Stereotactic Body Radiotherapy for Renal Cell Carcinoma in Patients with Von Hippel–Lindau Disease—Results of a Prospective Trial

Von Hippel–Lindau disease (VHL) is a hereditary disorder associated with malignant tumors including clear cell renal cell carcinoma (ccRCC). Partial nephrectomy is complicated by multilocular tumor occurrence and a high recurrence rate. The aim of this study was to evaluate the potential of stereota...

Full description

Bibliographic Details
Main Authors: Simon Kirste, Alexander Rühle, Stefan Zschiedrich, Wolfgang Schultze-Seemann, Cordula A. Jilg, Elke Neumann-Haefelin, Simon S. Lo, Anca-Ligia Grosu, Emily Kim
Format: Article
Language:English
Published: MDPI AG 2022-10-01
Series:Cancers
Subjects:
Online Access:https://www.mdpi.com/2072-6694/14/20/5069
_version_ 1797474499807936512
author Simon Kirste
Alexander Rühle
Stefan Zschiedrich
Wolfgang Schultze-Seemann
Cordula A. Jilg
Elke Neumann-Haefelin
Simon S. Lo
Anca-Ligia Grosu
Emily Kim
author_facet Simon Kirste
Alexander Rühle
Stefan Zschiedrich
Wolfgang Schultze-Seemann
Cordula A. Jilg
Elke Neumann-Haefelin
Simon S. Lo
Anca-Ligia Grosu
Emily Kim
author_sort Simon Kirste
collection DOAJ
description Von Hippel–Lindau disease (VHL) is a hereditary disorder associated with malignant tumors including clear cell renal cell carcinoma (ccRCC). Partial nephrectomy is complicated by multilocular tumor occurrence and a high recurrence rate. The aim of this study was to evaluate the potential of stereotactic body radiotherapy (SBRT) as an alternative treatment approach in VHL patients with multiple ccRCC. Patients with VHL and a diagnosis of ccRCC were enrolled. SBRT was conducted using five fractions of 10 Gy or eight fractions of 7.5 Gy. The primary endpoint was local control (LC). Secondary endpoints included alteration of renal function and adverse events. Seven patients with a total of eight treated lesions were enrolled. Median age was 44 years. Five patients exhibited multiple bilateral kidney cysts in addition to ccRCC. Three patients underwent at least one partial nephrectomy in the past. After a median follow-up of 43 months, 2-year LC was 100%, while 2-year CSS, 2-year PFS and 2-year OS was 100%, 85.7% and 85.7%, respectively. SBRT was very well tolerated with no acute or chronic toxicities grade ≥ 2. Mean estimated glomerular filtration rate (eGFR) at baseline was 83.7 ± 13.0 mL/min/1.73 m<sup>2</sup>, which decreased to 76.6 ± 8.0 mL/min/1.73 m<sup>2</sup> after 1 year. Although the sample size was small, SBRT resulted in an excellent LC rate and was very well tolerated with preservation of kidney function in patients with multiple renal lesions and cysts.
first_indexed 2024-03-09T20:31:56Z
format Article
id doaj.art-4834f59f468b4e97975eed93f98b3f79
institution Directory Open Access Journal
issn 2072-6694
language English
last_indexed 2024-03-09T20:31:56Z
publishDate 2022-10-01
publisher MDPI AG
record_format Article
series Cancers
spelling doaj.art-4834f59f468b4e97975eed93f98b3f792023-11-23T23:21:26ZengMDPI AGCancers2072-66942022-10-011420506910.3390/cancers14205069Stereotactic Body Radiotherapy for Renal Cell Carcinoma in Patients with Von Hippel–Lindau Disease—Results of a Prospective TrialSimon Kirste0Alexander Rühle1Stefan Zschiedrich2Wolfgang Schultze-Seemann3Cordula A. Jilg4Elke Neumann-Haefelin5Simon S. Lo6Anca-Ligia Grosu7Emily Kim8Department of Radiation Oncology, Medical Center—University of Freiburg, Faculty of Medicine, 79106 Freiburg, GermanyDepartment of Radiation Oncology, Medical Center—University of Freiburg, Faculty of Medicine, 79106 Freiburg, GermanyRenal Division, Department of Internal Medicine, Bürgerspital Solothurn, 4500 Solothurn, SwitzerlandDepartment of Urology, Medical Center—University of Freiburg, Faculty of Medicine, 79106 Freiburg, GermanyDepartment of Urology, Medical Center—University of Freiburg, Faculty of Medicine, 79106 Freiburg, GermanyRenal Division, Department of Medicine, Medical Center—University of Freiburg, Faculty of Medicine, 79106 Freiburg, GermanyDepartment of Radiation Oncology, University of Washington School of Medicine, Seattle, WA 98195, USADepartment of Radiation Oncology, Medical Center—University of Freiburg, Faculty of Medicine, 79106 Freiburg, GermanyDepartment of Radiation Oncology, Medical Center—University of