The Utility Of A Pre-Treatment Glomerular Filtration Rate (Gfr) Study In Radiotherapy Planning For High-Risk Neuroblastoma
Posted Date: Mar 8, 2021
- Investigator: Andrew Frankart
- Specialties: Cancer, Oncology, Radiation Oncology
- Type of Study: Observational/Survey
The current treatment approach for high-risk neuroblastoma entails induction chemotherapy followed by surgical resection, stem cell transplant, consolidative radiation therapy, and adjuvant targeted systemic therapy. While the volumes treated with radiotherapy vary based upon the need to treat metastatic disease, the primary tumor site is included in all instances of radiotherapy for high-risk disease. The adrenal bed and other abdominal sites make up the most common site of primary disease. Given the proximity of the tumor bed to the ipsilateral kidney in most cases of neuroblastoma, the impact of radiation exposure on subsequent renal function is a critical consideration in treatment planning. In addition, the vertebral bodies adjacent to the treated volume are uniformly treated to avoid scoliosis. This frequently results in contralateral kidney exposure. Classic radiation dose constraints for the kidney differentiate between the ipsilateral and contralateral kidney to allow for adequate dose to the target, but fail to take into account the subset of patients with asymmetric renal function. At our institution, we have attempted to address this issue by obtaining pre-treatment GFR studies prior to proton radiotherapy in high-risk neuroblastoma patients receiving radiation to a peri-nephric primary tumor. In this study, we aim to report our experience with this approach and the potential of GFR studies to improve radiation treatment planning to limit nephrotoxicity.
Neuroblastoma, Radiation, Gfr
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