PMID- 23652926
OWN - NLM
STAT- MEDLINE
DCOM- 20141006
LR  - 20211203
IS  - 1433-8726 (Electronic)
IS  - 0724-4983 (Linking)
VI  - 32
IP  - 1
DP  - 2014 Feb
TI  - To combine or not combine: the role of radiotherapy and targeted agents in the 
      treatment for renal cell carcinoma.
PG  - 59-67
LID - 10.1007/s00345-013-1068-5 [doi]
AB  - INTRODUCTION: Renal cell carcinoma is counted among the most resistant tumors to 
      chemotherapy and radiotherapy, respectively. However, therapeutic options 
      expanded since the introduction of molecular agents, targeting specific pathways 
      such as the vascular endothelial growth factor (VEGF)-alpha, the VEGF receptor 
      (VEGFR), or the mammalian target of rapamycin (mTOR) pathway. These new agents 
      almost doubled the time to tumor progression and in some trials even improved 
      overall survival. Against this background, the role of local treatment strategies 
      in metastasized or inoperable primary renal cell carcinoma has to be redefined. 
      With the onset of new technical developments in radiotherapy and the possibility 
      to precisely deliver higher doses per fraction, encouraging response and control 
      rates have been reported for kidney cancer, supporting a possible role for 
      irradiation in this setting. This overview summarizes the preclinical data and 
      clinical experiences of modern radiotherapy with focus on possible synergies and 
      toxicities when combined with molecular targeted agents. METHODS: The available 
      literature on preclinical and clinical data comprising prospective trials, 
      retrospective analyses and case reports was reviewed. CONCLUSION: With the recent 
      developments in stereotactic and image-guided radiotherapy, encouraging data 
      concerning local control in the treatment for metastasized renal cell carcinoma 
      have been generated and are therefore recommended whenever possible. It seems 
      that with these high- precision irradiation schedules, the combination with 
      targeted agents is feasible with no increase in severe adverse events. 
      Nevertheless, the addition of molecular targeted drugs to radiotherapy outside of 
      approved regimens or clinical trials warrants careful consideration for every 
      single case.
FAU - Weiss, Christian
AU  - Weiss C
AD  - Department of Radiation Therapy and Oncology, Goethe University, Frankfurt, 
      Germany, weiss.christian@hotmail.com.
FAU - Schulze, Bjorn
AU  - Schulze B
FAU - Ottinger, Annette
AU  - Ottinger A
FAU - Rodel, Claus
AU  - Rodel C
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20130508
PL  - Germany
TA  - World J Urol
JT  - World journal of urology
JID - 8307716
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Antineoplastic Agents/*therapeutic use
MH  - Carcinoma, Renal Cell/*therapy
MH  - Combined Modality Therapy
MH  - Dose-Response Relationship, Radiation
MH  - Humans
MH  - Kidney Neoplasms/*therapy
MH  - *Molecular Targeted Therapy
MH  - Neovascularization, Pathologic/drug therapy/radiotherapy
MH  - *Radiotherapy
MH  - TOR Serine-Threonine Kinases/antagonists & inhibitors
MH  - Treatment Outcome
MH  - Vascular Endothelial Growth Factor A/antagonists & inhibitors
EDAT- 2013/05/09 06:00
MHDA- 2014/10/07 06:00
CRDT- 2013/05/09 06:00
PHST- 2012/12/06 00:00 [received]
PHST- 2013/03/26 00:00 [accepted]
PHST- 2013/05/09 06:00 [entrez]
PHST- 2013/05/09 06:00 [pubmed]
PHST- 2014/10/07 06:00 [medline]
AID - 10.1007/s00345-013-1068-5 [doi]
PST - ppublish
SO  - World J Urol. 2014 Feb;32(1):59-67. doi: 10.1007/s00345-013-1068-5. Epub 2013 May 
      8.