Stereotactic body radiation therapy for renal cell carcinoma with inferior vena cava thrombus-initial experience report and literature review

Background: Renal cell carcinoma (RCC) with inferior vena cava thrombus (IVC-TT) represents a relatively infrequent presentation. Curative treatment includes extirpative surgery; however, this is associated with high rates of recurrence and complications. Stereotactic body radiation therapy (SBRT) has been used to treat metastatic RCC with good results. SBRT may be used as part of multimodal therapy to provide local control of IVC-TT. Objective: We report our initial experience with SBRT to IVC-TT, including extended follow-up, and review the literature. Results: We report on two patients with level IV IVC-TT. Both had progressive disease while receiving systemic therapy and were eventually treated with SBRT to the IVC-TT, which showed good local control. Overall survival from the time of SBRT was 18 and 34 months, with no additional systemic therapy; one patient underwent additional SBRT and resection of metastatic sites. Conclusions: SBRT to RCC IVC-TT may be considered in selected patients for local tumor control.