Radiotherapy can stop the growth of a cancer cell by destroying its DNA so that it cannot be repaired. Tumor cells are usually more sensitive to radiation than normal cells because they have accumulated so many mutations during their malignancy that they have a harder time escaping the radiation.
Unfortunately, kidney cancer cells are also inherently resistant to radiotherapy, so adjuvant radiotherapy is largely not considered for limited kidney cancer.
Radiotherapy is currently used in the following situations:
Postoperative radiotherapy
Postoperative radiotherapy to the tumor bed can be given to patients with localized regional invasion (including the renal tegument, perirenal fat, renal pelvis, renal veins, inferior vena cava, regional lymph nodes, etc.) or intraoperative tumor rupture, and a silver clip should be placed intraoperatively as a radiotherapy localization marker. Postoperative radiotherapy helps to reduce the local recurrence rate and distant metastasis rate.
Palliative radiotherapy
Palliative radiotherapy is limited in advanced patients with metastases and primary foci. However, for brain metastases, radiotherapy is more effective than surgery, and radiotherapy can take into account multiple brain metastases. Combined with dexamethasone and dehydrating agents, it can significantly shrink tumors and edema zones and relieve symptoms of intracranial hypertension and other neurological symptoms.
Radiotherapy can be used for both whole-cranial radiotherapy and locally targeted radiotherapy (Gamma Knife) when used for brain metastases from kidney cancer.
In general, treatment of brain metastases needs to precede systemic treatment, and the side effect of whole-brain radiation therapy is that it may lead to slowed thinking.
Treatment of metastatic bone pain
The use of low-dose local irradiation to treat bone pain caused by bone metastases has been more effective. Isotope internal radiation therapy is effective in controlling systemic skeletal symptoms, resulting in relief of bone pain in about 80% of patients.
Management of tumor emergencies
Localized radiotherapy can effectively relieve spinal cord compression, obstructive pneumonia, and superior vena cava compression syndrome caused by metastases. In these cases, the role of radiotherapy is not to completely kill the tumor cells, but to shrink the tumor to some extent, thereby relieving the symptoms associated with the metastases.