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First UK patient cohort treated with stereotactic ablative radiotherapy for primary kidney cancer
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Zarkar, A., Henderson, D., Carver, A., Heyes, G., Harrop, V., Stevenson, R., Kilkenny, J., Marshall, Andrea, Elbeltagi, N. and Howard, H. (2023) First UK patient cohort treated with stereotactic ablative radiotherapy for primary kidney cancer. BJUI Compass, 4 (4). pp. 464-472. doi:10.1002/bco2.199 ISSN 2688-4526.
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Official URL: https://doi.org/10.1002/bco2.199
Abstract
Aims
Stereotactic ablative radiotherapy (SABR) for primary renal cell carcinoma (RCC) is a promising non-invasive ablative treatment option. A prospective interventional clinical trial published showed that treatment was feasible and well tolerated. We present the first single-institution UK cohort of patients with primary RCC receiving protocol-based SABR with prospective follow-up. We also present a protocol that could be used to facilitate more widespread use of the treatment.
Materials and methods
Nineteen biopsy-proven primary RCC patients were treated with either 42 Gy in three fractions on alternate days or 26 Gy in a single fraction based on predefined eligibility criteria using either Linear Accelerator or CyberKnife platform. Prospective toxicity data using CTCAE V4.0 and outcome data such as estimated glomerular filtration rate (eGFR) and tumour response using CT thorax, abdomen and pelvis (CT-TAP) were collected at 6 weeks, 3, 6, 12, 18 and 24 months post treatment.
Results
The 19 patients had a median age of 76 years (interquartile range [IQR] 64–82 years) and 47.4% were males, and they had a median tumour size of 4.5 cm (IQR 3.8–5.2 cm). Single and fractionated treatment was well tolerated and there were no significant acute side effects. The mean drop from baseline in eGFR at 6 months was 5.4 ml/min and that at 12 months was 8.7 ml/min. The overall local control rate at both 6 and 12 months was 94.4%. Overall survival at 6 and 12 months was 94.7% and 78.3%, respectively. After a median follow-up of 17 months, three patients experienced a Grade 3 toxicity, which was resolved with conservative management.
Conclusion
SABR for primary RCC is a safe and feasible treatment for medically unfit patients, which can be delivered in most UK cancer centres using standard Linear Accelerator as well as CyberKnife platforms.
Item Type: | Journal Article | ||||||||
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Subjects: | Q Science > QM Human anatomy R Medicine > RC Internal medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Kidneys -- Cancer, Kidneys -- Cancer -- Patients, Kidneys -- Cancer -- Treatment, Cancer -- Radiotherapy, Stereotaxic techniques, Renal cell carcinoma , Renal cell carcinoma -- Treatment | ||||||||
Journal or Publication Title: | BJUI Compass | ||||||||
Publisher: | Wiley | ||||||||
ISSN: | 2688-4526 | ||||||||
Official Date: | July 2023 | ||||||||
Dates: |
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Volume: | 4 | ||||||||
Number: | 4 | ||||||||
Page Range: | pp. 464-472 | ||||||||
DOI: | 10.1002/bco2.199 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 13 December 2022 | ||||||||
Date of first compliant Open Access: | 15 June 2023 | ||||||||
RIOXX Funder/Project Grant: |
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