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A recent study conducted by Australian and Dutch experts has shed light on a promising treatment option for older patients with inoperable kidney tumors. The study, known as the TransTasman Radiation Oncology Group (TROG) FASTRACK II, is a multi-institutional phase II study that has shown remarkable results in the use of high-dose radiation therapy for this patient group.
In the study, patients with inoperable kidney cancer were treated with stereotactic ablative body radiotherapy (SABR), a form of targeted, high-dose radiation therapy. The results were nothing short of impressive, with 100% local control and cancer-specific survival for more than three years in the patient group. These findings are significant and will be presented at the Annual Meeting of the American Society of Radiation Oncology (ASTRO).
This groundbreaking research marks the first large-scale, multi-institutional clinical trial to assess the effectiveness of SABR for patients with inoperable kidney tumors. The significance of this study lies in its potential to provide hope and effective treatment options for a growing population of older adults who face unique challenges when it comes to kidney cancer.
As the global population ages, the incidence of kidney cancer among older adults is on the rise. This is particularly true for individuals over the age of 70, who often have lower rates of survival. Kidney cancer ranks as the sixth most diagnosed cancer in men and the tenth in women worldwide. Traditionally, surgery has been the primary treatment approach, involving the removal of the tumor or the entire kidney and surrounding tissue. However, many older patients face medical conditions such as high blood pressure or diabetes, making them higher-risk candidates for surgical procedures.
Dr. Shankar Siva, the lead author of the study, emphasizes that this research defines a new population of patients who can benefit from stereotactic radiation. These patients often lack viable treatment alternatives, and radiation therapy offers a promising solution for them.
SABR, also known as stereotactic body radiation (SBRT), works by delivering high doses of radiation directly to the tumor, typically in a small number of outpatient sessions. In this study, 70 patients diagnosed with inoperable, high-risk kidney tumors or those who declined surgery for renal cell cancer were treated with SABR. The results showed impressive outcomes, with no local progression of kidney cancer and no cancer-related deaths during the median follow-up of 43 months.
The study also highlights the relatively mild side effects of SABR treatment, with no severe toxicities observed. Most patients experienced only grade 1-2 treatment-related events, and there was a modest decline in kidney function, which plateaued after two years. Only one patient required dialysis following treatment.
Dr. Siva credits the high efficacy rate and the preservation of kidney function to rigorous quality control and the effectiveness of stereotactic radiation. He believes that the findings from this phase II trial justify the design of a randomized phase III trial to compare stereotactic radiation with surgery as the primary treatment modality for operable kidney cancer patients.
In conclusion, the study's findings offer new hope and treatment possibilities for older patients with inoperable kidney tumors. High-dose radiation therapy, particularly SABR, has shown remarkable effectiveness and relatively low side effects. As the population continues to age, this research represents a significant step toward improving the quality of life and survival rates for older adults facing kidney cancer, offering a viable alternative to invasive surgical procedures.