Solitary metastasis from: Kidneys, Melanoma, Sarcoma

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When it comes to metastases, this is when cancer cells migrate through the blood or the lymphatic vessels from their original location to other seats of the body.

During such process, the metastatic cells of a primary malignant tumour affect other organs or tissues and cause the development of new “secondary “tumours.

The capacity of developing metastases is a feature typical only of malignant tumours, it does not occur in benign tumours.

The development of the metastases is due to different factors, such as the type of the original tumour, the organs invoved and the proximity of paths of diffusion.

In most cases, metastatic tumours tend to keep some characteristics of the primary tumour from which they derive.

Metastases usually develop in the most advanced stages of the disease and are responsible for 90% of cancer deaths. Generally,  in the metastatic phase of the disease (phase IV), the cures have a pallatve role.

The treatment of metastases also aims to reduce the symptoms of the disease, in order to improve the patient's quality of life, and to prevent further spreading of the metastatic tumour.

Recent studies have proved that in the oligo-metastatic disease (i.e. when the number of metastases is limited), the ablationn of the metastatic sites may have a positive impact on the disease control in the longterm and on survival.

Another advantage of local treatments in the oligo-metastatic patient is given by thee opportunity of postponing the start of the systemic therapy and of the possible side-effects related to it.

Whenever, for clinical or technical reasons, other types of local treatment or radiotherapy techniques (such as stereotactic) are excluded, in case of metastasis for a radio-resistant tumour, hadrontherapy may represent an option of ablative treatment.

The treatment of METASTATIC patient has to be discussed and managed by a multidisciplinary team.

In particular, a hadronic radiation treatment may be taken into account in case of metastasis of the radio-resistant pathologies reported below:

Kidneys metastasis

Kidney cancer is a neoplasm that originates, in most cases, from the cells on the renal tubules that constitute nephrons.

It usually affects one of the two kidneys, although bi-lateral forms - arising in both kidneys- have been found.

The principal sites of metastatic diffusion in kidney cancer are:

• Lymph nodes 
• Lungs
• Brain
• Bones
• Liver
• Spleen
• Colon
• Skin

Metastasis from mucous membranes and/or skin melanomas

A melanoma is a malignant neoplasm originating from melanocytes.

Depending on the location of the original tumour, melanomas are divided into:

• Cutaneous melanoma
• Intraocular melanoma
• Mucosal melanoma

The principal sites of metastases in Melanoma are:

• Lymph nodes
• Lungs
• Liver
• Bones

Metastasis from sarcoma

Sarcomas are malignant tumours, rare, (incidence of 4-5 cases per million of inhabitants/year) originating from the connective tissues, they can therefore develop from:

• Muscles
• Bones
• Cartilage
• Tendons
• Deep layers of the skin
• Blood vessels
• Lymphatic vessels
• Nerves
• Ligaments
• Adipose tissue

Sarcomas can therefore arise in any part of the body, to the point that at present over 100 different types of Sarcomas have been identified; they are grouped into three main categories:

• Bone sarcomas
• Soft-tissue sarcomas
• Gastrointestinal stromal tumours

In their advanced stage, Sarcomas can mainly give rise to lung metastasis, although metastatic cells can easily reach any other part of the body.

Treatment of solitary metastasis from: Kidneys, Melanomas (mucous membranes/skin), Sarcomas

To treat these lesions, if properly classified from a multidisciplinary point of view, radiation with hadrons can be used.