sapporo, 060-0812, Japan

    Naoki Takeda

  2. Department of Orthopaedic Surgery, Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-tyome, Shiroishiku, Sapporo, 003-0804, Japan

    Kazuo Isu & Hiroaki Hiraga

  3. Department of Renal and Genito-Urinary Surgery, Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan

    Nobuo Shinohara

  4. Department of Orthopedic Surgery, School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan

    Akio Minami

  5. Department of Neurosurgery, Hokuto Hospital, Kisen 7-5, Inadatyou, Obihiro, Hokkaido, 080-0833, Japan

    Hajime Kamata

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  1. Naoki Takeda
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  2. Kazuo Isu
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  3. Hiroaki Hiraga
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  4. Nobuo Shinohara
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  5. Akio Minami
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  6. Hajime Kamata
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Correspondence to Naoki Takeda.

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Takeda, N., Isu, K., Hiraga, H. et al. Zoledronic acid enhances the effect of radiotherapy for bone metastases from renal cell carcinomas: more than a 24-month median follow-up. J Orthop Sci 17, 770–774 (2012). https://doi.org/10.1007/s00776-012-0294-9

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  • DOI: https://doi.org/10.1007/s00776-012-0294-9

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