Stereotactic Ablative Radiation Therapy for the Treatment of Upper Urinary Tract Urothelial Carcinoma

Khriguian, Julia; Patrocinio, Horacio; Andonian, Sero; Aprikian, Armen; Kassouf, Wassim; Tanguay, Simon; Cury, Fabio

doi:10.1016/j.prro.2021.07.006

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…A case series of nine patients with UTUC at the renal pelvis and seven patients with UTUC at the ureter who were treated with IMRT of 70 Gy in 35 fractions had at least partial response when evaluated with CT at 1 month and had only one recurrent case without any grade 2 or higher toxicity at a median follow-up time of 30 months ( 15 ). A retrospective study of nine renal pelvic UTUC and seven ureteric UTUC treated with stereotactic body radiotherapy varying from 20 to 40 Gy in 5–8 fractions revealed that 68.8% of patients have at least partial response at the primary tumor without renal failure requiring dialysis ( 16 ). A report of proton beam therapy of 60–66 Gy (or when assuming relative biological effectiveness of 1.1, 66–72.6 Gy RBE) delivered to three patients with UTUC at the renal pelvis showed grade 1–2 toxicity and had one in-field recurrent case at 36 months posttreatment and one distant metastatic case at 28 months posttreatment ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Stereotactic MR-guided adaptive radiotherapy for inoperable urothelial carcinoma at the renal pelvis

Thaweerat,

Dankulchai

2024

Front. Oncol.

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We report the case of an 87-year-old woman with upper tract urothelial carcinoma at the left renal pelvis. She received stereotactic body radiotherapy of 35 Gy in five fractions for palliative treatment of hematuria that was delivered by a 1.5-T magnetic resonance (MR) imaging-guided linear accelerator. Her symptom was relieved after treatment, and posttreatment imaging revealed a complete response of the primary tumor. Thus, this case showed that stereotactic MR-guided radiotherapy could be an appealing option for inoperable patients although radiotherapy is infrequently mentioned in the current treatment guideline of upper tract urothelial carcinoma. Daily adaptive planning from MR images obtained before treatment could improve the target dose and minimize the organ at risk dose. This may lead to a decrease in radiation adverse effects including worsening renal function due to the renal pelvis tumor’s proximity to the kidney.

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Section: Discussionmentioning

confidence: 99%

Case report: Stereotactic MR-guided adaptive radiotherapy for inoperable urothelial carcinoma at the renal pelvis

Thaweerat,

Dankulchai

2024

Front. Oncol.

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“…To further mitigate risk of gastrointestinal toxicity, an every-other-day schedule should be considered for multi-fraction regimens [62]. Caution should be used when treating with a single fraction regimen in close proximity to the ureters, particularly in the setting of a solitary kidney, due to the paucity of ureteral toxicity data for single-fraction treatment [63,64]. Dose to the ipsilateral kidney should be as low as reasonably achievable (ALARA), minimizing the volume receiving a high fractional dose (approximately > 50% isodose) [50].…”

Section: Selection Of Treatment Prescription and Normal Tissue Constr...mentioning

confidence: 99%

The Judicious Use of Stereotactic Ablative Radiotherapy in the Primary Management of Localized Renal Cell Carcinoma

Barbour

Kirste

Grosu

et al. 2023

Cancers

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Localized renal cell carcinoma is primarily managed surgically, but this disease commonly presents in highly comorbid patients who are poor operative candidates. Less invasive techniques, such as cryoablation and radiofrequency ablation, are effective, but require percutaneous or laparoscopic access, while generally being limited to cT1a tumors without proximity to the renal pelvis or ureter. Active surveillance is another management option for small renal masses, but many patients desire treatment or are poor candidates for active surveillance. For poor surgical candidates, a growing body of evidence supports stereotactic ablative radiotherapy (SABR) as a safe and effective non-invasive treatment modality. For example, a recent multi-institution individual patient data meta-analysis of 190 patients managed with SABR estimated a 5.5% five-year cumulative incidence of local failure with one patient experiencing grade 4 toxicity, and no other grade ≥3 toxic events. Here, we discuss the recent developments in SABR for the management of localized renal cell carcinoma, highlighting key concepts of appropriate patient selection, treatment design, treatment delivery, and response assessment.

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The long-term outcome of nephron-sparing surgery versus radical nephroureterectomy for organ-localized upper urinary tract urothelial carcinoma: a population-based study of 1969 patients

Qiu,

Deng,

et al. 2023

J Cancer Res Clin Oncol

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Stereotactic Ablative Radiation Therapy for the Treatment of Upper Urinary Tract Urothelial Carcinoma

Cited by 4 publications

References 31 publications

Case report: Stereotactic MR-guided adaptive radiotherapy for inoperable urothelial carcinoma at the renal pelvis

Case report: Stereotactic MR-guided adaptive radiotherapy for inoperable urothelial carcinoma at the renal pelvis

The Judicious Use of Stereotactic Ablative Radiotherapy in the Primary Management of Localized Renal Cell Carcinoma

The long-term outcome of nephron-sparing surgery versus radical nephroureterectomy for organ-localized upper urinary tract urothelial carcinoma: a population-based study of 1969 patients

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