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Stereotactic Body Radiation Therapy for Primary Renal Cell Carcinoma: A Case-Based Radiosurgery Society Practice
Andrew B Barbour1, Rituraj Upadhyay2, August C Anderson1
1Department of Radiation Oncology, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington.
Practical Radiation Oncology
|July 17, 2024
Summary
Stereotactic body radiation therapy (SBRT) offers high local control for primary renal cell carcinoma (RCC). This guide provides practical considerations for SBRT in RCC, addressing challenging cases and patient-specific factors.
Area of Science:
- Oncology
- Radiation Oncology
- Nephrology
Background:
- Renal cell carcinoma (RCC) was historically considered radioresistant, limiting radiation therapy options.
- Recent studies show stereotactic body radiation therapy (SBRT) achieves high local control rates for primary RCC.
- Expanding SBRT use necessitates practical guidance for its application in RCC treatment.
Purpose of the Study:
- To provide a practical, case-based framework for delivering SBRT to primary RCC.
- To address key considerations including patient selection, fractionation, and target delineation.
- To offer guidance for challenging scenarios like solitary kidneys, bulky tumors, and tumor thrombus.
Main Methods:
- Review of existing evidence and expert opinion on SBRT for primary RCC.
- Case-based examples illustrating practical application of SBRT.
- Exploration of specific topics: tumor size, dose fractionation, renal function, solitary kidney management, and tumor thrombus treatment.
Main Results:
- SBRT demonstrates efficacy in achieving local control for primary RCC.
- Guidance is provided for optimizing SBRT in complex patient populations.
- Advanced techniques and response assessment for SBRT in RCC are discussed.
Conclusions:
- SBRT is a viable and effective treatment option for primary renal cell carcinoma.
- This guide offers practical recommendations for SBRT delivery, particularly in challenging cases.
- Further research and consensus are needed to refine SBRT protocols for RCC.
