Examine began in London may mark breakthrough in kidney most cancers

Study started in London could mark breakthrough in kidney cancer

A precise, high-dose radiation technique — piloted in London — is showing promising long-term results for patients with inoperable kidney cancer, a new multi-center study says.

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The Lawson Health Research Institute – the research arm of London hospitals – was one of 12 organizations taking part in the study, recruiting kidney cancer patients from the London Health Sciences Center’s regional cancer program and collecting figures from other research organizations behind the scenes.

“It was a team effort, led in many ways by London in recent years,” LHSC radiation oncologist and Lawson scientist Rohann Correa said on Wednesday. “London’s contribution was to organize the collection and housing of the database, with all international contributors sending us their data and doing all the analysis.”

The researchers followed 190 patients with primary renal cell carcinoma, the most common kidney cancer, and tested whether a special radiation technique, stereotactic ablative radiation therapy (SABR), made a difference in their long-term outcomes.

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Patients received SABR treatment between March 23, 2007 and September 20, 2018

The 12-center study found SABR to be safe and effective with a low rate of cancer recurrence. Patients followed for five years after SABR treatment largely retained their kidney function, and only 5.5 percent had cancer return to the treated kidney.

SABR is a non-invasive treatment method that delivers high-precision, high-intensity radiation to cancerous tumors while limiting the impact on adjacent tissues. It differs from routine radiation therapy for many other cancers, Correa said.

“With normal irradiation, or what we call standard fractionation irradiation, we’re kind of going slow and slow, so to speak. We give lower doses over a long period of time, with daily doses spread over three to seven weeks of treatment,” he said. “With SABR, we can deliver fewer doses with more radiation per day.”

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SABR is guided by advanced medical imaging, including MRIs, CT scans, cone-beam CTs before each treatment, and even recordings taken during the delivery of radiation, Correa said.

Treatment is a really important option for patients who cannot undergo surgery.

“If someone has a lot of medical problems, they’re older, they’re facing a challenge going through anesthesia for a major surgery like a kidney removal, or their kidney function isn’t that good to begin with and having a kidney removed will help. It’s not good, there are some minimally invasive options, but they have limitations,” Correa said.

This type of precise, targeted radiation can even be used when a tumor is near key structures in the kidney because it causes limited damage to surrounding tissue, he said.

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The technique has been studied in the past with promising results, but the latest study is the first long-term follow-up of a large international patient cohort.

The study was led by Shankar Siva, a radiation oncologist at Peter MacCallum Cancer Center in Australia. Centers in Australia, Germany, Japan, Canada and the United States participated in the study.

The research was published in the medical journal The Lancet Oncology.


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