Stereotactic Ablative Body Radiotherapy for Primary Kidney Cancer: What have we Learned from Prospective Trials and What Does the Future Hold?

Daniels, Christopher P.; Ellis, Rodney J.; Ponsky, Lee; Lo, Simon S.

doi:10.2217/fon.16.6

Cited by 5 publications

(6 citation statements)

References 22 publications

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“…The baseline mean (range) eGFR was 55 (18-97) mL/ min. At 1 year the eGFR was reduced by 11 mL/min (95% CI 6-17), and in the subset of nine patients who were assessed at 2 years, there was a similar reduction from baseline by 11 mL/min (95% CI [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Whilst the change in eGFR was statistically significant at 1 year (P < 0.001) using linear mixed models, the slopes of change in eGFR in patients with pre-existing CKD were not different from patients without pre-existing CKD Table 2 Treatment-related adverse events according to period (acute and late) and overall.…”

Section: Resultsmentioning

confidence: 93%

“…SABR is well established in the treatment of cancers in the lung, liver and spine. Whilst the approach is still emerging in the kidney, it is not technically limited by tumour proximity to central pelvic‐calyceal structures or to small renal masses ; however, there is a paucity of prospective data to support the routine adoption of SABR for primary inoperable RCC . In this context we conducted a prospective clinical trial of SABR for this disease setting.…”

Section: Introductionmentioning

confidence: 99%

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Stereotactic ablative body radiotherapy for inoperable primary kidney cancer: a prospective clinical trial

et al. 2017

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Section: Resultsmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Stereotactic ablative body radiotherapy for inoperable primary kidney cancer: a prospective clinical trial

et al. 2017

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“…Sessions were spaced 48 h apart and were delivered on non-consecutive days (one day interval). SBRT procedures were adapted from consensus statements from the International Radiosurgery Oncology Consortium for primary renal cell carcinoma [10,11]. The total dose administered was in accordance with De Meerleer's guidelines [12].…”

Section: Stereotactic Body Radiotherapymentioning

confidence: 99%

Stereotactic Body Radiotherapy for Frail Patients with Primary Renal Cell Carcinoma: Preliminary Results after 4 Years of Experience

Grelier

Baboudjian

Gondran-Tellier

et al. 2021

Cancers

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Introduction: The aim of this study was to report the oncological outcomes and toxicity of stereotactic body radiotherapy (SBRT) to treat primary renal cell carcinoma (RCC) in frail patients unfit for surgery or standard alternative ablative therapies. Methods: We retrospectively enrolled 23 patients who had SBRT for primary, biopsy-proven RCC at our tertiary center between October 2016 and March 2020. Treatment-related toxicities were defined using CTCAE, version 4.0. The primary outcome was local control which was defined using the Response Evaluation Criteria in Solid Tumors. Results: The median age, Charlson score and tumor size were 81 (IQR 79–85) years, 7 (IQR 5–8) and 40 (IQR 28–48) mm, respectively. The most used dose fractionation schedule was 35 Gy (78.3%) in five or seven fractions. The median duration of follow-up for all living patients was 22 (IQR 10–39) months. Local recurrence-free survival, event-free survival, cancer-specific survival and overall survival were 96 (22/23), 74 (18/23), 96 (22/23) and 83% (19/23), respectively. There were no grade 3–4 side effects. No patients required dialysis during the study period. No treatment-related deaths or late complications were reported. Conclusion: SBRT appears to be a promising alternative to surgery or ablative therapy to treat primary RCC in frail patients.

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“… 46 , 47 In contrast to widely available ablative therapy modalities, SBRT has the potential to treat large (>4cm), complex endophytic tumors or local oligometastatic disease without high risk of fistula or stricture involving the collecting system and surrounding vasculature. 48–50 Some retrospective studies suggest that SBRT compares well to thermal ablation for safety and efficacy, but there are limited trials to prospectively compare outcomes of RFA and SBRT. 42 , 51 Across several trials, SBRT has promising benefit for patients with inoperable disease with high risk of functional sequelae (eg solitary kidney) or oligometastatic disease ( Table 3 ).…”

Section: Introductionmentioning

confidence: 99%

“… 42 , 51 Across several trials, SBRT has promising benefit for patients with inoperable disease with high risk of functional sequelae (eg solitary kidney) or oligometastatic disease ( Table 3 ). 41 , 48 , 49 , 52 , 53 …”

Section: Introductionmentioning

confidence: 99%

Adjuvant Therapy for High-Risk Localized Renal Cell Carcinoma: Current Landscape and Future Direction

Buller

Antony

Ristau

2023

OTT

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Locally and regionally advanced renal cell carcinoma (RCC) can recur at high rates even after visually complete resection of primary disease. Both targeted therapies and immunotherapies represent potential agents that might help reduce recurrence of RCC in these patients. This paper reviews the current body of evidence defining their potential impact and examines the large Phase III randomized clinical trials that have been performed to assess the safety and efficacy of these systemic therapies in the adjuvant setting. Given that the findings from these trials have been predominantly negative, this paper also explores the role of other potential adjuvant agents, including single and combination agent targeted therapies and immunotherapies, whose use is currently limited to metastatic RCC. Finally, the use of radiation therapy and the use of advanced imaging modalities in RCC are also considered.

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Stereotactic Ablative Body Radiotherapy for Primary Kidney Cancer: What have we Learned from Prospective Trials and What Does the Future Hold?

Cited by 5 publications

References 22 publications

Stereotactic ablative body radiotherapy for inoperable primary kidney cancer: a prospective clinical trial

Stereotactic ablative body radiotherapy for inoperable primary kidney cancer: a prospective clinical trial

Stereotactic Body Radiotherapy for Frail Patients with Primary Renal Cell Carcinoma: Preliminary Results after 4 Years of Experience

Adjuvant Therapy for High-Risk Localized Renal Cell Carcinoma: Current Landscape and Future Direction

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