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Strahlentherapie und Onkologie

, Volume 192, Issue 12, pp 875–885 | Cite as

Stereotactic body radiotherapy for renal cell cancer and pancreatic cancer

Literature review and practice recommendations of the DEGRO Working Group on Stereotactic Radiotherapy
  • Cédric Panje
  • Nikolaus Andratschke
  • Thomas B. Brunner
  • Maximilian Niyazi
  • Matthias GuckenbergerEmail author
Review Article

Abstract

Purpose

This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a literature review and practice recommendations for stereotactic body radiotherapy (SBRT) of primary renal cell cancer and primary pancreatic cancer.

Methods

A literature search on SBRT for both renal cancer and pancreatic cancer was performed with focus on prospective trials and technical aspects for clinical implementation.

Results

Data on renal and pancreatic SBRT are limited, but show promising rates of local control for both treatment sites. For pancreatic cancer, fractionated SBRT should be preferred to single-dose treatment to reduce the risk of gastrointestinal toxicity. Motion-compensation strategies and image guidance are paramount for safe SBRT delivery in both tumor entities.

Conclusion

SBRT for renal cancer and pancreatic cancer have been successfully evaluated in phase I and phase II trials. Pancreatic SBRT should be practiced carefully and only within prospective protocols due to the risk of severe gastrointestinal toxicity. SBRT for primary renal cell cancer appears a viable option for medically inoperable patients but future research needs to better define patient selection criteria and the detailed practice of SBRT.

Keywords

Stereotactic body radiotherapy Pancreatic cancer Renal cell cancer Pancreatic SBRT Renal SBRT 

Körperstereotaxie beim Nierenzell- und Pankreaskarzinom

Literaturüberblick und Praxisempfehlungen der DEGRO‐Arbeitsgruppe „Stereotaktische Radiotherapie“

Zusammenfassung

Ziel

Die Arbeitsgruppe „Stereotaktische Radiotherapie“ der Deutschen Gesellschaft für Radioonkologie (DEGRO) legt eine Zusammenfassung der aktuellen Literatur und daraus resultierende Empfehlungen zur Durchführung der stereotaktischen Strahlentherapie (SBRT) beim Nierenzellkarzinom und beim Pankreaskarzinom vor.

Methoden

Es erfolgte eine Literaturrecherche zur Evidenz der SBRT beim Nierenzell- und Pankreaskarzinom, wobei der Schwerpunkt auf prospektive Studien und technische Aspekte für die klinische Umsetzung gelegt wurde.

Ergebnisse

Für die SBRT beim Pankreaskarzinom und Nierenzellkarzinom sind bisher nur wenige Studien veröffentlicht worden, die jedoch konsistent eine hohe Rate an lokaler Tumorkontrolle berichten. Für das Pankreaskarzinom sollten fraktionierte Schemata einer einzeitigen Stereotaxie bevorzugt werden, um die gastrointestinale Toxizität zu reduzieren. Für beide Tumorentitäten sind Strategien zur Bewegungskompensation und bildgeführte Strahlentherapie für die sichere Durchführung der Behandlung zwingend notwendig.

Schlussfolgerung

Die SBRT zur Behandlung des Pankreaskarzinoms und des Nierenzellkarzinoms ist erfolgreich in Phase-I/II-Studien durchgeführt worden. Pankreas-SBRT sollte aktuell nur in prospektiven Studienprotokollen praktiziert werden, da ein potentielles Risiko für schwerwiegende gastrointestinale Nebenwirkungen besteht. Für das Nierenzellkarzinom stellt die SBRT eine Behandlungsoption für inoperable Patienten dar, wobei insbesondere die optimale Patientenselektion und technische Aspekte in zukünftigen Studien untersucht werden sollten.

Schlüsselwörter

Körperstereotaxie Pankreaskarzinom Nierenzellkarzinom Pankreas-SBRT Nieren-SBRT 

Notes

Compliance with ethical guidelines

Conflict of interest

Cédric Panje, N. Andratschke, T.B. Brunner, M. Niyazi, and M. Guckenberger declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Cédric Panje
    • 1
  • Nikolaus Andratschke
    • 1
  • Thomas B. Brunner
    • 2
  • Maximilian Niyazi
    • 3
  • Matthias Guckenberger
    • 1
    Email author
  1. 1.Department of Radiation OncologyZurich University HospitalZurichSwitzerland
  2. 2.Department of Radiation OncologyFreiburg University HospitalFreiburgGermany
  3. 3.Department of Radiation OncologyUniversity of MunichMunichGermany

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