A systematic review of stereotactic radiotherapy ablation for primary renal cell carcinoma

Shankar Siva, Daniel Pham, Suki Gill, Niall M. Corcoran, Farshad Foroudi

Research output: Contribution to journalReview articlepeer-review

111 Citations (Scopus)

Abstract

OBJECTIVE • To critically assess the use of stereotactic ablative body radiotherapy (SABR) for the treatment of primary renal cell carcinoma with particular focus on local control and toxicity outcomes. METHODS • A systematic search on PubMed was performed in January 2012 independently by two radiation oncologists using structured search terms. • Secondary manual searches were performed on citations in relevant publications and abstracts in major radiotherapy journals. • Outcomes, techniques, biological doses and scientific rigour of the studies were analysed. RESULTS • In total 10 publications (seven retrospective and three prospective) were identified. A wide range of techniques, doses and dose fractionation schedules were found. • Atotal of 126 patients were treated with between one and six fractions of SABR. Median or mean follow-up ranged from 9 to 57.5 months. A weighted local control was reported of 93.91% (range 84%-100%). • The weighted rate of severe grade 3 or higher adverse events was 3.8% (range 0%-19%). The weighted rate of grade 1-2 minor adverse events was 21.4% (range 0%-93%). The most commonly employed fractionation schedule was 40 Gy delivered over five fractions. CONCLUSIONS • Current literature suggests that SABR for primary renal cell carcinoma can be delivered with promising rates of local control and acceptable toxicity. • However, there was insufficient evidence to recommend a consensus view for dose fractionation or technique. • This indicates the need for further prospective studies assessing the role of this technique in medically inoperable patients.

Original languageEnglish
Pages (from-to)E737-E743
JournalBJU International
Volume110
Issue number11 B
DOIs
Publication statusPublished - Dec 2012
Externally publishedYes

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