Table 1.
Comparison of conventional RT and SBRT in RCC
| Characteristic | Conventional RT | SBRT |
|---|---|---|
| Total radiation dose | 45–50 Gy | 30–45 Gy |
| Dose per fraction | 1.8–2 Gy | 6–12 Gy |
| No. fractions | 25–30 | 3–5 |
| Total treatment duration | 5–6 weeks | 1–2 weeks |
| Treatment time per fraction | 5–10 minutes | 15–45 minutes |
| Maximum dose in tumour | 95–105% of prescription dose | 100–140% of prescription dose |
| Image guidance used | Occasionally | Routinely |
| Indications | ||
| Primary RCC | Minimal | Emerging |
| Adjuvant therapy | Uncommon, no survival benefit | Not studied |
| Neoadjuvant/pre-surgical therapy | None | Possible |
| Metastatic disease | Palliative | Radical (oligometastases) |
| Limitations | ||
| Technical | Inability to dose escalate due to bowel/kidney tolerance | Challenging when in close proximity to GI structures |
| Outcomes | No survival benefit in adjuvant setting | Although good local control in primary setting, need long term follow-up |
RT: radiotherapy; SBRT: stereotactic body radiotherapy; RCC: renal cell carcinoma; Gy: Gray