Stereotactic Body Radiotherapy for Palliation of Hematuria Arising From Urothelial Carcinoma of the Kidney in Unfavorable Surgical Candidates
Department of Radiation Oncology; Department of Urology; Department of Pathology; Department of Radiology; Department of Medicine, Division of Hematology Oncology
Female Urogenital Diseases and Pregnancy Complications | Male Urogenital Diseases | Neoplasms | Oncology | Pathological Conditions, Signs and Symptoms | Radiation Medicine | Radiology
INTRODUCTION: Hematuria can be a distressing and debilitating complication of urothelial carcinoma (UC) of the kidney for patients who are not candidates for surgery or ureteroscopic ablation. We retrospectively assessed the efficacy, tolerability, and safety of stereotactic body radiotherapy (SBRT) for controlling gross hematuria in this patient population.
MATERIALS AND METHODS: Institutional Review Board (IRB)-approved review of the records, laboratory values, pathology, and imaging of 8 consecutive patients treated with SBRT over a 5-year period for uncontrolled gross hematuria caused by UC of the renal pelvis or calyces.
RESULTS: Therapy was delivered in 3 to 5 treatments over 1 to weeks. Individual treatments lasted an average of 17.2 minutes. No patient experienced treatment-related pain, vomiting, or diarrhea. All enjoyed cessation of bleeding within a week of completing therapy. Hematuria recurred in 2 patients in 4 and 22 months. Of the patients who have not re-bled, 3 expired of metastatic disease or co-morbidities, and 3 remain alive up to 6 years posttreatment. Of patients who have survived longer than a year, creatinine has changed by -0.05 to +0.35, and estimated glomerular filtration rate has fallen by an average of 22%. No patient has required dialysis.
CONCLUSIONS: SBRT appears to be an effective and well-tolerated means of palliating gross hematuria secondary to UC of the renal pelvis or calyces in patients who are unfavorable candidates for nephrectomy or ureteroscopic ablation. Treatment was associated with a moderate decline in renal function.
DOI of Published Version
Aronowitz J, Ding L, Yates J, Zong Y, Zheng L, Jiang Z, Yancey J, Mittal K, Fitzgerald TJ. Stereotactic Body Radiotherapy for Palliation of Hematuria Arising From Urothelial Carcinoma of the Kidney in Unfavorable Surgical Candidates. Am J Clin Oncol. 2021 Mar 12. doi: 10.1097/COC.0000000000000801. Epub ahead of print. PMID: 33710134. Link to article on publisher's site
American journal of clinical oncology
Aronowitz JN, Ding L, Yates JK, Zong Y, Zheng LZ, Jiang Z, Yancey J, Mittal K, Fitzgerald TJ. (2021). Stereotactic Body Radiotherapy for Palliation of Hematuria Arising From Urothelial Carcinoma of the Kidney in Unfavorable Surgical Candidates. Radiology Publications. https://doi.org/10.1097/COC.0000000000000801. Retrieved from https://escholarship.umassmed.edu/radiology_pubs/604