Pelvic radiotherapy after renal transplantation

After renal transplantation, patients have a higher incidence of developing cancer necessitating pelvic radiotherapy, but there is a lack of data for such therapy in this patient group.

Nine patients with pelvic renal transplants were treated with pelvic radiotherapy between 04/2002 and 06/2011. Treatment was carried out for prostate (n=4), rectal (n=2), and anal cancer (n=1), osseous metastasis (n=1), and Hodgkin's disease (n=1). The mean age of the transplants was 12.6 years.

The mean total dose to the target volume was 60.2 Gy, the mean maximum dose to the transplant was 10.0 Gy, with a mean dose of 2.1 Gy. The mean creatinine clearance before start of radiotherapy was 48.9 ml/min. After a mean follow-up of 23 months, no patient showed failure of the transplant and the mean creatinine clearance was 64.2 ml/min.

Using modern radiotherapy techniques, low doses to the transplant can be achieved without compromising target treatment and without transplant failure. A mean dose of <4 Gy seems to be well-tolerated by the graft.