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Role of Radiation Therapy in Renal Cancer

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Renal Cancer

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Abstract

Renal cell cancer is an increasingly common tumor involving mostly adults. Surgical excision is the treatment of choice, and recently surgical innovation has resulted in excellent outcomes for nephron-sparing surgery. Energy-based ablative procedures are being increasingly explored as an alternative to surgery to minimize morbidity. Radiation therapy has had relatively little role in the management of patients with renal cell cancer until recently. Advances in the imaging, treatment planning, and treatment delivery have made radiation treatments safer now than ever before allowing for high-dose ablative radiation treatment. In advanced renal cell cancer, radiation therapy is playing a more prominent role in the management of extensive disease, in patients with poor overall condition, adjuvant to surgical or other ablative procedures, and in patients with metastatic disease.

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References

  1. Amendola BE, Wolf AL, Coy SR, Amendola M, Bloch L. Brain metastases in renal cell carcinoma: management with gamma knife radiosurgery. Cancer J. 2000;6:372–6.

    CAS  PubMed  Google Scholar 

  2. Atkins MB, Avigan DE, Bukowski RM, Childs RW, Dutcher JP, Eisen TG, et al. Innovations and challenges in renal cancer. Clin Cancer Res. 2004;10(18):6277S–81S.

    Article  PubMed  Google Scholar 

  3. Badalament RA, Kreutzer E, Cluck RW, Herr HW, Wong GY, Fair WR, et al. Surgical treatment of brain metastases from renal cell carcinoma. Urology. 1990;36(2):112–7.

    Article  CAS  PubMed  Google Scholar 

  4. Beitler JJ, Makara D, Silverman P, Lederman G. Definitive, high-dose-per-fraction, conformal, stereotactic external radiation for renal cell carcinoma. Am J Clin Oncol. 2004;27:646–8.

    Article  PubMed  Google Scholar 

  5. Bratherton D III. The place of radiotherapy in the treatment of hypernephroma. Br J Radiol. 1964;37(434):141.

    Article  CAS  PubMed  Google Scholar 

  6. Chakrabarty A, Hillman GG, Maughan RL, Ali E, Pontes JE, Haas GP. Radiation therapy enhances the therapeutic effect of immunotherapy on pulmonary metastases in a murine renal adenocarcinoma model. In Vivo. 1994;8:25–31.

    CAS  PubMed  Google Scholar 

  7. Chang EL, Shiu AS, Mendel E, Mathews LA, Mahajan A, Allen PK, et al. Phase I/II study of stereotactic body radiotherapy for spinal metastasis and its pattern of failure. J Neurosurg Spine. 2007;7:151–60.

    Article  PubMed  Google Scholar 

  8. Chiou RK, Vessella RL, Limas C, Shafer RB, Elson MK, Arfman EW, et al. Monoclonal antibody-targeted radiotherapy of renal cell carcinoma using a nude mouse model. Cancer. 1988;61(9):1766–75.

    Article  CAS  PubMed  Google Scholar 

  9. Correa RJM, Ahmad B, Warner A, Johnson C, Mackenzie MJ, Pautler SE, Bauman GS, Rodrigues GB, Louie AV. A prospective phase I dose-escalation trial of stereotactic ablative radiotherapy (SABR) as an alternative to cytoreductive nephrectomy for inoperable patients with metastatic renal cell carcinoma. Radiat Oncol. 2018;13:47. https://doi.org/10.1186/s13014-018-0992-3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Deschavanne PJ, Fertil B. A review of human cell radiosensitivity in vitro. Int J Radiat Oncol Biol Phys. 1996;34:251–66.

    Article  CAS  PubMed  Google Scholar 

  11. Dezso B, Haas GP, Hamzavi F, Kim S, Montecillo EJ, Benson PD, et al. The mechanism of local tumor irradiation combined with interleukin 2 therapy in murine renal carcinoma: histological evaluation of pulmonary metastases. Clin Cancer Res. 1996;2:1543–52.

    CAS  PubMed  Google Scholar 

  12. Finney R. The value of radiotherapy in the treatment of hypernephroma-a clinical trial. Br J Urol. 1973;45:258–69.

    Article  CAS  PubMed  Google Scholar 

  13. Flocks R, Kadesky M. Malignant neoplasms of the kidney; an analysis of 353 patients followed five years or more. J Urol. 1958;79:196–201.

