The Landscape of Stereotactic Ablative Radiotherapy (SABR) for Renal Cell Cancer (RCC).
Elena Moreno-OlmedoAmi SabharwalPrantik DasNicola DallasDaniel FordCarla PernaPhilip CamilleriPublished in: Cancers (2024)
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.
Keyphrases
- locally advanced
- early stage
- minimally invasive
- squamous cell carcinoma
- single cell
- small cell lung cancer
- renal cell carcinoma
- radiation therapy
- clinical trial
- radiation induced
- papillary thyroid
- rectal cancer
- coronary artery bypass
- healthcare
- chronic kidney disease
- squamous cell
- primary care
- stem cells
- adipose tissue
- randomized controlled trial
- mesenchymal stem cells
- tyrosine kinase
- end stage renal disease
- skeletal muscle
- dna damage
- surgical site infection
- quality improvement
- lymph node metastasis
- bone marrow
- acute coronary syndrome
- current status
- atrial fibrillation
- dna repair
- phase ii
- climate change
- smoking cessation