The emerging roles of stereotactic ablative radiotherapy for metastatic renal cell carcinoma

作者：Cheung Patrick^*; Thibault Isabelle; Bjamason Georg A

来源：Current Opinion in Supportive and Palliative Care, 2014, 8(3): 258-264.

DOI：10.1097/SPC.0000000000000074

• abscopal effect
• kidney cancer
• oligometastases
• oligoprogression
• stereotactic body radiotherapy

Purpose of review
To discuss the emerging roles of stereotactic ablative radiotherapy (SABR) in patients with metastatic renal cell carcinoma (RCC).
Recent findings
RCC tumours are not as radio-resistant as previously thought, as local control rates of tumours treated with SABR are high. Therefore, SABR is an attractive treatment option for RCC tumours in which effective long-term palliation of symptoms or local control is desired. Like surgical resection of metastatic tumours, SABR can also be used as a method of eradicating oligometastases to potentially 'cure' or offer prolonged disease-free survival in patients with low-volume metastatic disease. In patients who develop progression of a solitary or few tumours (termed oligoprogression), SABR to the progressing 'rogue' tumours may delay the need to start or change systemic therapy. Finally, there is the potential for SABR to improve the efficacy of immunotherapy for metastatic RCC, given the known immune-modulated abscopal effect of radiotherapy.
Summary
SABR is increasingly being used in metastatic RCC patients, given the great potential to improve various outcomes. More prospective clinical trials are needed to identify and quantify the clinical benefits.

• 出版日期2014-9