Microwave (MW) ablation and stereotactic body radiation therapy (SBRT) are both used in treating inoperable renal cell carcinoma (RCC). MW ablation and SBRT have potentially complementary advantages and limitations. Combining SBRT and MW ablation may optimize tumor control and toxicity for patients with larger (> 5 cm) RCCs or those with vascular involvement. Seven patients with RCC were treated at our institution with combination of SBRT and MW ablation, median tumor size of 6.4 cm. Local control was 100% with a median follow-up of 15 months. Four patients experienced grade 2 nausea during SBRT. Three patients experienced toxicities after MW ablation, 2 with grade 1 hematuria and 1 with grade 3 retroperitoneal bleed/collecting system injury. Median eGFR (estimated glomerular filtration rate) preceding and following SBRT and MW ablation was 69 mL/min/1.73 m2 and 68 mL/min/1.73 m2 (P = .19), respectively. In patients who are not surgical candidates, larger RCCs or those with vascular invasion are challenging to treat. Combination treatment with SBRT and MW ablation may balance the risks and benefits of both therapies and demonstrates high local control in our series. MW ablation and SBRT have potentially complementary advantages and limitations.
Clinical genitourinary cancer. 2021 Apr 20 [Epub ahead of print]
Grace C Blitzer, Andrzej Wojcieszynski, E Jason Abel, Sara Best, Fred T Lee, J Louis Hinshaw, Shane Wells, Timothy J Ziemlewicz, Meghan G Lubner, Marci Alexander, Poonam Yadav, John E Bayouth, John Floberg, Greg Cooley, Paul M Harari, Michael F Bassetti
Department of Human Oncology, University of Wisconsin Hospitals & Clinics, Madison, WI. Electronic address: ., Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA., Department of Urology, University of Wisconsin Hospitals & Clinics, Madison, WI., Department of Radiology, University of Wisconsin Hospitals & Clinics, Madison, WI., Department of Human Oncology, University of Wisconsin Hospitals & Clinics, Madison, WI.