ABSTRACT
Objective To retrospectively analyze the clinical outcome of radiotherapy for unresectable renal cell carcinoma and renal pelvis and ureter cancer. Methods A total of 29 patients with unresectable renal cell carcinoma or renal pelvis and ureter cancer received radiotherapy from 2006 to 2015. Those patients were 18 males and 11 females aged between 41 and 95 years(median age 76 years). In those patients,17 had renal cell carcinoma and 12 renal pelvis and ureter cancer;14 had hematuria and 7 low back pain. All patients received dose-escalation radiotherapy,with 17 treated by gamma knife treatment and 12 by helical tomotherapy(HT). For the gamma knife treatment, the 50% isodose line was set as the prescribed dose line;the radiation dose was 3 to 5 Gy per fraction, with a total dose of 40-50 Gy around the planning target volume and 60-70 Gy around the gross tumor volume. HT was performed with a dose of 50/60/70 Gy in 15-20 fractions. Results For the primary lesion, the complete response(CR)and partial response (PR)rates were 17%(5/29)and 69%(20/29),respectively,yielding an overall response rate(CR+PR) of 86%. After treatment,93% of patients recovered from hematuria and 100% of patients recovered from low back pain. The 3-and 5-year sample sizes were 15 and 11, respectively. The 3-, and 5-year survival rates were 81%,and 81%,respectively,for renal cell carcinoma,and,69%,and 69%,respectively,for renal pelvis and ureter cancer. During treatment, 25 patients had grade 1-2 digestive system reaction and 20 patients had grade 1-2 bone marrow suppression. The radiation-induced toxicity was reduced by medication. Conclusions Radiotherapy is safe and effective for treating renal cell carcinoma and renal pelvis and ureter cancer. It can improve the local control and overall survival rates. Radiotherapy provides an effective way to treat unresectable renal cell carcinoma and renal pelvis and ureter carcinoma.
ABSTRACT
Small asymptomatic renal masses are more commonly discovered in elderly patients; however, multiple comorbidities in this population may preclude definitive surgical treatment. In this context, treatment options include active surveillance and ablative techniques. Stereotactic radiosurgery is a relatively innovative method of delivering ablative energy to abdominal organs, with very few human or animal experiences published. We describe our experience treating a patient with a large centrally located renal mass using CyberKnife® stereotactic radiosurgery.
Pequenas massas renais assintomáticas são mais frequentemente encontradas em pacientes idosos; contudo, comorbidades múltiplas nesses pacientes podem contraindicar um tratamento cirúrgico definitivo. Em tal contexto, as opções terapêuticas incluem vigilância ativa e técnicas ablativas. A radiocirurgia estereotáxica é um método inovador que aplica energia ablativa em órgãos abdominais, mas há pouca experiência nesse campo tanto em seres humanos como em animais. Descrevemos nossa experiência com o tratamento de um paciente com uma grande massa renal de localização central, utilizando-se a radiocirurgia esterotáxica com CyberKnife®.