Piotr Wysocki: Stereotactic ablative body radiotherapy of primary tumor is highly active in patients with localized renal cell cancer
Piotr Wysocki, Professor of Medicine and Head of the Department of Oncology at Jagiellonian University Hospital in Poland, shared on LinkedIn:
“Results of a multi-center, non-randomized phase 2 study on stereotactic ablative body radiotherapy (SABR) have been just published in Lancet Oncology. Patients (71) with single biopsy-proven RCC who were medically inoperable, at high risk of surgery, or declined surgery were enrolled in the TROG 15.03 FASTRACK II study at seven centers in Australia and one in the Netherlands. Most patients had T1 disease (34% – T1a, 56% – T1b), and 9% had T2 disease. The most common histologic types of RCC were clear-cell (70%), papillary (17%), and chromophobe (4%).
The SABR intervention consisted of a single fraction of 26 Gy used for tumors 4 cm or less in maximum diameter or 42 Gy in three fractions for tumors more than 4 cm to 10 cm in maximum diameter.
After a median follow-up of 43 months, the local control at 12 months (primary endpoint) was 100%, with no local failures after this time point. Freedom from distant failure at 12 months and 36 months from treatment initiation was 97%, and overall survival was 99%. The most frequent G3 adverse event was vomiting (3%). Renal impairment, which was supposed to be the most fearsome consequence of radiotherapy to the kidney, was observed in only two patients who showed elevated creatinine (G2 – 3%).
Although RCC has been deemed radioresistant for many decades, recent data on SABR for oligometastatic lesions clearly showed the activity of this therapeutic modality. Results of the TROG 15.03 FASTRACK II study prove that ablative doses of radiotherapy administered to primary RCC are safe and potentially curable in non-metastatic RCC patients.”
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Source: Piotr Wysocki/LinkedIn
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