TY - JOUR
T1 - Renal atrophy after stereotactic body radiotherapy for renal cell carcinoma
AU - Yamamoto, Takaya
AU - Kadoya, Noriyuki
AU - Takeda, Ken
AU - Matsushita, Haruo
AU - Umezawa, Rei
AU - Sato, Kiyokazu
AU - Kubozono, Masaki
AU - Ito, Kengo
AU - Ishikawa, Yojiro
AU - Kozumi, Maiko
AU - Takahashi, Noriyoshi
AU - Katagiri, Yu
AU - Onishi, Hiroshi
AU - Jingu, Keiichi
N1 - Publisher Copyright:
© 2016 The Author(s).
PY - 2016/5/26
Y1 - 2016/5/26
N2 - Background: Renal atrophy is observed in an irradiated kidney. The aim of this study was to determine dose-volume histogram parameters and other factors that predict renal atrophy after 10-fraction stereotactic bodyradiotherapy (SBRT) for primary renal cell carcinoma (RCC). Methods: A total of 14 patients (11 males, 3 females) who received SBRT for RCC at Tohoku University Hospital between April 2010 and February 2014 were analyzed. The median serum creatinine level was 1.1mg/dl and two patients had a single kidney. Nine patients were implanted with fiducial markers. The median tumor diameter was 30mm. SBRT was delivered at 70Gy in 10 fractions for 7 tumors, at 60Gy in 10 fractions for 2 tumors, and at 50Gy in 10 fractions for 5 tumors with 6 and/or 15 MV X-ray using 5 to 8 multi-static beams. Renal atrophy was assessed using post-SBRT CT images after 12-24 months intervals. Correlations were examined by Spearman rank correlation analysis. Differences between two groups were evaluated by the Mann-Whitney test, and pairwise comparisons were made by the Wilcoxon signed-rank test. Results: The median tumor volume shrunk from 14.8cc to 10.6cc (p=0.12), and the median irradiated kidney volume changed from 160.4cc to 137.1cc (p<.01). The median peak creatinine level was 1.6mg/dl after treatment (p<.01). Percentage volumes of the irradiated kidney receiving at least 10Gy (V10, p=0.03), V20 (p<.01), V30(p<.01), V40 (p=0.01), mean irradiated kidney dose (p<.01), and magnitude of overlap between PTV and kidney volume (p=0.03) were significantly correlated with post-treatment irradiated kidney volume in percent, and V20-V30 had strong correlation (r<0.70, p<.01). Patients with implanted fiducial markers showed a significantly lower ratio of renal atrophy (p=0.02). Conclusions: Significant renal atrophic change was observed. Dose distribution of SBRT at 20-30Gy had a strong correlation with renal atrophy when irradiation was performed in 10 fractions.
AB - Background: Renal atrophy is observed in an irradiated kidney. The aim of this study was to determine dose-volume histogram parameters and other factors that predict renal atrophy after 10-fraction stereotactic bodyradiotherapy (SBRT) for primary renal cell carcinoma (RCC). Methods: A total of 14 patients (11 males, 3 females) who received SBRT for RCC at Tohoku University Hospital between April 2010 and February 2014 were analyzed. The median serum creatinine level was 1.1mg/dl and two patients had a single kidney. Nine patients were implanted with fiducial markers. The median tumor diameter was 30mm. SBRT was delivered at 70Gy in 10 fractions for 7 tumors, at 60Gy in 10 fractions for 2 tumors, and at 50Gy in 10 fractions for 5 tumors with 6 and/or 15 MV X-ray using 5 to 8 multi-static beams. Renal atrophy was assessed using post-SBRT CT images after 12-24 months intervals. Correlations were examined by Spearman rank correlation analysis. Differences between two groups were evaluated by the Mann-Whitney test, and pairwise comparisons were made by the Wilcoxon signed-rank test. Results: The median tumor volume shrunk from 14.8cc to 10.6cc (p=0.12), and the median irradiated kidney volume changed from 160.4cc to 137.1cc (p<.01). The median peak creatinine level was 1.6mg/dl after treatment (p<.01). Percentage volumes of the irradiated kidney receiving at least 10Gy (V10, p=0.03), V20 (p<.01), V30(p<.01), V40 (p=0.01), mean irradiated kidney dose (p<.01), and magnitude of overlap between PTV and kidney volume (p=0.03) were significantly correlated with post-treatment irradiated kidney volume in percent, and V20-V30 had strong correlation (r<0.70, p<.01). Patients with implanted fiducial markers showed a significantly lower ratio of renal atrophy (p=0.02). Conclusions: Significant renal atrophic change was observed. Dose distribution of SBRT at 20-30Gy had a strong correlation with renal atrophy when irradiation was performed in 10 fractions.
KW - Renal atrophy
KW - Renal cell cancer
KW - Renal remodeling
KW - SRT
KW - Stereotactic radiotherapy
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U2 - 10.1186/s13014-016-0651-5
DO - 10.1186/s13014-016-0651-5
M3 - Article
C2 - 27229710
AN - SCOPUS:84973281905
SN - 1748-717X
VL - 11
JO - Radiation Oncology
JF - Radiation Oncology
IS - 1
M1 - 72
ER -
