Overview
Primary renal cell carcinoma (RCC) is a malignancy arising from the renal parenchyma. Surgery is the standard of care for most patients with primary RCC 1. Stereotactic body radiotherapy (SBRT) is an emerging alternative for select patient groups 1.Diagnosis
No diagnostic criteria, tests, or grading information were provided in the abstracts.Management
Surgery is the standard of care for primary RCC 1.
Stereotactic body radiotherapy (SBRT) is an alternative for patients who are medically inoperable, technically high risk, or decline surgery 1.
For SBRT, optimal dose fractionation is 25-26 Gy in one fraction, or 42-48 Gy in three fractions for larger tumors 1.
Routine post-treatment biopsy after SBRT is not recommended as it is not predictive of patient outcome 1.
SBRT for primary RCC in a solitary kidney is considered safe and effective 1.Special Populations
SBRT for primary RCC in a solitary kidney is safe and effective 1.Key Recommendations
Surgery is the standard of care for primary renal cell carcinoma 1. (Evidence: Expert opinion)
Stereotactic body radiotherapy (SBRT) is a novel alternative for patients who are medically inoperable, technically high risk, or who decline surgery 1. (Evidence: Moderate)
For SBRT, optimal dose fractionation is 25-26 Gy in one fraction, or 42-48 Gy in three fractions for larger tumors 1. (Evidence: Moderate)
Routine post-treatment biopsy after SBRT is not recommended 1. (Evidence: Moderate)
SBRT for primary renal cell carcinoma in a solitary kidney is safe and effective 1. (Evidence: Moderate)
Post-treatment follow-up for SBRT should include cross-axial imaging of the abdomen including both kidneys and adrenals, and chest surveillance initially every 6 months 1. (Evidence: Expert opinion)References
1 Siva S, Louie AV, Kotecha R, Barber MN, Ali M, Zhang Z et al.. Stereotactic body radiotherapy for primary renal cell carcinoma: a systematic review and practice guideline from the International Society of Stereotactic Radiosurgery (ISRS). The Lancet. Oncology 2024. link00513-2)