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Safety and efficacy of radiotherapy combined with chemotherapy for recurrent metastatic renal pelvic and ureteral carcinoma

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Abstract

Purpose

To retrospectively investigate the safety and efficacy of radiotherapy combined with chemotherapy for recurrent metastatic renal pelvic and ureteral carcinoma.

Methods

109 patients were enrolled in this study, including 44 patients in the radiochemotherapy group and 65 patients in the chemotherapy group. Propensity score matching (PSM) was used to balance the baseline characteristics of the two groups by 1:1 matching. Kaplan–Meier method was used to calculate PFS and OS. Cox regression model was used for multivariate analysis. The side effects were evaluated by CTCAE v5.0

Results

The median follow-up time was 14.5 months. Multivariate analysis showed that radiotherapy was a good independent prognostic factor for OS (HR: 0.327, 95% CI 0.157–0.680, P = 0.003). After matching, there were 40 patients in both groups, and the median PFS and OS in the radiochemotherapy group were longer than those in the chemotherapy group (PFS: 10.4 vs. 6.7 months, P = 0.035; OS: 43.5 vs. 18.8 months, P < 0.001). In addition, in the radiochemotherapy group, patients treated with radiotherapy before first-line chemotherapy failure had a longer PFS than those treated with radiotherapy after chemotherapy failure (median PFS: 15.7 vs. 6 months, P = 0.003). There was no significant difference in the incidence of grade 3–4 toxicities between the two groups (52.3% vs. 50.8%, P = 0.878).

Conclusion

For patients with recurrent metastatic renal pelvic and ureteral carcinoma, radiotherapy combined with chemotherapy is well tolerable and expected to bring long-term survival benefits, and the benefits of early interventional radiotherapy may be more obvious.

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Data availability

The data that support the findings of this study are available from the corresponding authors upon reasonable request.

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Funding

This study was funded by National High Level Hospital Clinical Research Funding 2022CR30 (Interdepartmental Clinical Research Project of Peking University First Hospital).

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Author notes

  1. Ming-Zhu Liu, Xiao-Ying Li and Feng Lyu are co‐first authors who contributed equally to the work.

Authors and Affiliations

  1. Department of Radiation Oncology, Peking University First Hospital, No. 7 Xishiku Street, Beijing, 100034, China

    Ming-Zhu Liu, Xiao-Ying Li, Feng Lyu, Xian-Shu Gao, Jia-Yan Chen, Yan Gao, Mu Xie, Xue-Ying Ren & Ming-Wei Ma

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  1. Ming-Zhu Liu
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Contributions

MZL, XYL, and FL analyzed the data and drafted the manuscript, MX, JYC, XYR, and YG helped in data check, MWM revised the manuscript; XSG designed the study, revised the analysis framework, revised the manuscript, and interpreted the findings. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Xian-Shu Gao or Ming-Wei Ma.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by the institutional ethical committee of Peking University First Hospital (No. 2022-097).

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Liu, MZ., Li, XY., Lyu, F. et al. Safety and efficacy of radiotherapy combined with chemotherapy for recurrent metastatic renal pelvic and ureteral carcinoma. World J Urol 42, 23 (2024). https://doi.org/10.1007/s00345-023-04701-8

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