Chen Zhe, Suzuki Toshihiro, Mochizuki Zennosuke, Takahashi Hiroshi, Marino Kan, Komiyama Takafumi, Onishi Hiroshi
Department of Radiology, University of Yamanashi Hospital, Chuo, Yamanashi, Japan.
CyberKnife Center, Kasugai General Rehabilitation Hospital, Fuefuki, Yamanashi, Japan.
Cancer Rep (Hoboken). 2025 May;8(5):e70229. doi: 10.1002/cnr2.70229.
Renal cell carcinoma (RCC) is the most common malignant tumor of the kidney in adults, with poor prognosis in advanced or metastatic stages. Although traditionally considered radioresistant, RCC has shown a promising response to stereotactic body radiation therapy (SBRT), which not only offers local tumor control but may also induce an abscopal effect, resulting in regression of distant metastases.
A 54-year-old male with a history of right RCC underwent radical nephrectomy in 2000, followed by partial nephrectomy for a left kidney recurrence in 2005. In 2011, imaging revealed a second recurrence in the left kidney. In 2013, after declining further surgery, he was treated with SBRT for the recurrent left renal lesion. Follow-up imaging revealed a stable renal mass and a solid right lung nodule. Retrospective analysis of prior imaging suggested the presence of pulmonary metastases concurrent with the renal recurrence. The pulmonary nodule progressively enlarged until November 2016 but then spontaneously regressed by November 2017 without any additional systemic or local interventions, and remained stably reduced in size thereafter. Serial imaging from 2018 showed no evidence of new metastatic disease, and the left renal lesion exhibited partial regression. The pulmonary metastasis remained stable, consistent with the occurrence of an abscopal effect that persisted for 3 years. The patient ultimately passed away in 2024 from unrelated causes.
This case demonstrates the potential of SBRT to induce a systemic abscopal response in metastatic RCC, with sustained control of pulmonary metastasis over 3 years. The findings suggest that SBRT may play a critical role in managing metastatic RCC, warranting further research into its synergy with immunotherapy for long-term therapeutic benefit.
肾细胞癌（RCC）是成人中最常见的肾脏恶性肿瘤，晚期或转移阶段预后较差。尽管传统上认为RCC具有放射抗性，但它对立体定向体部放射治疗（SBRT）显示出有前景的反应，SBRT不仅能实现局部肿瘤控制，还可能引发远隔效应，导致远处转移灶消退。
一名54岁男性，有右肾细胞癌病史，于2000年接受根治性肾切除术，2005年因左肾复发接受部分肾切除术。2011年，影像学检查显示左肾再次复发。2013年，在拒绝进一步手术后，他接受了SBRT治疗左肾复发病变。随访影像学检查显示肾肿块稳定，右肺有一个实性结节。对先前影像学检查的回顾性分析提示肺转移与肾复发同时存在。肺结节逐渐增大，直至2016年11月，但随后在2017年11月自行消退，未进行任何额外的全身或局部干预，此后一直稳定缩小。2018年的系列影像学检查未发现新的转移病灶证据，左肾病变部分消退。肺转移灶保持稳定，符合持续3年的远隔效应的发生情况。该患者最终于2024年因无关原因去世。
本病例证明了SBRT在转移性RCC中诱导全身远隔反应的潜力，对肺转移灶持续控制超过3年。这些发现表明SBRT可能在转移性RCC的管理中发挥关键作用，有必要进一步研究其与免疫疗法的协同作用以获得长期治疗益处。
