Mp47-03 trends in sbrt for inoperable renal cell carcinoma

You have accessJournal of UrologyCME1 Apr 2023MP47-03 TRENDS IN SBRT FOR INOPERABLE RENAL CELL CARCINOMA Benjamin V. Stone, David-Dan Nguyen, Dejan K. Filipas, Muhieddine Labban, Edoardo Beatrici, Alexander P. Cole, Shawn Malone, Christopher J. D. Wallis, Quoc-Dien Trinh, Scott C. Morgan, and Soumyajit Roy Benjamin V. StoneBenjamin V. Stone More articles by this author , David-Dan NguyenDavid-Dan Nguyen More articles by this author , Dejan K. FilipasDejan K. Filipas More articles by this author , Muhieddine Labban Muhieddine Labban More articles by this author , Edoardo BeatriciEdoardo Beatrici More articles by this author , Alexander P. ColeAlexander P. Cole More articles by this author , Shawn MaloneShawn Malone More articles by this author , Christopher J. D. WallisChristopher J. D. Wallis More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , Scott C. MorganScott C. Morgan More articles by this author , and Soumyajit RoySoumyajit Roy More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003293.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A growing body of evidence suggests that stereotactic body radiotherapy (SBRT) could be an appropriate local treatment strategy for patients with renal cell carcinoma (RCC) who refuse surgery or are medically inoperable, but the degree of uptake of SBRT remains understudied. METHODS: The National Cancer Database was utilized to identify all patients from 2004-2020 with non-metastatic RCC for whom surgery was not performed due to medical comorbidities, age, locally advanced disease, or patient refusal. We evaluated trends over time in the use of radiation to the primary tumor for these patients, and the modality of radiation used. Multivariable logistic regression was used to determine the predictors of SBRT adjusted for baseline demographic and clinical covariates. We used multivariable Cox regression to determine the adjusted association of SBRT with overall survival (OS). RESULTS: There were 10,810 patients with RCC from 2004-2020 who were deemed poor surgical candidates or refused surgery. The proportion receiving radiation to the primary tumor increased from 1.7% from 2004-2009 to 3.3% in 2020 (p=0.02), and the proportion treated with SBRT vs. EBRT increased from 51% in 2004-2009 to 65% in 2020. There was a small but statistically significant increase in the odds of SBRT over time (OR=1.05, 95% CI 1.01-1.09, p=0.008 for each year of diagnosis). Age 70-79, treatment at a non-academic center, treatment in New England (versus Atlantic region) and VA insurance were associated with use of SBRT, while cT2 disease was associated with lower use of SBRT versus cT1 disease (Table 1). SBRT (HR 0.52, 95% CI 0.39-0.71, p<0.001) was associated with a significant OS benefit on multivariable Cox regression analysis adjusted for age, race, ethnicity, treatment setting, cT stage, cN stage, histology, and systemic treatment (Table 2). CONCLUSIONS: Although overall utilization of SBRT is very low in RCC patients who are poor candidates for surgery or who refuse surgery, there seems to be an increasing trend of utilization over time. Use of SBRT was associated with superior OS compared to patients treated with EBRT. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e643 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin V. Stone More articles by this author David-Dan Nguyen More articles by this author Dejan K. Filipas More articles by this author Muhieddine Labban More articles by this author Edoardo Beatrici More articles by this author Alexander P. Cole More articles by this author Shawn Malone More articles by this author Christopher J. D. Wallis More articles by this author Quoc-Dien Trinh More articles by this author Scott C. Morgan More articles by this author Soumyajit Roy More articles by this author Expand All Advertisement PDF downloadLoading ...