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Stereotactic Body Radiation Therapy: Noninvasive Alternative to Treating Oligometastatic Kidney Cancer?

By: Victoria Kuhr, BA
Posted: Tuesday, December 7, 2021

Stereotactic body radiation therapy (SBRT) appears to facilitate deferral of systemic therapy initiation as a noninvasive treatment option for patients with oligometastatic renal cell carcinoma, according to Chad Tang, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues. In addition, the researchers proposed that SBRT as monotherapy may reduce the level of toxicity experienced by patients compared with traditional radiation therapies. A detailed report of the study was published in The Lancet Oncology.

“We plan to continue studying this strategy on patients with slightly larger burdens of disease and to analyze biomarkers from these treated patients to improve our ability to select patients who benefit from this treatment,” said Dr. Tang in an MD Anderson press release.

The study enrolled 30 patients diagnosed with renal cell carcinoma from July 13, 2018, to September 18, 2020. All patients had five or fewer metastatic lesions, clear histology, a nephrectomy, and completed at least one round of radiotherapy with less than 7 days of unplanned breaks before enrollment. The study included an ethnically mixed group, with 24 men and 6 women. Patients were treated with SBRT to all lesions and refrained from systemic therapy.

CT-guided biopsies collected 3 months after treatment confirmed a reduction in tumor cell proliferation for eight patients, dropping from 15% before radiation therapy to 6% after treatment. At a median follow-up of 17·5 months, researchers found the median progression-free survival for patients was 22·7 months; the 1-year progression-free survival was 64%.

Of the 30 patients, 6 patients (20%) experienced a grade 2 or less adverse event, 2 patients experienced a grade 3 event (back pain and muscle weakness), and 1 patient experienced a grade 4 event (hyperglycemia). No treatment-related deaths were observed.

Disclosure: For full disclosures of the study authors, visit www.thelancet.com.



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