Pilosov Solomon Ilona, Rinott Mizrahi Gal, Klein Ilan, Dekel Yoram, Freifeld Yuval
Carmel Medical Center, Haifa 3436212, Israel.
Cancers (Basel). 2025 Feb 19;17(4):710. doi: 10.3390/cancers17040710.
The prognosis for untreated renal cell carcinoma (RCC) with inferior vena cava tumor thrombus (IVC TT) is poor, and the only curative treatment option is extirpative surgery. However, radical nephrectomy with IVC thrombectomy is associated with high rates of morbidity and mortality. Historically, RCC was considered radioresistant, but it appears to be sensitive to higher doses per fraction. Stereotactic body radiation therapy (SBRT), which delivers high ablative radiation doses to focal targets, has been shown to be an effective treatment option for both non-metastatic and metastatic RCC. Emerging data also suggest its role in the management of RCC with IVC TT. This article reviews the available evidence on the use of SBRT in RCC patients with IVC TT, considering its application as curative, palliative, and neoadjuvant therapy.
伴有下腔静脉瘤栓(IVC TT)的未治疗肾细胞癌(RCC)预后较差,唯一的治愈性治疗选择是根治性手术。然而,根治性肾切除术联合IVC血栓切除术的发病率和死亡率较高。从历史上看,RCC被认为对放疗耐药,但似乎对较高的分次剂量敏感。立体定向体部放射治疗(SBRT)可向局部靶区提供高消融辐射剂量,已被证明是治疗非转移性和转移性RCC的有效选择。新出现的数据也表明了其在伴有IVC TT的RCC治疗中的作用。本文回顾了关于SBRT用于伴有IVC TT的RCC患者的现有证据,考虑了其作为治愈性、姑息性和新辅助治疗的应用。