Kidney cancer Radiotherapy

Procedure

If the kidney cancer is confined to the kidney and has not yet spread, then surgery is the treatment method of first choice. If this is not possible or desirable, radiotherapy is a good alternative. Radiation therapy (also known as radiotherapy) is mainly used in kidney cancer when the kidney cancer has already spread in order to achieve local tumor control alone or together with medical oncology and sometimes to delay the start of systemic therapy. Radiotherapy can also prevent or alleviate symptoms caused by metastases, e.g. in the brain or bones(palliative radiotherapy).

Radiation therapy is performed as an outpatient treatment, is non-invasive (i.e. does not require anesthesia) and can thus be easily integrated into everyday private and professional life. Depending on the extent of the metastasis, radiotherapy can be carried out as radiosurgery in one or a few treatment sessions for small tumor foci, or as fractionated treatment over several weeks for larger metastases. Radiotherapy is often combined with targeted therapy or immunotherapy to improve its effectiveness. Close and personal support is a matter of course for us.

The Department of Radiation Oncology at the USZ uses only the most modern techniques for precise radiation with few side effects. They are supervised by internationally recognized experts in the research and treatment of kidney cancer.

For many patients, we are already offering the treatment of tomorrow: in clinical trials, we are continuously working to improve the treatment of kidney cancer in order to make it even more effective and tolerable. To the overview of currently open studies.

In the following, we will describe radiotherapy in different situations of kidney cancer.

Treatment of localized kidney cancer

Patients with localized kidney cancer for whom surgery is not suitable or desired have few treatment options, as the alternative of thermal ablation is less effective, especially for larger tumors (>4cm). Body stereotactic radiotherapy (SBRT) for larger renal cell carcinomas is an effective treatment option in this situation and is well tolerated with only minor effects on kidney function.

In the local treatment of kidney cancer, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator where possible. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.

Oligometastatic kidney cancer

If the kidney cancer has spread, i.e. metastasized, it was historically believed that a cure was no longer possible; consequently, patients were “only” treated with chemotherapy, targeted therapy or immunotherapy. Today we know that this has to be considered in a more differentiated way: if the kidney cancer has only formed a few metastases (maximum 3-5), then targeted therapy or immunotherapy can be supplemented by radiotherapy (or possibly surgery) of all cancer foci: The aim is not only to shrink the cancer, but to eliminate it completely. In a relevant proportion of patients, a cure or at least long-term tumor control can be achieved.

Body stereotactic radiotherapy (SBRT), a highly focused radiation treatment in just a few outpatient treatment sessions, is the best-studied local treatment method in the situation of oligometastasis. Body stereotactic radiation can combat metastases in almost all regions of the body highly effectively and with few side effects: metastases in lymph nodes, the lungs, the liver, the adrenal glands, in the brain and in bones. Tumor foci in distant regions can be treated in a single treatment session; unlike surgery, two separate procedures are not required. An optimal combination of local and systemic therapy is also important.

Oligometastatic kidney cancer is a clinical and scientific focus of Prof. Guckenberger and Dr. Kroeze’s clinic. They pass on our knowledge in a large number of international courses and congresses and are active as international experts. State-of-the-art equipment, such as the MRIdian, and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. Dr. H.I. Garcia and Prof. Guckenberger are responsible for the successful implementation of treatments with the MRIdian in our clinic.

In clinical trials, we are continuously working to improve the treatment of kidney cancer in order to make it even more effective and tolerable. To the overview of currently open trials.

Metastases of kidney cancer, e.g. in the brain or bones

Kidney cancer is an aggressive type of cancer that often forms metastases during the course of the disease: this is called metastasis. Common sites of metastasis are the lung, adrenal gland, bones, liver or brain. Radiotherapy is a highly effective method with few side effects to prevent or treat symptoms caused by metastases. This is usually done in combination with chemotherapy, immunotherapy or other targeted therapy. The smaller the metastases are and the earlier they are irradiated, the better the results. Today, metastases in the body can be treated in a focused manner in just a few effective radiation sessions.

For tumor foci in the abdominal area, e.g. liver or upper abdomen, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.

Today, brain metastases are treated at our center in most patients by means of a single high-dose radiation treatment: this is called radiosurgery.

Metastases at other locations in the body can now also be treated in a focused manner in just a few effective radiation sessions. Metastatic kidney cancer is a clinical and scientific focus of our clinic. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions. State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. At the same time, we work closely with our colleagues in medical oncology to guarantee “one-stop” treatment. We also consult with our colleagues in palliative medicine at an early stage.

In clinical trials, we are continuously trying to improve the treatment of kidney cancer in order to make it even more effective and tolerable. To the overview of currently open studies.