Renal-cell carcinoma is considered to be a radioresistant tumour, but this notion might be wrong.
If given in a few (even single) fractions, but at a high fraction dose, stereotactic body radiotherapy becomes increasingly important in the management of renal-cell carcinoma, both in primary settings and in treatment of oligometastatic disease. There is an established biological rationale for the radiosensitivity of renal-cell carcinoma to stereotactic body radiotherapy based on the ceramide pathway, which is activated only when a high dose per fraction is given. Apart from the direct effect of stereotactic body radiotherapy on renal-cell carcinoma, stereotactic body radiotherapy can also induce an abscopal effect. This effect, caused by immunological processes, might be enhanced when targeted drugs and stereotactic body radiotherapy are combined. Therefore, rigorous, prospective randomised trials involving a multidisciplinary scientific panel are needed urgently.
Written by:
De Meerleer G, Khoo V, Escudier B, Joniau S, Bossi A, Ost P, Briganti A, Fonteyne V, Van Vulpen M, Lumen N, Spahn M, Mareel M. Are you the author?
Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium; 2Department of Clinical Oncology, Royal Marsden NHS Foundation Trust, London, UK; Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France; Department of Urology, University Hospitals Leuven, Belgium; Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France; Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium; Department of Urology, Vita-Salute University San Raffaele, Milan, Italy; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands; Department of Urology, Ghent University Hospital, Ghent, Belgium; Department of Urology, University Hospital Bern, Bern, Switzerland.
Reference: Lancet Oncol. 2014 Apr;15(4):e170-7.
doi: 10.1016/S1470-2045(13)70569-2
PubMed Abstract
PMID: 24694640
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