Intensive Local Therapy to RCC Bone Metastases May Increase Survival

The approach was defined as surgical resection with a wide margin or radiotherapy with a biologically effective dose of 140 Gy or greater.
The approach was defined as surgical resection with a wide margin or radiotherapy with a biologically effective dose of 140 Gy or greater.

NEW ORLEANS—Intensive local therapy to bone lesions in patients with renal cell carcinoma (RCC) with bone metastases may improve survival, data presented at the 2015 American Urological Association annual meeting.

The data are from a retrospective Japanese study of 70 RCC patients with bone metastases (BM). Of these, 27 (39%) had multiple BM. BM sites included the vertebra (38 patients), pelvis (18 patients), long bones (21 patients), and other sites (23 patients).

For the study, Hiroshi Fukushima, MD, and colleagues at Tokyo Metropolitan Cancer and Infectious Diseases Center, defined intensive local therapy as surgical resection with a wide margin or radiotherapy with a biologically effective dose of 140 Gy or greater to BM. The investigators classified patients into 3 groups: intensive local therapy to BM with curative intent to the other lesions (level 1, 19 patients); intensive local therapy to BM without curative intent to the other lesions (level 2, 15 patients); and less intensive or no local therapy (level 3, 36 patients).

During a median follow-up of 13 months, 37 patients (53%) died. The median overall survival rate was 22 months. Patients in level 1, 2, and 3 had 1-year overall survival rates of 84%, 70%, and 51%, respectively. On multivariate analysis, intensive local therapy to BM independently predicted a significant 55% decreased risk of death compared with less intensive or no local therapy.

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