[Combined treatment of malignant kidney tumors]

The paper is devoted to the discussion of the results of combined therapy of 79 patients with malignant renal tumors. Eight patients underwent nephrectomy and postoperative irradiation at a mean dose of 28 Gy, a marked radiation reaction was noted in 3 of them, and irradiation had to be discontinued. All 8 patients died within 3 yrs. of a follow-up period. Thirty patients received preoperative irradiation at a single focal dose of 2-2.5 Gy and a summary dose of 30-50 Gy 3-4 weeks before nephrectomy. A dose of 30 Gy did not result in tumor reduction, a dose of 40 Gy led to an insignificant reduction of a tumor size by 1-2 cm, tumor resorption by 30-50% was noted at doses of 50-60 Gy. Thirty-eight patients were given preoperative irradiation at a daily single focal dose of 4 Gy and a summary dose of 20 Gy, followed by nephrectomy in 24-48 h. Radiation reactions in preoperative irradiation were less marked than in postoperative irradiation. The 3-year survival rate in preoperative irradiation and nephrectomy was 72.5%, the 5-year survival rate was 53.2%. A fractionation type did not influence the survival rates.