(P059) Trends in the Utilization of Radiotherapy in the Management of Renal Cell Carcinoma

April 30, 2015

There has been a decrease in the use of radiotherapy for patients with localized RCC, although patients with more aggressive disease were more likely to receive radiation. Modern trials are needed to better identify the role of radiation in the management of these patients.

Talha Shaikh, MD, Elizabeth A. Handorf, PhD, Colin Murphy, MD, Alexander Kutikov, MD, Robert G. Uzzo, MD, Mark Hallman, MD, PhD, Eric M. Horwitz, Marc C. Smaldone, MD, MSHP; Fox Chase Cancer Center

PURPOSE: The role of radiotherapy in the management of renal cell carcinoma (RCC) has been limited due to the belief that these tumors are relatively radioresistant. More recently, retrospective series have demonstrated good local control in patients undergoing radiation. We examined the temporal trends and patterns of use of radiotherapy in patients with localized RCC.

MATERIALS AND METHODS: Patients diagnosed with RCC were identified using the National Cancer Data Base. Our primary objective was to describe the temporal trends in the utilization of radiotherapy. Our second objective was to identify patient and treatment factors associated with receipt of radiation. Data were analyzed using the chi-square and Cochran-Armitage tests for trend.

RESULTS: A total of 330,426 were diagnosed with RCC between 1998 and 2010, with 18,522 (5.6%) patients receiving radiotherapy. After excluding patients with metastatic disease, 280,208 patients were diagnosed with localized RCC, with 3,552 (1.3%) patients receiving radiation therapy to the primary site. Factors associated with receipt of radiation included age > 71 years, no surgery (P < .0001), chemotherapy use (P < .0001), higher stage (P < .0001), higher grade (P < .0001), positive nodes (P < .0001), and sarcomatoid histology (P < .0001). A total of 257,304 patients underwent surgical resection in this cohort. Of these patients, 2,265 (0.9%) received adjuvant radiation. Patients receiving adjuvant radiotherapy were more likely to receive chemotherapy (P < .0001), have a higher stage (P < .0001), have a higher grade (P < .0001), have positive nodes (P < .0001), and have sarcomatoid histology (P < .0001).

CONCLUSIONS: There has been a decrease in the use of radiotherapy for patients with localized RCC, although patients with more aggressive disease were more likely to receive radiation. Modern trials are needed to better identify the role of radiation in the management of these patients.

Proceedings of the 97th Annual Meeting of the American Radium Society- americanradiumsociety.org