Stereotactic Body Radiation Therapy (SBRT) for Renal Cell Carcinoma with Inferior Vena Cava Tumor Thrombus

The prognosis for untreated renal cell carcinoma (RCC) with inferior vena cava tumor thrombus (IVC TT) is poor, and the only curative treatment option is extirpative surgery. However, radical nephrectomy with IVC thrombectomy is associated with high rates of morbidity and mortality. Historically, RCC was considered radioresistant, but it appears to be sensitive to higher doses per fraction. Stereotactic body radiation therapy (SBRT), which delivers high ablative radiation doses to focal targets, has been shown to be an effective treatment option for both non-metastatic and metastatic RCC. Emerging data also suggest its role in the management of RCC with IVC TT. This article reviews the available evidence on the use of SBRT in RCC patients with IVC TT, considering its application as curative, palliative, and neoadjuvant therapy.