IROCK, do you?

Stereotactic body radiotherapy (SBRT) is an appealing treatment option for patients with inoperable renal cell carcinoma (RCC) because it’s noninvasive, as opposed to other ablative interventions. The IROCK consortium has published their experience with single-fraction SBRT in 118 patients. Because it is a pooled experience, the treatment wasn’t very standardized. The median dose was 25 Gy with a range of 14-26 Gy. Impressively, the rate of local tumor control was nearly 98% and of grade 3-4 toxicity was only 1% up to four years out. The authors also bring up several interesting findings from their multi(!)variable analysis such as better progression-free and cancer-specific survivals after single- versus multi-fraction treatment. SBRT as definitive treatment of RCC among poor surgical candidates (and in the metastatic setting) is still gaining traction, but this data certainly greases the wheels.