Stereotactic irradiation using a linear accelerator for brain metastasis from renal cell carcinoma

  • Kazuyuki Kawashima
  • Hiroki Shirato
  • Akira Takamura
  • Nobuo Shinohara
  • Yutaka Sawamura
  • Kazuo Miyasaka
Original Article



The role of stereotactic irradiation using a linear accelerator for brain metastasis from renal cell carcinoma was investigated.


Fifteen brain metastases in 11 patients with a history of renal cell carcinoma were treated using convergent narrow x-ray beams from a linear accelerator and rigid fixation of the head with a stereotactic frame. Twelve metastatic tumors in8 patients were irradiated with 25 Gy at the center in a single fraction, and single tumors in 3 patients received the following doses: 25 Gy in 5 fractions, 28 Gy in 3 fractions, or 35 Gy in 4 fractions


The actuarial local control rate at 12 months was 90.6%. Twelve (92%) of 13 lesions that produced neurologic symptoms before stereotactic irradiation showed an improvement of symptoms. No complication related to the irradiation was observed. The median survival time was 6 months.


Stereotactic irradiation is more effective in achieving local control than is conventional radiotherapy, and achieves improvement in symptoms and survival rates similar to those of surgical resection of the brain metastasis from renal cell carcinoma. Urologists and oncologists should be aware of the usefulness of stereotactic radiation in the management of patients with renal cell carcinoma.

Key words

stereotactic radiosurgery radiotherapy brain metastasis renal cell carcinoma 


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  1. 1.
    Leung SW, Mitchell JB, al-Nabulsi I, Friedman N, Newsome J, Belldegrun A, Kasid U. Effect of L-buthionine sulfoximine on the radiation response of human renal carcinoma cell lines. Cancer 1993;71:2276–2285.PubMedCrossRefGoogle Scholar
  2. 2.
    Jacobsen KD, Folleras G, Fossa SD. Metastases from renal cell carcinoma to the humerus or the shoulder girdle. Br J Urol 1994;73:124–128.PubMedCrossRefGoogle Scholar
  3. 3.
    Maor MH, Frias AE, Oswald MJ. Palliative radiotherapy for brain metastases in renal carcinoma. Cancer 1988;62:1912–1917.PubMedCrossRefGoogle Scholar
  4. 4.
    Halperin EC, Harisiadis L. The role of radiation therapy in the management of metastatic renal cell carcinoma. Cancer 1983;51:614–617.PubMedCrossRefGoogle Scholar
  5. 5.
    Auchter RM, Lamond JP, Alexander III E, Buatti JM, Chappell R, Friedman WA, Kinsella TJ, Levin AB, Levin AB, Noyes WR, Schults CJ, Loeffler JS, Mehta MP. A multi-institutional outcome and prognostic factor analysis of radiosurgery for resectable single brain metastasis. Int J Radiat Oncol Bio Phys 1996;35:27–35.CrossRefGoogle Scholar
  6. 6.
    Alexander ER, Moriarty TM, Davis RB, Wen PY, Fine HA, Black PM, Kooy HM, Loeffler JS. Stereotactic radiosurgery for the definitive, noninvasive treatment of brain metastases. J Natl Cancer Inst 1995;87:34–40.PubMedGoogle Scholar
  7. 7.
    Flickinger JC, Kondziolka D, Lunsford LD, Coffey RJ, Goodman ML, Shaw EG, Hudgins WR, Weiner R, Harsh GR, Sneed PK, Larson DA. A multi-institutional experience with stereotactic radiosurgery for solitary brain metastasis. Int J Radiat Oncol Bio Phys 1994;28:797–802.Google Scholar
  8. 8.
    Shirato H, isu T, Matsumura S, Terae S, Nanbu T, Suzuki K, Nishioka T, Shimizu T. Daily intermittent multiportal therapy followed by stereotactic boost (DIMT-SB) for treatment of small intracranial lesions-technical aspects and preliminary results. J Jpn Soc Ther Radiol Oncol 1992;4:149–162.Google Scholar
  9. 9.
    Shirato H, Takamura A, Tomita M, Suzuki K, Nishioka T, Isu T, Kato T, Sawamura Y, Miyamachi K, Abe H, Miyasaka K. Stereotactic irradiation without whole brain irradiation for single brain metastasis. Int J Radiat Oncol Bio Phys 1997;37:385–391.CrossRefGoogle Scholar
  10. 10.
    Fuller BG, Kaplan ID, Adler J, Cox RS, Bagshaw MA. Stereotaxic radiosurgery for brain metastasis: the importance of adjuvant whole brain irradiation. Int J Radiat Oncol Bio Phys 1992;23:413–418.Google Scholar
  11. 11.
    Seitz W, Karcher KH, Binder W. Radiotherapy of metastatic renal cell carcinoma. Sem Surg Oncol 1988;4:100–102.Google Scholar
  12. 12.
    Loeffler JS, Alexander III E. Radiosurgery for the treatment of intracranial metastasis. In: Loeffler JS, Alexander III E, Lunsford LD, eds Stereotactic radiosurgery. New York; McGraw-Hill, 1993:197–206.Google Scholar
  13. 13.
    Asai A, Matsutani M, Kohno T, Nakamura O, Tanaka H, Fujimaki T, Funada N, Matsuda T, Nagata K, Takakura K. Subacute brain atrophy after radiation therapy for malignant brain tumor. Cancer 1989;63:1962–1974.PubMedCrossRefGoogle Scholar

Copyright information

© JSCO/CLJ 1997

Authors and Affiliations

  • Kazuyuki Kawashima
    • 1
  • Hiroki Shirato
    • 1
  • Akira Takamura
    • 2
  • Nobuo Shinohara
    • 3
  • Yutaka Sawamura
    • 4
  • Kazuo Miyasaka
    • 1
  1. 1.Department of RadiologyHokkaido University School of MedicineSapporoJapan
  2. 2.Department of RadiologyAsahikawa Kousei HospitalHokkaidoJapan
  3. 3.Department of UrologyHokkaido University School of MedicineSapporoJapan
  4. 4.Department of NeurosurgeryHokkaido University School of MedicineSapporoJapan

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