• Giulia Marvaso, Barbara Alicja Jereczek-Fossa, Mattia Zaffaroni, Maria Giulia Vincini, Giulia Corrao, Nicolaus Andratschke, Ehsan H Balagamwala, Jens Bedke, Oliver Blanck, Umberto Capitanio, Rohann J M Correa, Gert De Meerleer, Ciro Franzese, Aurora Gaeta, Sara Gandini, Cristina Garibaldi, Peter C Gerszten, Silke Gillessen, William R Grubb, Matthias Guckenberger, Raquibul Hannan, Pavan M Jhaveri, Mirjana Josipovic, Linda G W Kerkmeijer, Eric J Lehrer, Magnus Lindskog, Alexander V Louie, Quynh-Nhu Nguyen, Piet Ost, David A Palma, Giuseppe Procopio, Maddalena Rossi, Michael Staehler, Alison C Tree, Yat Man Tsang, Nicholas Van As, Nicholas G Zaorsky, Thomas Zilli, David Pasquier, and Shankar Siva.
• Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
• Lancet Oncol. 2024 May 1; 25 (5): e193e204e193-e204.

AbstractThe purpose of this European Society for Radiotherapy and Oncology (ESTRO) project, endorsed by the European Association of Urology, is to explore expert opinion on the management of patients with oligometastatic and oligoprogressive renal cell carcinoma by means of stereotactic ablative radiotherapy (SABR) on extracranial metastases, with the aim of developing consensus recommendations for patient selection, treatment doses, and concurrent systemic therapy. A questionnaire on SABR in oligometastatic renal cell carcinoma was prepared by a core group and reviewed by a panel of ten prominent experts in the field. The Delphi consensus methodology was applied, sending three rounds of questionnaires to clinicians identified as key opinion leaders in the field. At the end of the third round, participants were able to find consensus on eight of the 37 questions. Specifically, panellists agreed to apply no restrictions regarding age (25 [100%) of 25) and primary renal cell carcinoma histology (23 [92%] of 25) for SABR candidates, on the upper threshold of three lesions to offer ablative treatment in patients with oligoprogression, and on the concomitant administration of immune checkpoint inhibitor. SABR was indicated as the treatment modality of choice for renal cell carcinoma bone oligometatasis (20 [80%] of 25) and for adrenal oligometastases 22 (88%). No consensus or major agreement was reached regarding the appropriate schedule, but the majority of the poll (54%-58%) retained the every-other-day schedule as the optimal choice for all the investigated sites. The current ESTRO Delphi consensus might provide useful direction for the application of SABR in oligometastatic renal cell carcinoma and highlight the key areas of ongoing debate, perhaps directing future research efforts to close knowledge gaps.Copyright © 2024 Elsevier Ltd. All rights reserved.

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