Review Article

Combination with Stereotactic Body Radiotherapy Offers a Promising Strategy to Overcome Resistance to Immunotherapy in Advanced Renal Cell Cancer

Table 2

SBRT is effective in primary lesions and metastases of advance RCC.

Study typeNo. of patients/lesionsSBRT targetSBRT regimenLocal controlOSAE (≥Grade 3)Ref

Retrospective study50 lesionsBone metastasisMost common is 27 Gy/3fRates at 12 and 24 months were both 74.9%NAGrade 3 AE: 1 patient, dermatitisAmini et al. [35]
Retrospective study36 lesionsThoracic, abdominal, and soft-tissue lesionsMost common is 50 Gy/5fRates at 12, 24, and 36 months were 100%, 93.41%, and 93.41%, respectivelyMedian OS about 32 monthsGrade 3 AE: 1 patient, mucositisAltoos et al. [36]
Retrospective study27 pts/37 lesionsLung metastasisMedian SBRT dose and fraction were 50 Gy (range 25–60) and 3 (range 1–6)92.3% for median follow-up 16 monthsNA0Altoos et al. [37]
Retrospective study57 pts/88 lesionsSpinal metastasesSingle fraction, median 15 GyMedian 26 months8.3 months (1.5–38)0Balagamwala et al. [38]
Prospective phase I trial12 ptsPrimary renal lesions25 Gy, 30 Gy, or 35 Gy in 5 fractionsNA6.7 months (1.5–16.4)Grade 3 AE: 3 patients, fatigue (2) and bone pain (1)Correa et al. [39]
Retrospective study9 ptsBilateral primary renal lesions60–85 Gy was delivered at 5–7 Gy/fractionRates at 1, 3, and 5 years were 64.8, 43.2, and 43.2%, respectivelyRates at 1, 3, and 5 years were 66.7, 53.3, and 35.6%, respectively0Wang et al. [40]
Prospective phase I trial15 ptsPrimary renal lesions24–48 Gy/4f100% for median follow-up 13.67 monthsEstimated 3-year OS post-treatment was 72%, 95% CI (0.44–0.87)Grade 4 AE: 1 patient (5.3%) with duodenal ulcer possibly treatment-relatedPonsky et al. [41]
Prospective study37 ptsPrimary renal lesions26 Gy/1f for tumors <5 cm and 42 Gy/3f for tumors ≥5 cmRates at 2 years was 100%Rates at 2 years were 92%Grade 3 AE: 1 patient (3%).Siva et al. [42]
Retrospective study21 ptsPrimary renal lesions48 Gy/3fRates at 1 year and 2 years were 92 and 84%, respectivelyRates at 1 year and 2 years were both 95%0Kaplan et al. [43]
Retrospective study32 pts/52 lesionsBrain metastasis22.0 Gy (range, 12.8–24.0 Gy)NA6.3 months (0.4–100.4 months)NAShah et al. [44]
Retrospective study16 pts/99 lesionsBrain metastasis (≥5)SRS91% of targets50% after 6 months and 31% after 1 yearNAMohammadi et al. [45]
Retrospective study81 pts/117 lesionsBrain metastasis (from melanoma or renal cancer)18 Gy (range 15–20 Gy)Rate at 1 year was 79.4% for renal cancerRates at 6 months and 1 year were 55.4% and 30.2%, respectivelyNAFeng and Lemons et al.
Retrospective study15 ptsBrain metastasisSRSNA8.4 monthsNAFeng et al. [46]
Retrospective study18 pts/39 lesionsOligometastatic renal cancer (extracranial)8–14 Gy  3 fractions or 4–5 Gy  10 fractionsRate at 2 years was 91.4%2 years was 85%NARanck et al. [47]
Retrospective study84 pts/175 lesionsExtracranial metastasis(40–60 Gy/5f or 30–54 Gy/3f or 20-40 Gy/1f1-year LC rate was 91.2%NAGrade 3 events: 8 patients (4.6%).Wang et al. [48]
Retrospective study48 patients/70 lesionsSpinal metastasesNARate at 21 months was 72%66 months (CI95% 54–79)NASerrand et al. [49]

NA: not available; pts: patients; OS: overall survival; AE: adverse effect; SRS: stereotactic radiosurgery.