Solid as a rock.

The IROCK consortium is at it again. They’ve already demonstrated excellent safety and efficacy with single-fraction SBRT to a primary renal cell carcinoma (RCC) tumor in the setting of metastatic disease. Now they’re taking it one step further in those with a single kidney. This international pooled analysis of 81 patients with solitary kidneys evaluates objective changes in glomerular filtration rates (GFR) following SBRT to the (only) kidney. The majority (n=68, 71%) were treated in true IROCK fashion with a single fraction of mostly 25 Gy. Now remember, a GFR over 60 ml/min is considered normal, and this cohort started out with a pre-treatment median GFR of 67. The median change in GFR was only -3 (range: -35 to +18), leaving most well within normal range. They then compared this to a treated cohort with both kidneys intact, and the median change was pretty much exactly the same at -4. TBL: Don’t let an isolated kidney scare you away from single-fraction SBRT for a primary RCC tumor. | Correa, J Urol 2019