Renal SBRTImpact of stereotactic radiotherapy on kidney function in primary renal cell carcinoma: Establishing a dose–response relationship
Section snippets
Patients
The study received institutional ethical review board approval and was conducted as a translational substudy of a registered prospective clinical trial (clinicaltrials.gov identifier: NCT01676428). Eligible patients were medically inoperable, technically high risk for surgery or declined surgery, with an ECOG performance status of 0–2 inclusive. Patients with previous high-dose radiotherapy to the upper abdomen were excluded from the study. Patients underwent serial renal function assessments
Study population
In total, 21 patients were included in this study, with a median follow-up of 1.1 years. Pre-treatment patient characteristics can be found in Table 1. This was a patient population with significant comorbidities and pre-existing renal dysfunction with a median Charlson comorbidity score of 9 (range 3–12), mean ± standard deviation (SD) serum creatinine of 131 ± 28 μmol/L and calculated GFR of 52 ± 24 ml/min. Nine of the patients were referred for the clinical trial due to the perceived high risk of
Discussion
In this study we describe a dose-dependent relationship with regional kidney dysfunction secondary to radiation nephritis. Nephron sparing was observed at two weeks and three months after SABR, but late regional loss in function was observed at 1-year post treatment. We observed regional kidney dysfunction to be exponentially associated with physical delivered dose. Importantly, when normalising to BED using an α/β value of 3, both single and multi-fraction SABR displayed similar dose–response
Conflicts of interest statement
No disclosures.
Acknowledgment
This study was supported by the Royal Australian and New Zealand College of Radiologists FROGG – Ferring Fellowship Award, 2013.
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