Stereotactic body radiotherapy (SBRT) in combination with drugs in metastatic kidney cancer: A systematic review

•Tyrosine Kinases Inhibitors were used in combination with SBRT in 93% of cases.•Radiotherapy schedules of single fraction doses were 10–20 Gy.•Radiotherapy schedules of hypofractionated doses were 35–60 Gy in 3–5 fractions.•Local control of irradiated lesions was achieved in 76–100% of the patients.•The 2-year overall survival was 71% after combined approach. To conduct a systematic review and meta-analysis of the role of SBRTdrug combination in patients affected by mRCC and associated oncologic outcomes and toxicity profiles. We performed a critical review of the Pubmed, Medline, and Embase databases from January 1, 2000 through April 30, 2020 according to the Preferred Reporting Items and Meta-Analyses statement. To assess the overall quality of the literature reviewed, we used a modified Delphi tool. A total of 6 studies were included, corresponding to a cohort of 216 patients. Tyrosine Kinases Inhibitors were the most widely used drugs in combination with SBRT, being administered in 93% patients. No study reported an increase of radiation-induced toxicity. SBRT resulted to be safe, without increase in terms of drugs-related adverse events in this setting. Moreover, this approach showed promising clinical outcomes in terms of LC and OS