Freiburg, Faculty of Medicine, 79106 Freiburg, GermanyVon Hippel–Lindau disease (VHL) is a hereditary disorder associated with malignant tumors including clear cell renal cell carcinoma (ccRCC). Partial nephrectomy is complicated by multilocular tumor occurrence and a high recurrence rate. The aim of this study was to evaluate the potential of stereotactic body radiotherapy (SBRT) as an alternative treatment approach in VHL patients with multiple ccRCC. Patients with VHL and a diagnosis of ccRCC were enrolled. SBRT was conducted using five fractions of 10 Gy or eight fractions of 7.5 Gy. The primary endpoint was local control (LC). Secondary endpoints included alteration of renal function and adverse events. Seven patients with a total of eight treated lesions were enrolled. Median age was 44 years. Five patients exhibited multiple bilateral kidney cysts in addition to ccRCC. Three patients underwent at least one partial nephrectomy in the past. After a median follow-up of 43 months, 2-year LC was 100%, while 2-year CSS, 2-year PFS and 2-year OS was 100%, 85.7% and 85.7%, respectively. SBRT was very well tolerated with no acute or chronic toxicities grade ≥ 2. Mean estimated glomerular filtration rate (eGFR) at baseline was 83.7 ± 13.0 mL/min/1.73 m<sup>2</sup>, which decreased to 76.6 ± 8.0 mL/min/1.73 m<sup>2</sup> after 1 year. Although the sample size was small, SBRT resulted in an excellent LC rate and was very well tolerated with preservation of kidney function in patients with multiple renal lesions and cysts.https://www.mdpi.com/2072-6694/14/20/5069stereotactic body radiotherapySBRTstereotactic ablative radiotherapySABRrenal cell carcinomavon Hippel–Lindau disease
spellingShingle Simon Kirste
Alexander Rühle
Stefan Zschiedrich
Wolfgang Schultze-Seemann
Cordula A. Jilg
Elke Neumann-Haefelin
Simon S. Lo
Anca-Ligia Grosu
Emily Kim
Stereotactic Body Radiotherapy for Renal Cell Carcinoma in Patients with Von Hippel–Lindau Disease—Results of a Prospective Trial
Cancers
stereotactic body radiotherapy
SBRT
stereotactic ablative radiotherapy
SABR
renal cell carcinoma
von Hippel–Lindau disease
title Stereotactic Body Radiotherapy for Renal Cell Carcinoma in Patients with Von Hippel–Lindau Disease—Results of a Prospective Trial
title_full Stereotactic Body Radiotherapy for Renal Cell Carcinoma in Patients with Von Hippel–Lindau Disease—Results of a Prospective Trial
title_fullStr Stereotactic Body Radiotherapy for Renal Cell Carcinoma in Patients with Von Hippel–Lindau Disease—Results of a Prospective Trial
title_full_unstemmed Stereotactic Body Radiotherapy for Renal Cell Carcinoma in Patients with Von Hippel–Lindau Disease—Results of a Prospective Trial
title_short Stereotactic Body Radiotherapy for Renal Cell Carcinoma in Patients with Von Hippel–Lindau Disease—Results of a Prospective Trial
title_sort stereotactic body radiotherapy for renal cell carcinoma in patients with von hippel lindau disease results of a prospective trial
topic stereotactic body radiotherapy
SBRT
stereotactic ablative radiotherapy
SABR
renal cell carcinoma
von Hippel–Lindau disease
url https://www.mdpi.com/2072-6694/14/20/5069
work_keys_str_mv AT simonkirste stereotacticbodyradiotherapyforrenalcellcarcinomainpatientswithvonhippellindaudiseaseresultsofaprospectivetrial
AT alexanderruhle stereotacticbodyradiotherapyforrenalcellcarcinomainpatientswithvonhippellindaudiseaseresultsofaprospectivetrial
AT stefanzschiedrich stereotacticbodyradiotherapyforrenalcellcarcinomainpatientswithvonhippellindaudiseaseresultsofaprospectivetrial
AT wolfgangschultzeseemann stereotacticbodyradiotherapyforrenalcellcarcinomainpatientswithvonhippellindaudiseaseresultsofaprospectivetrial
AT cordulaajilg stereotacticbodyradiotherapyforrenalcellcarcinomainpatientswithvonhippellindaudiseaseresultsofaprospectivetrial
AT elkeneumannhaefelin stereotacticbodyradiotherapyforrenalcellcarcinomainpatientswithvonhippellindaudiseaseresultsofaprospectivetrial
AT simonslo stereotacticbodyradiotherapyforrenalcellcarcinomainpatientswithvonhippellindaudiseaseresultsofaprospectivetrial
AT ancaligiagrosu stereotacticbodyradiotherapyforrenalcellcarcinomainpatientswithvonhippellindaudiseaseresultsofaprospectivetrial
AT emilykim stereotacticbodyradiotherapyforrenalcellcarcinomainpatientswithvonhippellindaudiseaseresultsofaprospectivetrial