Oligometastatic renal cell carcinoma: radiotherapy as a new standard of care?

[...]in a prospective analysis of 30 patients with 82 secondary renal cancer lesions, local control rate with SBRT was nearly 98%, with a median overall survival of 32 months.7 The number and size of metastatic lesions outside the field of radiation were shown to reduce due to the abscopal effect via an immune response and the secretion of antitumour and antiangiogenic factors. [...]with the delivery of high doses per fraction, SBRT was a minimally invasive and effective treatment for metastatic renal cell carcinoma.8 The integration of SBRT into the holistic management of patients with oligometastatic renal cell carcinoma might have a positive effect on the systemic control of the disease by postponing the introduction of systemic treatments. Of note, the study by Tang and colleagues2 showed that the median time between SBRT and systemic treatment initiation was extended in patients treated on all metastatic sites without changing patients’ survival outcome.9 In case of extracranial metastases from renal cell carcinoma, SBRT was associated with a 90% overall response rate with no major toxicity. [...]the study by Tang and colleagues2 shows that renal cell carcinoma can no longer be considered as radioresistant due to the biological effect of SBRT in oligometastic renal cell carcinoma.