This paper reviews the use of stereotactic ablative radiotherapy (SABR) (also called stereotactic body radiotherapy, SBRT) for treating primary renal cell carcinoma (RCC) that cannot be removed with surgery.

SABR is a treatment that automatically targets high doses of radiotherapy to the tumour with high precision. SABR is very accurate, and thereby maximises the cell-killing effect on the tumour, while minimising radiation-related injury in nearby tissues. SABR could, therefore, be used to preserve kidney function.

Using SABR to target the primary RCC tumour causes the release of tumour-associated antigens and tumour-infiltrating T-lymphocytes, thereby demonstrating the potential immunomodulatory effect of SABR in RCC. SABR seems to have important synergistic effects when combined with immune checkpoint inhibitors. Future clinical trials of SABR for RCC are needed to look at the safety and efficacy of combining SABR with immunotherapy.

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