How SBRT Has Evolved Over the Decades to Manage Kidney Cancer

During the 2022 Society for Urologic Oncology (SUO) Annual Meeting, CancerNetwork^® spoke with Raquibul Hannan, MD, PhD, a professor in the Department of Radiation Oncology, Urology and Immunology at the University of Texas Southwestern Medical Center in Dallas about how the use of stereotactic radiation has been adapted for the treatment of patients with metastatic kidney cancer.

Hannan highlighted stereotactic radiation’s original purpose of managing brain and spinal metastases in the palliative setting before describing some of the challenges involved in delivering radiation doses to patients. He, however, said that using stereotactic radiation was a collaborative effort between urologists and neurosurgeons.

“[Stereotactic radiation] is always done in the multimodality setting where we work with the neurosurgeons, and if they’re able to resect, they will resect it first, and we come in with stereotactic radiation in the postoperative setting,” he said.

Transcript:

So, in the palliative setting, the brain metastases [are] actually where stereotactic radiation therapy originated. Back even as early as the late 90s and early 2000s, we have seen very good control rates. The control rates are close to 100% for some of these brain metastases. For spine metastasis, [it is] a little bit more challenging because the spinal cord is right there. And that limits our ability to deliver a high ablative radiation dose to give local control. But it's always done in the multimodality setting where we work with the neurosurgeons, and if they're able to resect, they will resect it first, and we come in with stereotactic radiation in the postoperative setting.