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• W2154689096 abstract "Purpose/Objective(s)Small Renal Masses (SRM) are increasingly found as incidental findings during axial imaging. Size and contrast enhancement characteristics can accurately predict malignant potential. Treatment for SRM is usually total or partial nephrectomy. However, some patients are not candidates for surgery or thermal ablation. In this report, the results of a phase I does escalation study using fractionated stereotactic body radiosurgery (SBRS) is described.Materials/MethodsA Phase I dose escalation study began in November 2006 using SBRS in medically inoperable patients. Three patients were treated per dose cohort. Gold fiducials where implanted into or immediately adjacent to the tumor percutaneously. The CyberKnife was used to deliver the treatments. Dose levels where 21 Gy, 28 Gy, 32 Gy, or 39 Gy delivered in 3 fractions. Tumors up to 5.0 cm in diameter where included. Tumor plus 3 mm was defined as the PTV. PTV ranged from 8.2-50.5 ccs (median size 18.0 ccs). Tumors involving the renal pelvis or near the ureter were not excluded. Patents where monitored with pre and post treatment MRI or CT scans, laboratory tests and renal perfusions scans. Last patient was entered into the 39 Gy cohort in December 2009.ResultsNo RTOG grade I or higher toxicity was observed to date. Two patients with chronic renal failure had worsening of their renal function during follow-up. All other patients did not significant changes in the creatinine. However, no patient had significant changes in renal perfusion. One patient treated at the 21 Gy level developed local progression, no other patients have had radiologic progression.ConclusionsSBRS is a safe procedure for the treatment of SRMs. Tumors not appropriate for radiofrequency ablation or cryosurgery (near major vessels or collecting system) can be treated with SBRS. A final dose level of 48 Gy in 3 fractions has been added to the original protocol. A phase II multi-institutional is under design. Purpose/Objective(s)Small Renal Masses (SRM) are increasingly found as incidental findings during axial imaging. Size and contrast enhancement characteristics can accurately predict malignant potential. Treatment for SRM is usually total or partial nephrectomy. However, some patients are not candidates for surgery or thermal ablation. In this report, the results of a phase I does escalation study using fractionated stereotactic body radiosurgery (SBRS) is described. Small Renal Masses (SRM) are increasingly found as incidental findings during axial imaging. Size and contrast enhancement characteristics can accurately predict malignant potential. Treatment for SRM is usually total or partial nephrectomy. However, some patients are not candidates for surgery or thermal ablation. In this report, the results of a phase I does escalation study using fractionated stereotactic body radiosurgery (SBRS) is described. Materials/MethodsA Phase I dose escalation study began in November 2006 using SBRS in medically inoperable patients. Three patients were treated per dose cohort. Gold fiducials where implanted into or immediately adjacent to the tumor percutaneously. The CyberKnife was used to deliver the treatments. Dose levels where 21 Gy, 28 Gy, 32 Gy, or 39 Gy delivered in 3 fractions. Tumors up to 5.0 cm in diameter where included. Tumor plus 3 mm was defined as the PTV. PTV ranged from 8.2-50.5 ccs (median size 18.0 ccs). Tumors involving the renal pelvis or near the ureter were not excluded. Patents where monitored with pre and post treatment MRI or CT scans, laboratory tests and renal perfusions scans. Last patient was entered into the 39 Gy cohort in December 2009. A Phase I dose escalation study began in November 2006 using SBRS in medically inoperable patients. Three patients were treated per dose cohort. Gold fiducials where implanted into or immediately adjacent to the tumor percutaneously. The CyberKnife was used to deliver the treatments. Dose levels where 21 Gy, 28 Gy, 32 Gy, or 39 Gy delivered in 3 fractions. Tumors up to 5.0 cm in diameter where included. Tumor plus 3 mm was defined as the PTV. PTV ranged from 8.2-50.5 ccs (median size 18.0 ccs). Tumors involving the renal pelvis or near the ureter were not excluded. Patents where monitored with pre and post treatment MRI or CT scans, laboratory tests and renal perfusions scans. Last patient was entered into the 39 Gy cohort in December 2009. ResultsNo RTOG grade I or higher toxicity was observed to date. Two patients with chronic renal failure had worsening of their renal function during follow-up. All other patients did not significant changes in the creatinine. However, no patient had significant changes in renal perfusion. One patient treated at the 21 Gy level developed local progression, no other patients have had radiologic progression. No RTOG grade I or higher toxicity was observed to date. Two patients with chronic renal failure had worsening of their renal function during follow-up. All other patients did not significant changes in the creatinine. However, no patient had significant changes in renal perfusion. One patient treated at the 21 Gy level developed local progression, no other patients have had radiologic progression. ConclusionsSBRS is a safe procedure for the treatment of SRMs. Tumors not appropriate for radiofrequency ablation or cryosurgery (near major vessels or collecting system) can be treated with SBRS. A final dose level of 48 Gy in 3 fractions has been added to the original protocol. A phase II multi-institutional is under design. SBRS is a safe procedure for the treatment of SRMs. Tumors not appropriate for radiofrequency ablation or cryosurgery (near major vessels or collecting system) can be treated with SBRS. A final dose level of 48 Gy in 3 fractions has been added to the original protocol. A phase II multi-institutional is under design." @default.
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• W2154689096 title "Results of a Phase I Dose Escalation Study of Stereotactic Radiosurgery for Primary Renal Tumors" @default.
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