Stereotactic Ablative Radiation for Renal Tumors
Stereotactic ablative radiotherapy is emerging as a widely accepted treatment option for a growing number of patients with renal tumors, including primary renal cell carcinoma, central nervous system (CNS) renal cell carcinoma metastases, as well as extracranial oligometastases. Raquibul Hannan, MD, PhD, a radiation oncologist at The University of Texas Southwestern Medical Center, Dallas, reviewed the emerging data on the use of this technique as an alternative to invasive approaches in the Kidney Cancer Journal.
A consensus is emerging around stereotactic ablative radiotherapy for an array of renal cell tumors at multiple stages, Dr. Hannan reported. The significant advantage of this type of definitive radiotherapy is its ability to deliver a high and ablative dose of radiation to the tumor while minimizing the dose to adjacent normal tissues, in cases previously thought to be radioresistant.
Renal tumors consistently show a very high (> 85%) rate of local control in these settings after treatment with stereotactic ablative radiotherapy, stated Dr. Hannan. But appropriate dose selection is the pivotal factor in optimizing the effectiveness of this treatment.
Although the potential for local control of renal tumors with stereotactic ablative radiotherapy has been established, the treatment’s impact on progression-free and overall survival is not yet known. Thus, there is a real need for prospective clinical trials in this setting to establish clear guidelines for the optimal dose in controlling renal cell carcinoma and careful selection of patients for the technique.