    Article  CAS  PubMed  Google Scholar 

  14. Formenti SC, Demaria S. Systemic effects of local radiotherapy. Lancet Oncol. 2009;10:718–26.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Frydenberg M, Gunderson L, Hahn G, Fieck J, Zincke H. Preoperative external beam radiotherapy followed by cytoreductive surgery and intraoperative radiotherapy for locally advanced primary or recurrent renal malignancies. J Urol. 1994;152:15–21.

    Article  CAS  PubMed  Google Scholar 

  16. Fuks Z, Kolesnick R. Engaging the vascular component of the tumor response. Cancer Cell. 2005;8:89–91.

    Article  CAS  PubMed  Google Scholar 

  17. Gerszten PC, Burton SA, Ozhasoglu C, Vogel WJ, Welch WC, Baar J, et al. Stereotactic radiosurgery for spinal metastases from renal cell carcinoma. J Neurosurg Spine. 2005;3:288–95.

    Article  PubMed  Google Scholar 

  18. Gez E, Libes M, Bar-Deroma R, Rubinov R, Stein M, Kuten A. Postoperative irradiation in localized renal cell carcinoma: the Rambam Medical Center experience. Tumori. 2002;88:500–2.

    Article  PubMed  Google Scholar 

  19. Goyal LK, Suh JH, Reddy CA, Barnett GH. The role of whole brain radiotherapy and stereotactic radiosurgery on brain metastases from renal cell carcinoma. Int J Radiat Oncol Biol Phys. 2000;47:1007–12.

    Article  CAS  PubMed  Google Scholar 

  20. Halperin EC, Harisiadis L. The role of radiation therapy in the management of metastatic renal cell carcinoma. Cancer. 1983;51:614–7.

    Article  CAS  PubMed  Google Scholar 

  21. Haque W, Verma V, Lewis GD, Lo SS, Butler EB, Teh BS. Utilization of radiotherapy and stereotactic body radiation therapy for renal cell cancer in the USA. Future Oncol. 2018;14:819–27.

    Article  CAS  PubMed  Google Scholar 

  22. Hui Z, Tretiakova M, Zhang Z, Li Y, Wang X, Zhu JX, Gao Y, Mai W, Furge K, Qian CN, Amato R, Butler EB, Teh BT, Teh BS. Radiosensitization by inhibiting STAT1 in renal cell carcinoma. Int J Radiat Oncol Biol Phys. 2009;73:288–95.

    Article  CAS  PubMed  Google Scholar 

  23. Ikushima H, Tokuuye K, Sumi M, Kagami Y, Murayama S, Ikeda H, et al. Fractionated stereotactic radiotherapy of brain metastases from renal cell carcinoma. Int J Radiat Oncol Biol Phys. 2000;48:1389–93.

    Article  CAS  PubMed  Google Scholar 

  24. Juusela H, Malmio K, Alfthan O, Oravisto K. Preoperative irradiation in the treatment of renal adenocarcinoma. Scand J Urol Nephrol. 1977;11:277–81.

    Article  CAS  PubMed  Google Scholar 

  25. Kao GD, Malkowicz SB, Whittington R, D’Amico AV, Wein AJ. Locally advanced renal cell carcinoma: low complication rate and efficacy of postnephrectomy radiation therapy planned with CT. Radiology. 1994;193:725–30.

    Article  CAS  PubMed  Google Scholar 

  26. Kim WH, Kim DG, Han JH, Paek SH, Chung HT, Park CK, Kim CY, Kim YH, Kim JW, Jung HW. Early significant tumor volume reduction after radiosurgery in brain metastases from renal cell carcinoma results in long-term survival. Int J Radiat Oncol Biol Phys. 2012;82:1749–55.

    Article  PubMed  Google Scholar 

  27. Kjaer M, Frederiksen PL, Engelholm S. Postoperative radiotherapy in stage II and III renal adenocarcinoma. A randomized trial by the Copenhagen Renal Cancer Study Group. Int J Radiat Oncol Biol Phys. 1987;13:665–72.

    Article  CAS  PubMed  Google Scholar 

  28. Krengli M, Calvo FA, Terrone C, Haddock MG, Hannoun-Levi JM, Thariat J, et al. Genitourinary cancer. In: Gunderson L, editor. Intraoperative irradiation: techniques and results. Totowa: Springer Science+Business Media; 2011. p. 459–79.

