Stereotactic ablative radiotherapy for primary kidney cancer

The FASTRACK II study by Shankar Siva and colleagues 1 Siva S Bressel M Sidhom M et al. Stereotactic ablative body radiotherapy for primary kidney cancer (TROG 15.03 FASTRACK II): a non-randomised phase 2 trial. Lancet Oncol. 2024; 25: 308-316 Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar provided short-term evidence of renal tumour sensitivity to high-dose radiation in the non-surgical treatment of T1 renal tumours. Stereotactic ablative body radiotherapy for primary kidney cancer (TROG 15.03 FASTRACK II): a non-randomised phase 2 trialTo our knowledge, this is the first multicentre prospective clinical trial of non-surgical definitive therapy in patients with primary renal cell cancer. In a cohort with predominantly T1b or larger disease, SABR was an effective treatment strategy with no observed local failures or cancer-related deaths. We observed an acceptable side-effect profile and renal function after SABR. These outcomes support the design of a future randomised trial of SABR versus surgery for primary renal cell cancer. Full-Text PDF Stereotactic ablative radiotherapy for primary kidney cancerShankar Siva and colleagues1 published their findings on the use of stereotactic ablative radiotherapy (SABR) in primary renal cell cancer in patients who were inoperable due to medical reasons or who did not want surgery. We read this article with curiosity and acknowledge the long and hard work behind such a study. The authors investigated the role of SABR in patients with predominantly T1 renal cell cancers who required active treatment but could not be operated on due to various reasons including medical comorbidities. Full-Text PDF Stereotactic ablative radiotherapy for primary kidney cancer – Authors' replyWe thank Priyank Bhargava and colleagues and Nicholas Brown and colleagues for their interest in TROG 15.03 FASTRACK II trial.1 The main consideration of these correspondences regards the use of thermal ablation, which was not the topic of investigation in the trial. Guidelines from the European Association of Urology2 state that thermal ablation should not be offered routinely to patients with tumours larger than 3 cm and cryotherapy should not be offered for tumours larger than 4 cm (notwithstanding the need for general anaesthetic in a comorbid population with cryotherapy). Full-Text PDF