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25.07.2019 | Original Article

Prospective evaluation of CT-guided HDR brachytherapy as a local ablative treatment for renal masses: a single-arm pilot trial

verfasst von: Dr. R. Damm, T. Streitparth, P. Hass, M. Seidensticker, C. Heinze, M. Powerski, J. J. Wendler, U. B. Liehr, K. Mohnike, M. Pech, J. Ricke

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 11/2019

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Abstract

Purpose

In this pilot trial, we investigate the safety of CT-guided high-dose-rate brachytherapy (HDR-BT) as a local ablative treatment for renal masses not eligible for resection or nephrectomy.

Methods

We investigated renal function after irradiation by HDR-BT in 16 patients (11 male, 5 female, mean age 76 years) with 20 renal lesions (renal cell carcinoma n = 18; renal metastases n = 2). Two patients had previous contralateral nephrectomy and two had ipsilateral partial nephrectomy. Six lesions had a hilar localization with proximity to the renal pelvis and would have not been favorable for thermal ablation. Renal function loss was determined within 1 year after HDR-BT by renal scintigraphy and laboratory parameters. Further investigations included CT and MRI every 3 months to observe procedural safety and local tumor control. Renal function tests were analyzed by Wilcoxon’s signed rank test with Bonferroni–Holm correction of p-values. Survival and local tumor control underwent a Kaplan–Meier estimation.

Results

Median follow-up was 22.5 months. One patient required permanent hemodialysis 32 months after repeated HDR-BT and contralateral radiofrequency ablation of multifocal renal cell carcinoma. No other patient developed a significant worsening in global renal function and no gastrointestinal or urogenital side effects were observed. Only one patient died of renal tumor progression. Local control rate was 95% including repeated HDR-BT of two recurrences.

Conclusion

HDR-BT is a feasible and safe technique for the local ablation of renal masses. A phase II study is recruiting to evaluate the efficacy of this novel local ablative treatment in a larger study population.

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Titel: Prospective evaluation of CT-guided HDR brachytherapy as a local ablative treatment for renal masses: a single-arm pilot trial
verfasst von: Dr. R. Damm
T. Streitparth
P. Hass
M. Seidensticker
C. Heinze
M. Powerski
J. J. Wendler
U. B. Liehr
K. Mohnike
M. Pech
J. Ricke
Publikationsdatum: 25.07.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 11/2019
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-019-01501-1

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25.04.2024 | Nierenkarzinom | Nachrichten

Springer Medizin

Prospective evaluation of CT-guided HDR brachytherapy as a local ablative treatment for renal masses: a single-arm pilot trial

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Purpose

Methods

Results

Conclusion

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Conclusion

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