Context

Stereotactic ablative body radiotherapy (SABR) is an emerging treatment modality for primary and metastatic renal cell carcinoma (RCC).

Objective

To review and summarise the evidence on the use of SABR in RCC in a narrative review.

Evidence acquisition

We performed an online search of the PubMed database from January 2000 through December 2021. Studies of SABR/stereotactic radiosurgery (SRS) targeting primary, extracranial, or intracranial metastatic RCC were included.

Evidence synthesis

Two meta-analyses (including 54 studies), and 13 prospective and 20 retrospective studies were included in this review. In aggregate, SABR for 589 primary RCCs in 575 patients resulted in a local control rate of above 90% with grade 3–4 toxicity of 0–9%. Similarly, the local control rate ranged between 90% and 97% with SRS in 1225 patients with intracranial metastatic RCC. SABR was able to delay systemic therapy for at least 1 yr in 70–90% of oligometastatic RCC patients with grade 3–4 toxicity of <10%. As per the early data, the combination of SABR with systemic therapy for metastatic RCC, such as targeted therapy or immunotherapy, appears safe, feasible, and tolerable.

Conclusions

We outlined data supporting SABR in the key clinical scenarios of primary and metastatic, including oligometastatic, RCC in lieu of systemic therapy, in combination with systemic therapy, and palliation of brain and spinal metastases.

Patient summary

Stereotactic ablative body radiotherapy (SABR) is a relatively new treatment option in kidney cancer. Here, we review the published literature on the experience of using SABR in kidney cancer. The accumulated evidence demonstrates that SABR can be used safely and effectively to treat selected cases of primary or secondary kidney cancer.

中文翻译：

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立体定向消融体放疗在肾细胞癌中的作用

语境

立体定向消融体放疗 (SABR) 是一种新兴的治疗原发性和转移性肾细胞癌 (RCC) 的方法。

客观的

在叙述性综述中回顾和总结在 RCC 中使用 SABR 的证据。

取证

我们对 PubMed 数据库从 2000 年 1 月到 2021 年 12 月进行了在线搜索。包括针对原发性、颅外或颅内转移性 RCC 的 SABR/立体定向放射外科 (SRS) 研究。

证据综合

本综述纳入了两项荟萃分析（包括 54 项研究）以及 13 项前瞻性和 20 项回顾性研究。总的来说，SABR 对 575 名患者的 589 个原发性 RCC 产生了超过 90% 的局部控制率，3-4 级毒性为 0-9%。同样，在 1225 名颅内转移性 RCC 患者中，SRS 的局部控制率介于 90% 和 97% 之间。SABR 能够将 70-90% 的寡转移 RCC 患者的全身治疗延迟至少 1 年，且 3-4 级毒性 <10%。根据早期数据，SABR 联合全身治疗转移性 RCC，如靶向治疗或免疫治疗，似乎安全、可行且可耐受。

结论

我们概述了在原发性和转移性关键临床情况下支持 SABR 的数据，包括寡转移、RCC 代替全身治疗、与全身治疗相结合，以及脑和脊柱转移的姑息治疗。

患者总结

立体定向消融体放疗 (SABR) 是一种相对较新的肾癌治疗选择。在这里，我们回顾了有关在肾癌中使用 SABR 的经验的已发表文献。积累的证据表明，SABR 可以安全有效地用于治疗选定的原发性或继发性肾癌病例。