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Communication

Image-Guided Robotic Radiosurgery for the Treatment of Lung Metastases of Renal Cell Carcinoma—A Retrospective, Single Center Analysis

1
Department of Urology, University Hospital of Munich, 81377 Munich, Germany
2
European CyberKnife® Center, 81377 Munich, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Harriet Kluger
Cancers 2022, 14(2), 356; https://doi.org/10.3390/cancers14020356
Received: 30 November 2021 / Revised: 5 January 2022 / Accepted: 11 January 2022 / Published: 12 January 2022
Patients with metastatic renal cell carcinoma are difficult to treat despite many new systemic therapy options. Patients often present with pulmonary metastases. Local treatment of those metastases is traditionally performed surgically. In this study, robotic radiosurgery is tested in 50 patients with pulmonary metastases and is demonstrated to be a safe and highly effective treatment option in this patient group. Future research might focus on the combination of robotic radiosurgery with systemic treatment.
Pulmonary metastases are the most frequent site of metastases in renal cell carcinoma (RCC). Metastases directed treatment remains an important treatment option despite advances in systemic therapies. However, the safety and efficacy of robotic radiosurgery (RRS) for the treatment of lung metastases of RCC remains unclear. Patients with metastatic RCC and lung metastases treated by RRS were retrospectively analyzed for overall survival (OS), progression-free survival (PFS), local recurrence free survival (LRFS) and adverse events. The Kaplan–Meier method was used for survival analysis and the common terminology criteria for adverse events (CTCAE; Version 5.0) classification for assessment of adverse events. A total of 50 patients were included in this study. Median age was 64 (range 45–92) years at the time of RRS. Prior to RRS, 20 patients (40.0%) had received either tyrosine kinase inhibitors or immunotherapy and 27 patients (54.0%) were treatment naïve. In our patient cohort, the median PFS was 13 months (range: 2–93). LRFS was 96.7% after two years with only one patient revealing progressive disease of the treated metastases 13 months after RRS. Median OS was 35 months (range 2–94). Adverse events were documented in six patients (12%) and were limited to grade 2. Fatigue (n = 4) and pneumonitis (n = 2) were observed within 3 months after RRS. In conclusion, RRS is safe and effective for patients with metastatic RCC and pulmonary metastases. Radiation induced pneumonitis is specific in the treatment of pulmonary lesions, but not clinically relevant and survival rates seem favorable in this highly selected patient cohort. Future directions are the implementation of RRS in multimodal treatment approaches for oligometastatic or oligoprogressive disease. View Full-Text
Keywords: renal cell carcinoma; robotic radiosurgery; metastatic disease; lung metastases renal cell carcinoma; robotic radiosurgery; metastatic disease; lung metastases
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MDPI and ACS Style

Rodler, S.; Götz, M.; Mumm, J.-N.; Buchner, A.; Graser, A.; Casuscelli, J.; Stief, C.; Fürweger, C.; Muacevic, A.; Staehler, M. Image-Guided Robotic Radiosurgery for the Treatment of Lung Metastases of Renal Cell Carcinoma—A Retrospective, Single Center Analysis. Cancers 2022, 14, 356. https://doi.org/10.3390/cancers14020356

AMA Style

Rodler S, Götz M, Mumm J-N, Buchner A, Graser A, Casuscelli J, Stief C, Fürweger C, Muacevic A, Staehler M. Image-Guided Robotic Radiosurgery for the Treatment of Lung Metastases of Renal Cell Carcinoma—A Retrospective, Single Center Analysis. Cancers. 2022; 14(2):356. https://doi.org/10.3390/cancers14020356

Chicago/Turabian Style

Rodler, Severin, Melanie Götz, Jan-Niclas Mumm, Alexander Buchner, Annabel Graser, Jozefina Casuscelli, Christian Stief, Christoph Fürweger, Alexander Muacevic, and Michael Staehler. 2022. "Image-Guided Robotic Radiosurgery for the Treatment of Lung Metastases of Renal Cell Carcinoma—A Retrospective, Single Center Analysis" Cancers 14, no. 2: 356. https://doi.org/10.3390/cancers14020356

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