Renal-Cell Carcinoma

To the Editor: The review of renal-cell carcinoma by Cohen and McGovern (Dec. 8 issue) 1 was extensive but did not discuss radiotherapy. As noted in the article, nearly half the patients with renal-cell carcinoma have metastatic disease on presentation or will have a recurrence. Conventional radiotherapy has been an effective palliative treatment for most sites of metastatic renal-cell carcinoma, including lung, bone, and soft tissues. 2 In particular, stereotactic radiosurgery has been reported to have local control rates for brain metastases of more than 85 percent. 3 Recently, stereotactic radiosurgery for spinal metastases has demonstrated high efficacy in pain relief with minimal . . .