Our study is consistent with others in showing progressive decline in renal function as measured by functional scintigraphic imaging and biochemical endpoints (6), (9), (11). In contrast to Kost et al who noted decline after one year, we observed decreases in relative renal function and biochemical endpoints as early as 6 months post-radiation. We observed significant decline in both relative renal function of the primarily irradiated kidney detected on scintigraphy and global renal function as measured by selleck compound creatinine clearance following abdominal
chemoradiation. Post-radiation renography in combination with biochemical measures may allow Inhibitors,research,lifescience,medical for early identification and assessment of patients at greater risk for developing clinical manifestations of radiation nephropathy. As radiation induced renal injury is progressive, it is likely that the functional impairments observed in this study will increase over time. With longer follow up, further correlation between changes detected on renal scintigraphy, biochemical endpoints, and radiation dose volume parameters may be observed. Conclusions Decline Inhibitors,research,lifescience,medical in split renal function using Technetium99m MAG-3 scintigraphy correlates with decrease in creatinine clearance and radiation dose-volume parameters following
abdominal chemoradiation. Change in split Inhibitors,research,lifescience,medical perfusion can be detected as early as 6 months post-radiation. This observation suggests post-radiation scintigraphy may allow for early determination and quantification of subclinical renal injury prior to development of clinical nephropathy.
Oligometastatic Inhibitors,research,lifescience,medical disease is hypothesized to be a state of limited metastases in which frank widespread
metastasis has not yet evolved. Milano et al. reported on patients with oligometastases undergoing two or more curative-intent stereotactic body radiation treatment (SBRT). In these selected patients, the 4-year overall survival and progression-free survival rates were 33% and 28%, respectively (1). Oligometastases should be limited in number and extent while amendable to targeted local therapies for ablation with potential cure. For example, Inhibitors,research,lifescience,medical liver resection of oncologic lesions can be associated with long-term survival in selected patients (2). High dose and focal external beam radiation in the form of SBRT may be an alternative to invasive procedures in dealing with certain sites of disease. In this issue of Idoxuridine Journal of GI Oncology, Perkins and colleagues focused on the treatment of oligometastases in patients with abdomino-pelvic recurrence or inoperable diseases. As the authors rightfully pointed out, these patients often have received heavy prior treatment of surgery, local radiotherapy, and chemotherapy, which precludes standard local treatment for the oligometastases (3). Perkins et al. review the application of SBRT and early gastrointestinal (GI) toxicities and radiographic responses based on computed tomography (CT) and positron emission tomography (PET).