Stereotactic body radiotherapy for poor surgical candidates with primary renal cell carcinoma
Yoon Young Jo ,
Korea Republic of
PD-0848
Abstract
Stereotactic body radiotherapy for poor surgical candidates with primary renal cell carcinoma
1Asan Medical Center, Radiation Oncology , Seoul , Korea Republic of
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Purpose or Objective
Stereotactic body radiotherapy (SBRT) has considerable
advantages including its ability to provide a non-invasive ablative treatment
with very few treatment sessions, with emerging evidence showing promising
rates of local control (LC). Therefore, it might be an alternative curative
treatment strategy for patients who are unfit for radical surgery. This prospective
study was performed to assess the feasibility and safety of SBRT for renal cell
carcinoma (RCC).
Material and Methods
This protocol is a single
arm, single-institutional phase II study. 40 patients will be recruited from
2016 and followed for a total of 2 years. preliminary report completed a
minimum of 12 months follow up 17 persons. All patients had T1a(≤4cm) diseases. Median patient age was 78 years and all
patients had Charlson comorbidity score≤8. Median tumor
size was 24mm at Diagnosis CT and 25mm at Planning CT. A total of 42 Gy in 3
fractions was delivered every other day using Cyberknife system. The tumor sizes and serum
creatinine also GFR were compared between the pre-treatment assessment and
subsequent postRT 3 month, 12 month assessment. Tumor response was assessed by imaging results using Response Evaluation
Criteria In Solid Tumors (RECIST v1.1) measurement. Toxicities were recorded
using Common Terminology Criteria for Adverse Events V5.0.
Results
In total, 14 patients were included to analyze so far.
We evaluated post RT 3 month radiographic response and finally post RT 1 year
response, one(7%) patient achieved complete response at 1yr follow up, six (43%)
had partial responses, seven (50%) had stable disease and none had progressive
disease, indicating a local control rate of 100%.
Two patients had grade 2 acute nausea and only one
patient had grade 3 renal toxicity who had history of radical nephrectomy of
opposite side kidney because of RCC. And there were No grade 4-5 toxicities
were recorded. And there were procedure related Hemoperitoneum resulted from
fiducial marker insertion(n=1). Additionally, Cyberknife synchrony tumor
tracking log file was analyzed. intrafractional movement in terms of overall correlation
error were -0.3±1.3, 0.0±0.6, -0.2±0.6
for CC, LR, and AP axis, respectively.
Conclusion
This preliminary results show that CK for primary RCC was feasible and
also well tolerated. with high rate of local control and functional
preservation.