94Radiotherapy dose fractionation Third edition
There are limited indications for radiotherapy in renal cancer, apart from the treatment of
bone and brain metastases, which are covered in the relevant sections of this document
(sections 18 and 19).
It has no role in neoadjuvant or primary treatment.
Adjuvant radiotherapy
Adjuvant radiotherapy is not currently recommended.
There is evidence (Grade C) of improvement in local control when radiotherapy is given
adjuvantly postoperatively in high-risk patients with T3 localised tumours using doses of
41.4–63 Gray (Gy) in 1.8–2 Gy fractions.
1–6
Stereotactic body radiotherapy (SBRT) has been used for highly selected patients with
localised primary tumours (>T1a) who are not able to have surgery. Doses of 40–45 Gy in
ve fractions have been used (Grade C).
1
This is not recommended outside clinical trials
atpresent.
7
Palliative radiotherapy
Palliative radiotherapy may be considered for persistent haematuria or pain from large soft
tissue masses. Single doses of 8–10 Gy in poor performance status patients (Grade D)
for haematuria and 30 Gy in ten fractions for soft tissue masses and pain (Grade D) may
beused.
1
13.
Renal cancer
95Radiotherapy dose fractionation Third edition
1. www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009
(last accessed 30/9/16)
2. Ulutin HC, Aksu G, Fayda M, Kuzhan O, Tahmaz L, Beyzadeoglu M. The value of postoperative
radiotherapy in renal cell carcinoma: a single-institution experience. Tumori 2006; 92(3): 202–206.
3. Stein M, Kuten A, Halpern J, Coachman NM, Cohen Y, Robinson E. The value of postoperative
irradiation in renal cell cancer. Radiother Oncol 1992; 24(1): 41–44.
4. Scherer E, Wirtz C. The role of postoperative radiotherapy in the treatment of hypernephroid
carcinoma. Strahlenther Onkol 1988; 164(7): 371–385.
5. Kao GD, Malkowicz SB, Whittington R, D’Amico AV, Wein AJ. Locally advanced renal carcinoma: low
complication rate and ecacy of postnephrectomy radiation therapy planned with CT. Radiology 1994;
193(3): 725–730.
6. Makarewicz R, Zarzycka M, Kulińska G, Windorbska W. The value of postoperative radiotherapy in
advanced renal cell cancer. Neoplasma 1998; 45(6): 380–383.
7. Kirkbride T, Cooper T. Stereotactic body radiotherapy. Guidelines for commissioners, providers and
clinicians: a national report. Clin Oncol (R Coll Radiol) 2011; 23(3): 163–164
References
