AI Article Synopsis
- Renal-cell carcinoma may be more sensitive to high-dose stereotactic body radiotherapy than previously thought, challenging its classification as a radioresistant tumor.
- The ceramide pathway can be activated by high fraction doses, providing a biological basis for this increased radiosensitivity.
- Combining stereotactic body radiotherapy with targeted drugs may enhance immunological effects, necessitating urgent research through controlled trials.
Article Abstract
Renal-cell carcinoma is considered to be a radioresistant tumour, but this notion might be wrong. If given in a few (even single) fractions, but at a high fraction dose, stereotactic body radiotherapy becomes increasingly important in the management of renal-cell carcinoma, both in primary settings and in treatment of oligometastatic disease. There is an established biological rationale for the radiosensitivity of renal-cell carcinoma to stereotactic body radiotherapy based on the ceramide pathway, which is activated only when a high dose per fraction is given. Apart from the direct effect of stereotactic body radiotherapy on renal-cell carcinoma, stereotactic body radiotherapy can also induce an abscopal effect. This effect, caused by immunological processes, might be enhanced when targeted drugs and stereotactic body radiotherapy are combined. Therefore, rigorous, prospective randomised trials involving a multidisciplinary scientific panel are needed urgently.
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| http://dx.doi.org/10.1016/S1470-2045(13)70569-2 | DOI Listing |
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