LOCALLY ADVANCED RENAL-CELL CARCINOMA - LOW COMPLICATION RATE AND EFFICACY OF POSTNEPHRECTOMY RADIATION-THERAPY PLANNED WITH CT

PURPOSE: To determine the usefulness of computed tomography (CT) in pl anning radiation therapy for locally advanced renal cell carcinoma aft er nephrectomy. MATERIALS AND METHODS: The authors retrospectively ana lyzed the treatment records and follow-up status of 12 consecutive pat ients who underwent radical nephrectomy and postoperative radiation th erapy for locally advanced renal cell carcinoma. Records of 12 consecu tive patients who underwent only radical nephrectomy were also analyze d. RESULTS: None of the patients who received radiation therapy after nephrectomy had local-regional recurrence, despite disease at the surg ical margins in six patients; the actuarial disease-free survival at 5 years was 75%. In contrast, the 5-year actuarial local failure rate i n the surgery-only group was 30% (significant difference at P < .01) a nd the disease-free survival rate was 62% (mean and median follow-up w as 4.6 and 5.1 years, respectively). CONCLUSION: With CT, radiation ca n be delivered to the renal bed safely and without undue morbidity. Gi ven the lack of chronic complications associated with the side effects of radiation therapy and uniform local control of cancer in these pat ients, the role of radiation therapy in patients at high risk for loca l failure may be reconsidered.