Radiotherapy for metastatic carcinomas of the kidney or melanomas: An analysis using palliative end points

Purpose: To assess the rate and duration of response to palliative radiotherapy (RT) in patients with metastatic melanoma or renal cell carcinoma. Patients and Methods: From 1992 to 1995, 90 patients were entered into a nonrandomized study. Goals of palliatve RT were prospectively defined and subjective response was documented at the end of RT, after 2-6 weeks, and every 3 months thereafter. Most patients were treated with 5 x 4 Gy or 10 x 3 Gy. Results: Relief of pain from bone lesions was observed in 26 of 40 cases, with a duration of response of 2.4 months, corresponding to 57% of the remaining lifetime. A total of 55% of patients with persistent neurologic dysfunction despite corticosteroids improved, for a duration of 2.5 months (86% of the further lifespan). Freedom from symptoms in patients treated for impending neurological complications from metastases to the brain, spine, or nerve plexus was documented for 86-100% of their lifetime. Conclusions: Despite the methodological flaws discussed, the efficacy of a short course of palliative RT for so-called radioresistent tumors is demonstrated