Treatment of renal cell carcinoma with stereotactic radiation therapy is as safe and effective for patients with one kidney as it is for those who have two, according to an analysis of the largest-ever, international dataset of solitary kidney patients to receive this emerging treatment. The findings will be presented today at the 60th Annual Meeting of the American Society for Radiation Oncology (ASTRO).
Renal cell carcinoma (RCC), which has been rising in incidence for decades, is the most common form of kidney cancer in adults in the United States, with approximately 65,000 new cases diagnosed annually. It is responsible for nearly 15,000 deaths each year. It is typically treated surgically, with tumor ablation reserved for patients who are not able or willing to have surgery.
A specialized form of radiation treatment known as stereotactic ablative radiotherapy (SABR), also known as stereotactic body radiation therapy (SBRT), is emerging as a potential alternative for kidney cancer patients. SABR has been shown to be effective in treating cancers in the lung, liver and spine using substantially higher doses of radiation delivered in a single, or just a few, treatment sessions. Earlier this year, a study published in the journal Cancer showed that SABR was safe and effective in treating patients with RCC who had both kidneys remaining. This new study shows it is just as safe and effective for patients who have only one kidney.
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“Although RCC historically has been considered resistant to conventional radiation therapy, the high doses and high precision achievable with SABR overcome this resistance,” said lead author Rohann J. M. Correa, MD, PhD, a radiation oncology resident at London Health Sciences Center in London, Canada. “Kidney SABR is thus emerging as a versatile, non-invasive outpatient treatment requiring one visit or a few visits. Our analysis demonstrates SABR to be highly effective with minimal side effects for RCC patients with a single kidney.”
Dr. Correa and his colleagues analyzed patient data from nine institutions across the United States, Germany, Australia, Canada and Japan within the International Radiosurgery Oncology Consortium for Kidney (IROCK) group. Of the 223 patients who underwent renal SABR, 81 had a solitary kidney. In the single-kidney cohort, patients were an average of 67.5 years old at time of treatment, mostly male (69 percent) and of good performance status (ECOG 0-1 in 97.5 percent). The median biologically-effective dose of radiation therapy was 87.5 Gray (Gy) and was identical in the solitary and bilateral cohorts (p=0.103).
