关键词: Cancer Carcinoma Cyberknife Radiation Tumor

Mesh : Male Humans Middle Aged Carcinoma, Renal Cell / radiotherapy pathology Kidney Neoplasms / radiotherapy pathology Vena Cava, Inferior / pathology surgery Radiosurgery / adverse effects Venous Thrombosis / radiotherapy complications Nephrectomy / adverse effects Retrospective Studies

来  源:   DOI:10.1007/s00066-023-02054-0

Abstract:
Treatment options for renal cell carcinoma (RCC) with inferior vena cava tumor thrombus (IVC-TT) are limited and carry substantial risks. Currently, there are no standard treatment options in the setting of recurrent or unresectable RCC with IVC-TT.
We report our experience of treating an IVC-TT RCC patient with stereotactic body radiation therapy (SBRT).
This 62-year-old gentleman presented renal cell carcinoma with IVC-TT and liver metastases. Initial treatment consisted of radical nephrectomy and thrombectomy followed by continuous sunitinib. At 3 months, he developed an unresectable IVC-TT recurrence. A fiducial marker was implanted into the IVC-TT by catheterization. New biopsies were performed at the same time, demonstrating a recurrence of the RCC. SBRT consisted of 5 fractions of 7 Gy to the IVC-TT with excellent initial tolerance. He subsequently received anti-PD1 therapy (nivolumab). At 4 years follow-up, he is doing well with no IVC-TT recurrence and no late toxicity.
SBRT appears to be a feasible and safe treatment for IVC-TT secondary to RCC in patients who are not candidates for surgery.
摘要:
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