Stereotactic Body Radiation Therapy for Primary Renal Cell Carcinoma: A Case-Based Radiosurgery Society Practice Guide

Andrew B. Barbour, Rituraj Upadhyay, August C. Anderson, Tugce Kutuk, Ritesh Kumar, Shang Jui Wang, Sarah P. Psutka, Fatemeh Fekrmandi, Karin A. Skalina, Anna M.E. Bruynzeel, Rohann J.M. Correa, Alan Dal Pra, Cesar Della Biancia, Raquibul Hannan, Alexander Louie, Anurag K. Singh, Anand Swaminath, Chad Tang, Bin S. Teh, Nicholas G. ZaorskySimon S. Lo, Shankar Siva

Research output: Contribution to journalArticlepeer-review

Abstract

Traditionally, renal cell carcinoma (RCC) was considered a radioresistant tumor, thereby limiting definitive radiation therapy management options. However, several recent studies have demonstrated that stereotactic body radiation therapy (SBRT) can achieve high rates of local control for the treatment of primary RCC. In the setting of expanding use of SBRT for primary RCC, it is crucial to provide guidance on practical considerations such as patient selection, fractionation, target delineation, and response assessment. This is particularly important in challenging scenarios where a paucity of evidence exists, such as in patients with a solitary kidney, bulky tumors, or tumor thrombus. The Radiosurgery Society endorses this case-based guide to provide a practical framework for delivering SBRT to primary RCC, exemplified by 3 cases. This article explores topics of tumor size and dose fractionation, impact on renal function and treatment in the setting of a solitary kidney, and radiation's role in the management of inferior vena cava tumor thrombus. Additionally, we review existing evidence and expert opinion on target delineation, advanced techniques such as magnetic resonance imaging guided SBRT, and SBRT response assessment.

Original languageEnglish (US)
JournalPractical Radiation Oncology
DOIs
StateAccepted/In press - 2024

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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