演題番号 : P34-6
Approximately 30% of patients with metastatic renal cell carcinoma (mRCC) have bone metastases. Although bone metastases are reported to be poor prognostic factors and often cause skeletal-related events (SRE) which deteriorate quality of life, effects on bone lesions of targeted therapies or immune checkpoint inhibitors are limited. Furthermore, it is not proven that bone-modifying agents (BMAs) reduce SRE attributed to renal cell carcinoma. Therefore, treating bone metastases of renal cell carcinoma remains challenging. We retrospectively examined how bone metastases of renal cell carcinoma have been treated at Kyushu Cancer Center.
Material and method
We retrospectively reviewed 43 patients with bone metastases of renal cell carcinoma who were treated at National Hospital Organization Kyushu Cancer Center between 2006 and 2018. Median follow-up period was 12.7 months.
21 patients (49%) had bone metastases when they were diagnosed as RCC and 22 patients (51%) had bone metastases in the course of treatment for mRCC. 42 patients (98%) received targeted therapy and 5 patients (12%) received immune checkpoint inhibitors. 1 patient (2%) underwent best supportive care only. The median Overall survival calculated from the diagnosis of bone metastases was 17.3 months. SRE occurred to 33 patients (77%). The median time from diagnosis of bone metastasis to SRE occurrence was 0.6 month. BMAs were administered to 17 patients (40%) and 4 of them underwent osteonecrosis of the jaw. The Overall survival of patients who received BMAs and those who did not receive BMAs were not significantly different (p=0.463).
Although most patients with bone metastases of RCC underwent SRE shortly after diagnosis, benefits of BMAs to mRCC were unclear and they often caused severe side effects. That is why we should consider not only drug therapy but also physical therapy with healthcare professionals when treating bone metastases of RCC.