A groundbreaking phase II study, SPARE, is currently recruiting nineteen patients with primary renal cell carcinoma (RCC). Aimed at those who are medically unfit for surgery or local ablation, or who have declined these treatments, the study examines the efficacy of proton-based stereotactic body radiation therapy (SBRT) in preserving kidney function.
Innovative Treatment Approach
Traditional treatment options for localized kidney cancer, such as surgical resection and local ablation, are not suitable for all patients. Recent advancements have seen SBRT using conventional x-rays improve local control and toxicity outcomes; however, it often leads to significant declines in renal function, potentially necessitating dialysis. In contrast, proton therapy leverages the Bragg peak phenomenon to concentrate energy at the tumor site, thereby minimizing exposure to surrounding healthy tissues, including both the ipsilateral and contralateral kidneys.
Study Objectives and Outcomes
The SPARE study utilizes four-dimensional computed tomography to account for respiratory motion during radiotherapy planning. Participants will undergo proton-based SBRT, receiving doses of 40-42 Gy over three to five fractions. The primary endpoint focuses on assessing changes in kidney function post-treatment, while secondary endpoints include local control rates, toxicity profiles, disease progression, and overall survival over a two-year follow-up period.
- Proton SBRT may offer superior kidney function preservation compared to photon SBRT.
- Potentially reducing the need for dialysis in at-risk patient populations.
- Enhancing treatment options for patients with solitary kidneys or tumors adjacent to critical organs.
The expected results from SPARE could revolutionize treatment strategies for primary RCC by providing a viable alternative that minimizes renal impairment. This approach could significantly improve patient quality of life and present a safer therapeutic option for those with limited surgical candidacy.
Ultimately, SPARE aims to establish proton-based SBRT as a standard treatment protocol for difficult RCC cases, balancing effective cancer control with the preservation of vital kidney function, thus offering a promising avenue for future clinical practices.
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