    Chapter  Google Scholar 

  29. Lam JS, Shvarts O, Pantuck AJ. Changing concepts in the surgical management of renal cell carcinoma. Eur Urol. 2004;45:692–705.

    Article  PubMed  Google Scholar 

  30. Leith JT, Cook S, Chougule P, Calabresi P, Wahlberg L, Lindquist C, et al. Intrinsic and extrinsic characteristics of human tumors relevant to radiosurgery: comparative cellular radiosensitivity and hypoxic percentages. Acta Neurochir Suppl. 1994;62:18–27.

    Article  CAS  PubMed  Google Scholar 

  31. Makarewicz R, Zarzycka M, Kulińska G, Windorbska W. The value of postoperative radiotherapy in advanced renal cell cancer. Neoplasma. 1998;45:380.

    CAS  PubMed  Google Scholar 

  32. Master VA, Gottschalk AR, Kane C, Carroll PR. Management of isolated renal fossa recurrence following radical nephrectomy. J Urol. 2005;174:473–7.

    Article  PubMed  Google Scholar 

  33. Meyer E, Pasquier D, Bernadou G, et al. Stereotactic radiation therapy in the strategy of treatment of metastatic renal cell carcinoma: a study of the Getug group. Eur J Cancer. 2018;98:38–47.

    Article  PubMed  Google Scholar 

  34. Michalski JM. Kidney, renal pelvis, and ureter. In: Perez C, Brady LW, Halperin EC, Schmidt-Ullrich RK, editors. Principles and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2008.

    Google Scholar 

  35. Miller JA, Balagamwala EH, Angelov L, Suh JH, Rini B, Garcia JA, Ahluwalia M, Chao ST. Spine stereotactic radiosurgery with concurrent tyrosine kinase inhibitors for metastatic renal cell carcinoma. J Neurosurg Spine. 2016;25:766–74.

    Article  PubMed  Google Scholar 

  36. Nias A. Radiobiological aspects of preoperative irradiation. Br J Radiol. 1967;40:166–9.

    Article  CAS  PubMed  Google Scholar 

  37. Novick AC. Advances in the management of localized renal cell cancer. Can J Urol. 2000;7(2):960–6.

    CAS  PubMed  Google Scholar 

  38. Onufrey V, Mohiuddin M. Radiation therapy in the treatment of metastatic renal cell carcinoma. Int J Radiat Oncol Biol Phys. 1985;11:2007–9.

    Article  CAS  PubMed  Google Scholar 

  39. Otto U, Huland H, Baisch H, Klöppel G. Transplantation of human renal cell carcinoma into NMRI nu/nu mice. III. Effect of irradiation on tumor acceptance and tumor growth. J Urol. 1985;134:170–4.

    Article  CAS  PubMed  Google Scholar 

  40. Paly JJ, Hallemeier CL, Biggs PJ, et al. Outcomes in a multi-institutional cohort of patients treated with intraoperative radiation therapy for advanced or recurrent renal cell carcinoma. Int J Radiat Oncol Biol Phys. 2014;88:618–23.

    Article  PubMed  Google Scholar 

  41. Payne BR, Prasad D, Szeifert G, Steiner M, Steiner L. Gamma surgery for intracranial metastases from renal cell carcinoma. J Neurosurg. 2000;92:760–5.

    Article  CAS  PubMed  Google Scholar 

  42. Psutka SP, Master VA. Role of metastasis-directed treatment in kidney cancer. Cancer. 2018;124:3641. https://doi.org/10.1002/cncr.31341.

    Article  PubMed  Google Scholar 

  43. Rabinovitch RA, Zelefsky MJ, Gaynor JJ, Fuks Z. Patterns of failure following surgical resection of renal cell carcinoma: implications for adjuvant local and systemic therapy. J Clin Oncol. 1994;12:206–12.

    Article  CAS  PubMed  Google Scholar 

  44. Rafla S. Renal cell carcinoma. Natural history and results of treatment. Cancer. 1970;25:26–40.

    Article  CAS  PubMed  Google Scholar 

  45. Ranck MC, Golden DW, Corbin KS, Hasselle MD, Liauw SL, Stadler WM, Hahn OM, Weichselbaum RR, Salama JK. Stereotactic body radiotherapy for the treatment of oligometastatic renal cell carcinoma. Am J Clin Oncol. 2013;36:589–95.

