Brain metastases from renal cell carcinoma: Effects of novel systemic agents on brain metastasis outcomes.

Autor: Ressler HW; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: hwalsh@wakehealth.edu., Cramer CK; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Isom S; Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA., McCormack M; Department of Medicine (Hematology & Oncology), Wake Forest School of Medicine, Winston-Salem, NC, USA., Ruiz J; Department of Medicine (Hematology & Oncology), Wake Forest School of Medicine, Winston-Salem, NC, USA., Xing F; Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Li W; Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Whitlow CT; Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA., White JJ; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA., Laxton AW; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA., Tatter SB; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA., Chan MD; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2024 Mar; Vol. 238, pp. 108191. Date of Electronic Publication: 2024 Feb 24.
DOI: 10.1016/j.clineuro.2024.108191
Abstrakt: Objective: The objective of this study was to examine survival outcomes in 136 patients with renal cell carcinoma with metastases to the brain who were treated with radiation combined with immunotherapy or tyrosine kinase inhibitor compared to those who were treated with radiation therapy alone.
Methods: The Wake Forest Gamma Knife prospective database was searched for all patients with renal cell carcinoma brain metastases. Outcome measurements included overall survival, determined via the Kaplan-Meier Method, and cumulative incidence of local and distant failure, determined using the Fine Gray competing risks analysis with death as a competing risk for the 136 patients included.
Results: Overall survival for the entire population at 6 months, 12 months, and 24 months was 67%, 47% and 30%, respectively. For the TKI (non-immunotherapy-treated) population (n = 37), overall survival was 75%, 61%, and 40% at 6 months, 12 months, and 24 months, respectively. For the immunotherapy-treated population (n = 35), overall survival was 85%, 64%, and 50% at 6 months, 12 months, and 24 months, respectively. Overall survival was significantly increased for patients who received radiation with either immunotherapy or TKI (p < 0.0001).
Conclusion: Prior series of patients with brain metastases of multiple histologies have demonstrated an improvement in the local efficacy of stereotactic radiosurgery when combined with systemic agents. We found that patients treated with targeted agents and patients treated with immunotherapy demonstrated a trend towards improvement over patients treated in the era prior to the advent of either classes of novel therapies.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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