Would you consider local therapy (e.g. XRT) in patients with mRCC with oligometastatic disease progression?

If current systemic treatment is otherwise controlling the disease and is well-tolerated, is there value to locally aggressive therapy in an attempt to preserve future treatment options?

1 Answer

Mednet Member

Medical Oncology · Cleveland Clinic

Answered on

This is a good question. The role of local therapy in mRCC should (in my opinion) be limited to 2 settings.

a) A patient with mRCC who is experiencing pain from a metastatic site.

b) A patient with an indolent disease course and overall low volume of metastatic disease in whom local therapy such as XRT/SBRT is done with the intention of cure. This is the more common setting for local therapy in mRCC.

The optimal patient for such an approach is a patient who underwent definitive surgery for local or locally advanced RCC and developed a new lung lesion a few years later. In this setting, SBRT can potentially render the patient disease free for an extended period of time. In a patient with aggressive, rapidly progressing mRCC the role of loc...

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