The Landscape of Stereotactic Ablative Radiotherapy (SABR) for Renal Cell Cancer (RCC)

Renal cell cancer (RCC) has traditionally been considered radioresistant. Because of this, conventional radiotherapy (RT) has been predominantly relegated to the palliation of symptomatic metastatic disease. The implementation of stereotactic ablative radiotherapy (SABR) has made it possible to deli...

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Bibliographic Details
Published in:Cancers 2024-07, Vol.16 (15), p.2678
Main Authors: Moreno-Olmedo, Elena, Sabharwal, Ami, Das, Prantik, Dallas, Nicola, Ford, Daniel, Perna, Carla, Camilleri, Philip
Format: Article
Language:English
Subjects:
Ablation
Cancer therapies
Clinical trials
Cryotherapy
Dialysis
Hemodialysis
Immunogenicity
Invasiveness
Kidney cancer
Metastases
Metastasis
Oncology
Palliation
Patients
Radiation therapy
Radioresistance
Radiosurgery
Renal function
Surgery
Surgical outcomes
Toxicity
Tumors
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Summary:Renal cell cancer (RCC) has traditionally been considered radioresistant. Because of this, conventional radiotherapy (RT) has been predominantly relegated to the palliation of symptomatic metastatic disease. The implementation of stereotactic ablative radiotherapy (SABR) has made it possible to deliver higher ablative doses safely, shifting the renal radioresistance paradigm. SABR has increasingly been adopted into the multidisciplinary framework for the treatment of locally recurrent, oligoprogressive, and oligometastatic disease. Furthermore, there is growing evidence of SABR as a non-invasive definitive therapy in patients with primary RCC who are medically inoperable or who decline surgery, unsuited to invasive ablation (surgery or percutaneous techniques), or at high-risk of requiring post-operative dialysis. Encouraging outcomes have even been reported in cases of solitary kidney or pre-existing chronic disease (poor eGFR), with a high likelihood of preserving renal function. A review of clinical evidence supporting the use of ablative radiotherapy (SABR) in primary, recurrent, and metastatic RCC has been conducted. Given the potential immunogenic effect of the high RT doses, we also explore emerging opportunities to combine SABR with systemic treatments. In addition, we explore future directions and ongoing clinical trials in the evolving landscape of this disease.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers16152678