Nephron-Sparing Robotic Radiosurgical Therapy for Primary Renal Cell Carcinoma: Single-Institution Experience and Review of the Literature

Anuj V Peddada; Danyon Anderson; Olivier C Blasi; Kiernan McCollough; Scott B Jennings; Alan T Monroe

doi:10.1016/j.adro.2019.10.001

Nephron-Sparing Robotic Radiosurgical Therapy for Primary Renal Cell Carcinoma: Single-Institution Experience and Review of the Literature

Adv Radiat Oncol. 2019 Oct 15;5(2):204-211. doi: 10.1016/j.adro.2019.10.001. eCollection 2020 Mar-Apr.

Authors

Anuj V Peddada¹, Danyon Anderson¹, Olivier C Blasi², Kiernan McCollough², Scott B Jennings³, Alan T Monroe¹

Affiliations

¹ Radiation Oncology, Colorado Springs, Colorado.
² Colorado Associates in Medical Physics, Penrose Cancer Center, Colorado Springs, Colorado.
³ Department of Urology, DaVita Medical Group, Colorado Springs, Colorado.

Abstract

Purpose: We report our single-institution stereotactic body radiation therapy (SBRT) experience on stage I renal cancer with prospectively collected toxicity and efficacy data.

Methods and materials: A total of 21 patients with solitary renal tumors, including 14 surgical candidates who refused surgery (66%), were treated with SBRT. Histologic confirmation was obtained on all patients before treatment; 2 had transitional cell carcinoma and 19 had renal cell carcinoma. The median age was 71 years (range, 58-88). Nearly all patients received 48 Gy in 3 fractions.

Results: The median follow-up was 78 months (range, 5-107). At 5 years post treatment, the local tumor control rate was 100%. Tumor size decreased by a median value of 5.3% at 1 year post treatment, 15.6% at 2 years post treatment, and 15.4% at 5 years post treatment. Glomerular filtration rate had decreased by a median value of 1.5% at 1 year post treatment, 7.0% at 2 years post treatment, and 14.2% at 5 years post treatment. Three patients experienced grade 1 toxicity; no other treatment-related adverse effects were reported.

Conclusions: SBRT is a promising noninvasive treatment in the management of primary renal cell carcinoma, with evolving clinical evidence demonstrating encouraging results with respect to local control and toxicity.