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Late renal function following whole abdominal irradiation
1Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Canada.
Summary
Whole abdominal radiotherapy did not show late renal toxicity in patients with cancer. Age, not radiation dose, was the main factor affecting kidney function years after treatment.
Area of Science:
- Oncology
- Nephrology
- Radiation Oncology
Background:
- Whole abdominal radiotherapy (WAR) is used for certain cancers.
- Bilateral renal irradiation is an unavoidable component of WAR.
- Late effects of renal irradiation are a concern.
Purpose of the Study:
- To assess late clinical and biochemical effects of bilateral renal irradiation.
- To evaluate renal function in patients treated with WAR.
- To identify factors influencing renal function post-WAR.
Main Methods:
- Sixty disease-free patients post-WAR were studied.
- Follow-up ranged from 5 to 20 years (median 9 years).
- Renal dose was retrospectively calculated (mean 19.28 Gy).
- Clinical and biochemical assessments of renal function were performed.
Main Results:
- No patient showed clinical evidence of renal impairment.
- Hypertension developed in 5/60 patients post-treatment.
- Serum creatinine and creatinine clearance were within normal limits.
- Age was the only significant factor affecting creatinine clearance (P < 0.00001).
- Renal dose and time since treatment were not significant factors.
Conclusions:
- No evidence of late renal toxicity was observed more than 5 years after WAR.
- The dose/fractionation schedule and technique used appear safe for renal function.
- Age is a significant determinant of long-term renal function in this cohort.