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Hypofractionated postoperative irradiation in localized renal cell cancer: A case report and pertinent literature review


1 School of Medical and Life Sciences, Shandong Academy of Medical Sciences, Jinan University; Department of Radiation Oncology II, Shandong Cancer Hospital and Institute, Jinan, China
2 Department of Oncology Medicine, People's Hospital of Xintai City, Affiliated to Taishan Medical University, Xintai, China
3 Department of Radiation Oncology II, Shandong Cancer Hospital and Institute, Jinan, China

Correspondence Address:
Yong-Hua Yu,
Department of Radiation Oncology II, Shandong Cancer Hospital and Institute, 440 Ji Yan Road, Jinan
China
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Source of Support: None, Conflict of Interest: None

For localized the incidence of renal cell carcinoma (RCC), nephrectomy is the standard treatment. As RCC is generally regarded as a radiation-resistant tumor, the value of postoperative adjuvant radiotherapy is controversial. However, with new advance in radiotherapy (i.e., three-dimensional conformal radiation therapy [3DCRT] and intensity-modulated radiation therapy [IMRT]), target volume delineation, intensity modulation in treatment planning, and treatment delivery are more accurate with fewer adverse effect. A right renal tumor was identified in a 50-year-old man during a routine examination. T1N0M0 RCC was clinically diagnosed as the tumor was 3 cm ΄ 3.5 cm and well-enhanced with intravenously infused contrast material in the arterial phase on computed tomography (CT). No metastases to regional lymph nodes or distant sites were evident. 3DCRT after the operation was carried out. A total dose of 50 Gy in 20 fractions over 28 days was delivered using a 15-MV X-ray. No clinical acute or chronic side effects were recorded during or after treatment, which was well tolerated. After radiotherapy, the patient came back to the hospital for a check regularly, with no evidence of recurrence and metastasis more than 11 years, and the CT for abdominal showed partial function of the right renal remained. The present case showed a good response with recovery after CRT of 50 Gy in 20 fractions for postoperative RCC. Although further experiences and longer follow-up are mandatory to conclude the optimal treatment schedule and efficacy of CRT for RCC, postoperative radiotherapy definitely reduces locoregional recurrences and with acceptable gastrointestinal toxicity if modern techniques (CRT and IMRT) are utilized.


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