OBJECTIVE: To assess the feasibility and safety of stereotactic ablative body radiotherapy (SABR) for renal cell carcinoma (RCC) in patients unsuitable for surgery. Secondary objectives were to assess oncological and functional outcomes. MATERIALS AND METHODS: This was a prospective interventional clinical trial with institutional ethics board approval. Inoperable patients were enrolled, after multidisciplinary consensus, for intervention with informed consent. Tumour response was defined using Response Evaluation Criteria In Solid Tumors v1.1. Toxicities were recorded using Common Terminology Criteria for Adverse Events v4.0. Time-to-event outcomes were described using the Kaplan-Meier method, and associations of baseline variables with tumour shrinkage was assessed using linear regression. Patients received either single fraction of 26 Gy or three fractions of 14 Gy, dependent on tumour size. RESULTS: Of 37 patients (median age 78 years), 62% had T1b, 35% had T1a and 3% had T2a disease. One patient presented with bilateral primaries. Histology was confirmed in 92%. In total, 33 patients and 34 kidneys received all prescribed SABR fractions (89% feasibility). The median follow-up was 24 months. Treatment-related grade 1-2 toxicities occurred in 26 patients (78%) and grade 3 toxicity in one patient (3%). No grade 4-5 toxicities were recorded and six patients (18%) reported no toxicity. Freedom from local progression, distant progression and overall survival rates at 2 years were 100%, 89% and 92%, respectively. The mean baseline glomerular filtration rate was 55 mL/min, which decreased to 44 mL/min at 1 and 2 years (P < 0.001). Neutrophil:lymphocyte ratio correlated to % change in tumour size at 1 year, r2 = 0.45 (P < 0.001). CONCLUSION: The study results show that SABR for primary RCC was feasible and well tolerated. We observed encouraging cancer control, functional preservation and early survival outcomes in an inoperable cohort. Baseline neutrophil:lymphocyte ratio may be predictive of immune-mediated response and warrants further investigation.
OBJECTIVE: To assess the feasibility and safety of stereotactic ablative body radiotherapy (SABR) for renal cell carcinoma (RCC) in patients unsuitable for surgery. Secondary objectives were to assess oncological and functional outcomes. MATERIALS AND METHODS: This was a prospective interventional clinical trial with institutional ethics board approval. Inoperable patients were enrolled, after multidisciplinary consensus, for intervention with informed consent. Tumour response was defined using Response Evaluation Criteria In Solid Tumors v1.1. Toxicities were recorded using Common Terminology Criteria for Adverse Events v4.0. Time-to-event outcomes were described using the Kaplan-Meier method, and associations of baseline variables with tumour shrinkage was assessed using linear regression. Patients received either single fraction of 26 Gy or three fractions of 14 Gy, dependent on tumour size. RESULTS: Of 37 patients (median age 78 years), 62% had T1b, 35% had T1a and 3% had T2a disease. One patient presented with bilateral primaries. Histology was confirmed in 92%. In total, 33 patients and 34 kidneys received all prescribed SABR fractions (89% feasibility). The median follow-up was 24 months. Treatment-related grade 1-2 toxicities occurred in 26 patients (78%) and grade 3 toxicity in one patient (3%). No grade 4-5 toxicities were recorded and six patients (18%) reported no toxicity. Freedom from local progression, distant progression and overall survival rates at 2 years were 100%, 89% and 92%, respectively. The mean baseline glomerular filtration rate was 55 mL/min, which decreased to 44 mL/min at 1 and 2 years (P < 0.001). Neutrophil:lymphocyte ratio correlated to % change in tumour size at 1 year, r2 = 0.45 (P < 0.001). CONCLUSION: The study results show that SABR for primary RCC was feasible and well tolerated. We observed encouraging cancer control, functional preservation and early survival outcomes in an inoperable cohort. Baseline neutrophil:lymphocyte ratio may be predictive of immune-mediated response and warrants further investigation.
Authors: Sebastien J Hotte; Anil Kapoor; Naveen S Basappa; Georg Bjarnason; Christina Canil; Henry J Conter; Piotr Czaykowski; Jeffrey Graham; Samantha Gray; Daniel Y C Heng; Pierre I Karakiewicz; Christian Kollmannsberger; Aly-Khan A Lalani; Scott A North; François Patenaude; Denis Soulières; Phillippe Violette; Eric Winquist; Lori A Wood; Shaan Dudani; Ranjena Maloni; M Neil Reaume Journal: Can Urol Assoc J Date: 2019-10 Impact factor: 1.862
Authors: R Damm; T Streitparth; P Hass; M Seidensticker; C Heinze; M Powerski; J J Wendler; U B Liehr; K Mohnike; M Pech; J Ricke Journal: Strahlenther Onkol Date: 2019-07-25 Impact factor: 3.621
Authors: V Dell'Acqua; A Surgo; F Kraja; J Kobiela; Maria Alessia Zerella; P Spychalski; S Gandini; C M Francia; D Ciardo; C Fodor; A M Ferrari; G Piperno; F Cattani; S Vigorito; F Pansini; W Petz; R Orecchia; M C Leonardi; B A Jereczek-Fossa Journal: Clin Exp Metastasis Date: 2019-06-04 Impact factor: 5.150
Authors: M Neil Reaume; Naveen S Basappa; Lori Wood; Anil Kapoor; Georg A Bjarnason; Normand Blais; Rodney H Breau; Christina Canil; Patrick Cheung; Henry J Conter; Sebastien J Hotte; Claudio Jeldres; Michael A S Jewett; Pierre I Karakiewicz; Christian Kollmannsberger; Francois Patenaude; Alan So; Denis Soulières; Peter Venner; Phillippe Violette; Pawel Zalewski; Heather Chappell; Scott A North Journal: Can Urol Assoc J Date: 2017-10 Impact factor: 1.862
Authors: Hayley M Reynolds; Bimal K Parameswaran; Mary E Finnegan; Diana Roettger; Eddie Lau; Tomas Kron; Mark Shaw; Sarat Chander; Shankar Siva Journal: PLoS One Date: 2018-08-16 Impact factor: 3.240
Authors: Hossein Aslian; Tomas Kron; Troy Watts; Cagla Akalanli; Nicholas Hardcastle; Peta Lonski; Atousa Montaseri; Barry Hay; James Korte; Kemal Berk; Francesco Longo; Mara Severgnini Journal: J Appl Clin Med Phys Date: 2020-04-11 Impact factor: 2.102
Authors: Shankar Siva; Brent Chesson; Mathias Bressel; David Pryor; Braden Higgs; Hayley M Reynolds; Nicholas Hardcastle; Rebecca Montgomery; Ben Vanneste; Vincent Khoo; Jeremy Ruben; Eddie Lau; Michael S Hofman; Richard De Abreu Lourenco; Swetha Sridharan; Nicholas R Brook; Jarad Martin; Nathan Lawrentschuk; Tomas Kron; Farshad Foroudi Journal: BMC Cancer Date: 2018-10-23 Impact factor: 4.430