    Article  CAS  PubMed  Google Scholar 

  46. Riches E. The place of irradiation. JAMA. 1968;204(3):230–1.

    Article  CAS  PubMed  Google Scholar 

  47. Riches E, Griffiths I, Thackray A. New growths of the kidney and ureter. Br J Urol. 1951;23:297–356.

    Article  CAS  PubMed  Google Scholar 

  48. Rost A, Brosig W. Preoperative irradiation of renal cell carcinoma. Urology. 1977;10:414–7.

    Article  CAS  PubMed  Google Scholar 

  49. Sheehan JP, Sun MH, Kondziolka D, Flickinger J, Lunsford LD. Radiosurgery in patients with renal cell carcinoma metastasis to the brain: long-term outcomes and prognostic factors influencing survival and local tumor control. J Neurosurg. 2003;98:342–9.

    Article  PubMed  Google Scholar 

  50. Siva S, Pham D, Gill S, Corcoran NM, Foroudi F. A systematic review of stereotactic radiotherapy ablation for primary renal cell carcinoma. BJU Int. 2012;110:E737. https://doi.org/10.1111/j.1464-410x.2012.11550.x.

    Article  PubMed  Google Scholar 

  51. Siva S, Ellis RJ, Ponsky L, et al. Consensus statement from the International Radiosurgery Oncology Consortium for Kidney for primary renal cell carcinoma. Future Oncol. 2016;12:637–45.

    Article  CAS  PubMed  Google Scholar 

  52. Siva S, Jackson P, Kron T, et al. Impact of stereotactic radiotherapy on kidney function in primary renal cell carcinoma: establishing a dose–response relationship. Radiother Oncol. 2016;118:540–6.

    Article  PubMed  Google Scholar 

  53. Siva S, Kothari G, Muacevic A, Louie AV, Slotman BJ, Teh BS, Lo SS. Radiotherapy for renal cell carcinoma: renaissance of an overlooked approach. Nat Rev Urol. 2017;14:549–63.

    Article  PubMed  Google Scholar 

  54. Siva S, Louie AV, Warner A, et al. Pooled analysis of stereotactic ablative radiotherapy for primary renal cell carcinoma: a report from the International Radiosurgery Oncology Consortium for Kidney (IROCK). Cancer. 2017;124:934–42.

    Article  PubMed  Google Scholar 

  55. Siva S, Pham D, Kron T, et al. Stereotactic ablative body radiotherapy for inoperable primary kidney cancer: a prospective clinical trial. BJU Int. 2017;120:623–30.

    Article  PubMed  Google Scholar 

  56. Smith BW, Joseph JR, Saadeh YS, Marca FL, Szerlip NJ, Schermerhorn TC, Spratt DE, Younge KC, Park P. Radiosurgery for treatment of renal cell metastases to spine: a systematic review of the literature. World Neurosurg. 2018;109:e502. https://doi.org/10.1016/j.wneu.2017.10.011.

    Article  PubMed  Google Scholar 

  57. Staehler M, Haseke N, Nuhn P, Tüllmann C, Karl A, Siebels M, et al. Simultaneous antiangiogenic therapy and single-fraction radiosurgery in clinically relevant metastases from renal cell carcinoma. BJU Int. 2011;108:673–8.

    PubMed  Google Scholar 

  58. Stein M, Kuten A, Halpern J, Coachman NM, Cohen Y, Robinson E. The value of postoperative irradiation in renal cell cancer. Radiother Oncol. 1992;24:41–4.

    Article  CAS  PubMed  Google Scholar 

  59. Syljuåsen RG, Belldegrun A, Tso CL, Withers HR, McBride WH. Sensitization of renal carcinoma to radiation using alpha interferon (IFNA) gene transfection. Radiat Res. 1997;148:443–8.

    Article  PubMed  Google Scholar 

  60. Tunio M, Hashmi A, Rafi M. Need for a new trial to evaluate postoperative radiotherapy in renal cell carcinoma: a meta-analysis of randomized controlled trials. Ann Oncol. 2010;21:1839–45.

    Article  CAS  PubMed  Google Scholar 

  61. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02613819 (2017). Accessed 1 Aug 2018.

  62. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT03108703 (2017). Accessed 1 Aug 2018.

