Short communication: timeline of radiation-induced kidney function loss after stereotactic ablative body radiotherapy of renal cell carcinoma as evaluated by serial 99mTc-DMSA SPECT/CT
Short communication: timeline of radiation-induced kidney function loss after stereotactic ablative body radiotherapy of renal cell carcinoma as evaluated by serial 99mTc-DMSA SPECT/CT
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DOI：
10.1186/s13014-014-0253-z
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发表时间：
2014-11-26
影响因子：
3.6
通讯作者：
Siva, Shankar
中科院分区：
文献类型：
--
作者：
Jackson, Price;Foroudi, Farshad;Siva, Shankar
背景：立体定向消融体放疗（SABR）已被提出作为不能手术的原发性肾细胞癌患者的最终治疗方法。然而，很少有文献详细说明低分割辐射对健康肾组织的放射生物学影响。结果：在这项研究中，我们描述了一种评估26 Gy单组分SABR对肾功能区域变化的方法。在一例孤立肾患者中，通过三维SPECT/CT成像和Cr-51-EDTA测量确定治疗后肾功能的详细随访。根据肾小球滤过率的测量，肾功能在3个月时迅速下降34%，在12个月时稳定在43%，在18个月时进一步下降到基线的49%。结论：Tc-99m-DMSA摄取在SPECT/CT上的肾功能改变模式与给药剂量相关。本研究表明SABR与肾功能丧失存在剂量效应关系。
Background: Stereotactic ablative body radiotherapy (SABR) has been proposed as a definitive treatment for patients with inoperable primary renal cell carcinoma. However, there is little documentation detailing the radiobiological effects of hypofractionated radiation on healthy renal tissue.Findings: In this study we describe a methodology for assessment of regional change in renal function in response to single fraction SABR of 26 Gy. In a patient with a solitary kidney, detailed follow-up of kidney function post-treatment was determined through 3-dimensional SPECT/CT imaging and Cr-51-EDTA measurements. Based on measurements of glomerular filtration rate, renal function declined rapidly by 34% at 3 months, plateaued at 43% loss at 12 months, with minimal further decrease to 49% of baseline by 18 months.Conclusions: The pattern of renal functional change in Tc-99m-DMSA uptake on SPECT/CT imaging correlates with dose delivered. This study demonstrates a dose effect relationship of SABR with loss of kidney function.