Results of stereotactic radiation therapy in treatment of patients with T1N0M0 kidney cancer

Abstract

Background. Currently, the main treatment for T1N0M0 kidney cancer is surgery, mainly in the amount of kidney resection. However, not all patients can be operated on, and most often due to the severity of comorbidity, some patients refuse surgery. In such cases, it becomes necessary to search for an acceptable operation of an alternative method of treatment. Such requirements can be met by stereotactic radiotherapy (SBRT), being a non-invasive method of treating renal cell carcinoma.Purpose. To determine overall survival (OS), local control, and renal toxicity after treatment of T1N0M0 renal cell carcinoma (RCC) with stereotactic radiotherapy.Material and methods. Since 2011 to 2022 in the Chelyabinsk Regional Clinical Centre of Oncology and Nuclear Medicine, 50 patients with verified RCC underwent SBRT up to 30–45 Grey in three fractions using the CyberKnife. The mean age of the patients was 69.8 years. Primary tumor was diagnosed in 44 cases, recurrence after previous surgical treatment in 6 cases, including one patient with recurrence of cancer of both kidneys. The average tumor volume was 29.1 cm3 .Results. Median overall survival was not reached as most patients were alive at the time of the study. Indicators of 1-, 3- and 5-year OS are 94.8%, 87.3% and 75.1%, respectively. In 74.5% of cases, according to the RECIST 1.1 criteria, stabilization of the process was recorded 6 months after STLT, in 21.6% of cases – a partial response, in 3.9% – progression of the process. One-year local control – 98%. Renal toxicity occurred in 26% of patients 6 months after radiation therapy, but within a year, kidney function was restored in these patients.Conclusions. Stereotactic radiation therapy T1N0M0 of kidney cancer in SOD = 30–45 Grey allows to stabilize the tumor process with sufficiently high results of overall survival and local control with low renal toxicity, respectively, can be used in the treatment of inoperable patients with localized renal cell carcinoma.