Stereotactic Body Radiotherapy for Metastatic Kidney Cancer: U.S. Temporal Trends
Posted: Friday, May 14, 2021
A Letter to the Editor published in The Oncologist outlined the temporal trends in the use of stereotactic body radiotherapy for metastatic renal cell carcinoma in the United States. Using the National Cancer Database, Toni K. Choueiri, MD, of the Dana‐Farber Cancer Institute, Boston, and colleagues also identified the clinical predictors of utilization of this treatment.
“Less resourced individuals may derive greater benefit from [a] shorter duration of therapy, resulting in less contact time at cancer centers,” the investigators commented. “The observation of a lower likelihood of being treated with stereotactic body radiotherapy at nonacademic centers highlights the importance of multidisciplinary care within institutions or integration of care between regional and major centers for patients with advanced disease.”
Of the 65,345 patients diagnosed with metastatic renal cell carcinoma between 2004 and 2016, 1,919 underwent stereotactic body radiotherapy, 15,871 received conventional radiotherapy, and 47,555 did not receive radiotherapy. The proportion of patients undergoing stereotactic body radiotherapy increased from 1.4% in 2004 to 3.7% in 2016; on the other hand, conventional radiotherapy utilization decreased from 26.6% to 24.1% during this period. Based on the results of a Cochran‐Armitage test, there seemed to be a significant increase in the utilization of stereotactic body radiotherapy in the overall cohort as well as in those receiving either conventional or stereotactic body radiotherapy.
The brain and neck (75.1%) and spine (14.5%) were the most common sites of treatment for patients undergoing stereotactic body radiotherapy. In those who underwent conventional radiotherapy, the spine (35.6%) and other bony sites (24.5%) were most frequently treated. A later year of diagnosis and higher educational status seemed to be significantly associated with the receipt of stereotactic body radiotherapy. Patients who were older than age 70, female, of the Black race, and with Medicaid or no insurance tended to be less likely to receive stereotactic body radiotherapy.
Disclosure: For full disclosures of the study authors, visit theoncologist.onlinelibrary.wiley.com.