Adjuvant radiation or systemic therapy for renal cell carcinoma: A brief review

Several clinical trials have been performed in which radiation therapy or systemic therapy have been given to patients in an attempt to reduce relapse following nephrectomy for renal cell carcinoma. Since only randomized trials can give valid information about the value of adjuvant therapy as compared with surgery alone, this short review evaluates critically the randomized trials that have been performed. Four randomized trials of radiation therapy given pre- or postoperatively suggest an overall detrimental effect on survival because of toxicity. Randomized trials of medroxyprogesterone acetate and of interferon-α have shown no benefit. There is current interest in the potential benefit of adjuvant treatment with other biological modifiers such as interleukin-2, but adjuvant therapy of any type should only be given in the context of a well-designed, randomized clinical trial.