Robotic Radiosurgery for Kidney Cancer in Patients With Impaired Renal Function
Posted: Friday, November 15, 2019
Robotic stereotactic ablative radiotherapy (SABR) seems to be an efficient treatment of renal cell carcinoma in patients with preexisting kidney disease, according to a retrospective study published in BMC Urology. Carolin Senger, Dr Med, of the Charité - Universitätsmedizin Berlin, and colleagues suggest further studies are warranted to understand the long-term results beyond their 2-year follow-up.
“Our study demonstrates that this [minimally] invasive and highly sophisticated treatment method provides good response rates and local control with negligible toxicity,” the authors commented. “SABR with motion compensation is a nephron-sparing treatment that perfectly adapts to patients with renal cell carcinoma and significant preexisting chronic renal failure.”
Records from 10 patients with a total of 13 lesions who received treatment at the Charité - Universitätsmedizin Berlin were analyzed. Before SABR treatment, eight patients had previous complete and/or partial nephrectomy, and seven patients had chronic kidney disease. A total of seven patients had T1a disease, and three patients had T3a tumors.
Patients received a treatment with either single-fraction SABR of 24 or 25 Gy or three fractions of 12 Gy prescribed to the 70% isodose line. Despite the high doses of radiation delivered to the kidneys, renal function remained stable after treatment in all patients, the investigators noted. Two patients died 15 months after SABR. For 9 of the 10 patients, or 92.3% of all lesions, persistent local control by robotic SABR was recorded within 27 months. Because one patient’s progressive disease and renal function impacted the contralateral kidney, the patient had a nephrectomy.
Disclosure: The study authors’ disclosure information can be found at bmcurol.biomedcentral.com.