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RT promising in kidney Ca patients with thrombus


Two case studies of stereotactic ablative radiation therapy yielded survival times comparable to those seen with surgical treatment.

Researchers have published what is believed to be the first study on the successful use of stereotactic ablative radiation therapy (SABR) for the treatment of kidney cancer patients with inferior vena cava tumor thrombus (IVC-TT).

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For the study, which was published online in Cancer Biology & Therapy (March 24, 2015), researchers from the University of Texas Southwestern Medical Center in Dallas reported on two renal cell carcinoma patients with level IV IVC-TT. They treated the patients-one recurrent, the other unresectable-with SABR.

A 75-year-old man presenting 9 months after radical nephrectomy and thrombectomy with a growing level IV IVC-TT that was refractory to four targeted agents received stereotactic body radiation of 50 Gy in five fractions. An 83-year-old presenting with metastatic right kidney cancer was not a surgical candidate. After progression on temsirolimus (Torisel), he received 36 Gy in four fractions to his IVC-TT.

The first patient is doing well at 2 years post SABR, according to UT Southwestern. The size and enhancement of his IVC-TT have decreased significantly. The 83-year-old survived 18 months after SABR treatment.

The authors reported no acute or late treatment-related toxicity. Survival times with SABR are comparable to the reported median survival of 20 months in patients with level IV IVC-TT undergoing surgical resection, they wrote.

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“Our case studies showed similar survival with the use of stereotactic radiation therapy compared with surgery. This result is important because people with this disease have a traditionally poor prognosis and few options,” said lead author Raquibul Hannan, MD, PhD, in a press release from UT Southwestern.

The authors say they hope to follow up the research with a study to evaluate the application of SABR for IVC-TT in conjunction with surgery.

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