Renal Radiosurgery: Initial Clinical Experience With Histological Evaluation
ABSTRACT The purpose of this study was to determine whether radiosurgical technology can be safely applied to renal tumors. Patients received radiosurgical treatment of renal lesions. At 8 weeks after radiosurgical treatment, patients underwent a partial or radical nephrectomy and histologic evaluation. The patients received a radiation dose of 4 Gy per fraction for 4 fractions. Patients were followed, and radiation-induced toxicities were noted. Three patients were treated for a minimum of 1 year of follow-up. All patients completed the treatments, tolerating each of the 4 fractions with no adverse events. No acute toxicities or changes in renal function were noted. None of the patients had any evidence of acute radiation injury or toxicity noted at the time of surgery or within the subsequent 12 months after the radiosurgical treatment. The last patient treated was found to have a cavity with no microscopic evidence of viable tumor after radiosurgical treatment; pathology was consistent with necrotic renal cell carcinoma, papillary type. The other 2 tumors demonstrated pathologic evidence of viable renal cell carcinoma (grade I and grade II). Tumor size remained relatively unchanged for 8 weeks after the radiosurgical treatment in all patients. The authors are extremely encouraged and cautiously optimistic with the initial results. Radiosurgery for renal tumors appears to be safe at this initial dose level.
- SourceAvailable from: my.clevelandclinic.org
- [Show abstract] [Hide abstract]
ABSTRACT: This article focuses on the laparoscopic approaches to radical and partial nephrectomy for the managment of renal cell carcinoma and on the laparoscopic and endoscopic approaches for treating upper tract urothelial carcimoma. An in-depth discussion of treatment for transitional cell carcinoma is also presented.Urologic Clinics of North America 09/2008; 35(3):365-83, vii. DOI:10.1016/j.ucl.2008.05.010 · 1.35 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To review the evolution and current status of minimally invasive nephron-sparing surgery for renal tumors. Minimally invasive nephron-sparing surgery for renal tumors encompasses extirpative laparoscopic partial nephrectomy and ablative procedures such as cryoablation, radiofrequency ablation, and recently radiosurgery. Minimally invasive nephron-sparing surgery modalities are associated with decreased morbidity when compared with open partial nephrectomy. Recent multicenter study comparing laparoscopic partial nephrectomy and open partial nephrectomy demonstrated that equivalent cancer-specific survival was similar between the two modalities. Encouraging long-term data are available for laparoscopic partial nephrectomy and cryoablation. However, some concerns remain about incomplete tumor cell kill after radiofrequency ablation. Radiosurgery is a promising new technology, but is still experimental. In 2008, open partial nephrectomy and laparoscopic partial nephrectomy are the reference standards for treating the small renal mass, with laparoscopic partial nephrectomy increasingly becoming the preferred option at major tertiary referral centers. Encouraging long-term data for ablative technologies are emerging.Current opinion in urology 10/2008; 18(5):462-6. DOI:10.1097/MOU.0b013e32830a4f10 · 2.12 Impact Factor