{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:50:18Z","timestamp":1782190218499,"version":"3.54.5"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Forschung, Technologie und Raumfahrt","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Definitive renal stereotactic ablative radiotherapy (SABR) is gaining momentum, with promising data showing excellent local control and short-term renal function comparable to surgery. However, data on late radiation-associated kidney injury and renal safety remain limited. We therefore assessed post-treatment renal outcomes and dose-response after kidney irradiation to inform nephron-sparing SABR for primary renal cell carcinoma (pRCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of trunk radiotherapy patients at a tertiary university cancer center, with incidental kidney exposure (EQD2 \u226510 Gy) and longitudinal renal function follow-up. Of 731 screened patients, 232 met inclusion criteria. Chronic-kidney-disease (CKD) deterioration was analyzed against renal dose using multivariable Cox, cut-off, and spline analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During median follow-up of 170 days (IQR 60-541), CKD worsening occurred in 46.98% of patients, at a median of 173 days (IQR 55-423). Mean and maximum kidney doses (EQD2) were 14.2 Gy (SD 4.68) and 14.6 Gy (SD 4.86), respectively. Higher renal dose independently predicted renal function decline (HR 1.04\/Gy; p=0.028 for mean; p=0.014 for max). Female sex was a risk factor (HR 2.08; p&amp;lt;0.001). Cut-offs were 18.7 Gy (mean) and 19.0 Gy (max), with monotonic dose-response. Retrospective design limits causal inference; constraints remain exploratory; validation required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within low-to-moderate dose ranges to non-tumorous kidney tissue, irradiation was associated with a dose-dependent post-treatment decline in renal function, while severe toxicity was rare. Nephron-sparing SABR is a safe treatment option for pRCC, informing risk-adapted dose constraint refinement to minimize late injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1868006","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:32:30Z","timestamp":1782189150000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-treatment renal function deterioration following radiation therapy: implications for SABR in primary renal cell cancer"],"prefix":"10.3389","volume":"16","author":[{"given":"Marthe Sophie","family":"Kilian","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center G\u00f6ttingen","place":["G\u00f6ttingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Anna","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, 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Hendrik","family":"Dr\u00f6ge","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center G\u00f6ttingen","place":["G\u00f6ttingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tibor I.","family":"Keszty\u00fcs","sequence":"additional","affiliation":[{"name":"Medical Data Integration Center (MeDIC), University Medical Center G\u00f6ttingen","place":["G\u00f6ttingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarie","family":"Uhlig","sequence":"additional","affiliation":[{"name":"Department of Urology, University Medical Center G\u00f6ttingen","place":["G\u00f6ttingen, Germany"]},{"name":"Department of Urology, University Hospital T\u00fcbingen","place":["T\u00fcbingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Rieken","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center 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