  63. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02855203 (2016). Accessed 1 Aug 2018.

  64. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02473536 (2015). Accessed 1 Aug 2018.

  65. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT01896271 (2016). Accessed 1 Aug 2018.

  66. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02334709 (2017). Accessed 1 Aug 2018.

  67. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02599779 (2016). Accessed 1 Aug 2018.

  68. US National Library of Medicine. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT03065179 (2016). Accessed 1 Aug 2018.

  69. Van der Werf-Messing B. Carcinoma of the kidney. Cancer. 1973;32:1056–61.

    Article  PubMed  Google Scholar 

  70. van der Werf-Messing B, van der Heul RO, Ledeboer RC. Renal cell carcinoma trial. Strahlentherapie [Sonderb]. 1981;76:169–75.

    Google Scholar 

  71. Verma J, Mahajan A. The role of radiation therapy in renal cell carcinoma. In: Lara Jr PN, Jonasch E, editors. Kidney cancer. Berlin, Heidelberg: Springer-Verlag; 2012. p. 163–70.

    Chapter  Google Scholar 

  72. Walsh L, Stanfield JL, Cho LC, Chang C, Forster K, Kabbani W, et al. Efficacy of ablative high-dose-per-fraction radiation for implanted human renal cell cancer in a nude mouse model. Eur Urol. 2006;50:795–800.

    Article  PubMed  Google Scholar 

  73. Wang CJ, Christie A, Lin M-H, et al. Safety and efficacy of stereotactic ablative radiation therapy for renal cell carcinoma extracranial metastases. Int J Radiat Oncol Biol Phys. 2017;98:91–100.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Wersäll PJ, Blomgren H, Lax I, Kälkner KM, Linder C, Lundell G, et al. Extracranial stereotactic radiotherapy for primary and metastatic renal cell carcinoma. Radiother Oncol. 2005;77:88–95.

    Article  PubMed  Google Scholar 

  75. Wolf KD, Rottey S, Vermaelen K, et al. Combined high dose radiation and pazopanib in metastatic renal cell carcinoma: a phase I dose escalation trial. Radiat Oncol. 2017;12:157. https://doi.org/10.1186/s13014-017-0893-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Wronski M, Arbit E, Russo P, Galicich JH. Surgical resection of brain metastases from renal cell carcinoma in 50 patients. Urology. 1996;47:187–93.

    Article  CAS  PubMed  Google Scholar 

  77. Wronski M, Maor MH, Davis BJ, Sawaya R, Levin VA. External radiation of brain metastases from renal carcinoma: a retrospective study of 119 patients from the MD Anderson Cancer Center. Int J Radiat Oncol Biol Phys. 1997;37:753–9.

    Article  CAS  PubMed  Google Scholar 

  78. Yamada Y, Bilsky MH, Lovelock DM, Venkatraman ES, Toner S, Johnson J, et al. High-dose, single-fraction image-guided intensity-modulated radiotherapy for metastatic spinal lesions. Int J Radiat Oncol Biol Phys. 2008;71:484–90.

    Article  PubMed  Google Scholar 

  79. Zelefsky MJ, Greco C, Motzer R, Magsanoc JM, Pei X, Lovelock M, Mechalakos J, Zatcky J, Fuks Z, Yamada Y. Tumor control outcomes after hypofractionated and single-dose stereotactic image-guided intensity-modulated radiotherapy for extracranial metastases from renal cell carcinoma. Int J Radiat Oncol Biol Phys. 2012;82:1744–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiation Oncology, Sophia Gordon Cancer Center, Lahey Clinic Medical Center, Burlington, MA, USA

    Andrea McKee & Arul Mahadevan

  2. Department of Radiation Oncology, Tufts University School of Medicine, Boston, MA, USA

    Timothy Walsh

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  1. Andrea McKee
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  2. Arul Mahadevan
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Correspondence to Andrea McKee .

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Editors and Affiliations

  1. Professor of Urology, Tufts University School of Medicine, Boston, MA, USA

    John A. Libertino

  2. Associate Professor of Urology, Tufts University School of Medicine, Boston, MA, USA

    Jason R. Gee

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McKee, A., Mahadevan, A., Walsh, T. (2020). Role of Radiation Therapy in Renal Cancer. In: Libertino, J., Gee, J. (eds) Renal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-24378-4_22

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