Adding Stereotactic Radiation to the Multidisciplinary Armamentarium for Localized Renal Cell Carcinoma: Ready for Primetime?

Excerpt

Recent publications have highlighted the potential utility of stereotactic ablative body radiotherapy (SABR) in the management of localized^1,2 and metastatic^2,3 renal cell carcinoma, specifically for patients whose competing comorbidities, frailty, and/or baseline renal insufficiency preclude definitive conventional treatment. The Lancet Oncology recently published the report of Siva et al.⁴ detailing 5-year efficacy and safety results from a retrospective, multicenter review of 12 institutions across five countries performing SABR as primary treatment for nonmetastatic renal cell carcinoma (RCC). Most of the patients (83 %, 157/190) in the cohort underwent biopsy before treatment, and 23 (12 %) had a non-clear cell histology. With a median follow-up period of 5 years, this is the most mature follow-up evaluation reported for SABR as definitive therapy used to treat localized RCC to date. The primary end point was investigator-assessed local failure as per Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1. The secondary end points were treatment-related toxicity, patterns of failure, and change in renal function. …