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Stereotactic ablative radiotherapy for unresectable inferior vena cava tumor thrombus in a patient with renal cell carcinoma: a case report

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Abstract

Purpose

Treatment options for renal cell carcinoma (RCC) with inferior vena cava tumor thrombus (IVC-TT) are limited and carry substantial risks. Currently, there are no standard treatment options in the setting of recurrent or unresectable RCC with IVC-TT.

Methods

We report our experience of treating an IVC-TT RCC patient with stereotactic body radiation therapy (SBRT).

Results

This 62-year-old gentleman presented renal cell carcinoma with IVC-TT and liver metastases. Initial treatment consisted of radical nephrectomy and thrombectomy followed by continuous sunitinib. At 3 months, he developed an unresectable IVC-TT recurrence. A fiducial marker was implanted into the IVC-TT by catheterization. New biopsies were performed at the same time, demonstrating a recurrence of the RCC. SBRT consisted of 5 fractions of 7 Gy to the IVC-TT with excellent initial tolerance. He subsequently received anti-PD1 therapy (nivolumab). At 4 years follow-up, he is doing well with no IVC-TT recurrence and no late toxicity.

Conclusion

SBRT appears to be a feasible and safe treatment for IVC-TT secondary to RCC in patients who are not candidates for surgery.

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Funding

No specific funding was used for this study.

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Authors and Affiliations

  1. Hartmann Radiotherapy and Radiosurgery Institute, 4 rue Kleber, 92200, Levallois Perret, Ile de France, France

    Pauline Castelnau-Marchand, Nathaniel Scher, Marc Bollet & Alain Toledano

  2. Integrative medecine department, Rafael Institute, Levallois Perret, France

    Marc Bollet & Alain Toledano

  3. Gustave Roussy Institut, Villejuif, France

    Cyrus Chargari

  4. Integrative health chair, National Conservatory of Arts and Crafts, Paris, France

    Alain Toledano

Authors
  1. Pauline Castelnau-Marchand
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  2. Nathaniel Scher
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  3. Marc Bollet
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  4. Cyrus Chargari
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  5. Alain Toledano
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Corresponding author

Correspondence to Nathaniel Scher.

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Conflict of interest

P. Castelnau-Marchand, N. Scher, M. Bollet, C. Chargari, and A. Toledano declare that they have no competing interests.

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Castelnau-Marchand, P., Scher, N., Bollet, M. et al. Stereotactic ablative radiotherapy for unresectable inferior vena cava tumor thrombus in a patient with renal cell carcinoma: a case report. Strahlenther Onkol 199, 420–424 (2023). https://doi.org/10.1007/s00066-023-02054-0

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  • DOI: https://doi.org/10.1007/s00066-023-02054-0

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