Radiation Therapy for the Management of Renal Medullary Carcinoma: A Multi-Case Study.

Introduction Renal medullary carcinoma (RMC) is a rare and aggressive cancer that occurs in young individuals of African descent with sickle cell trait. Unlike renal cell carcinoma with a five-year overall survival rate of up to 77%, fewer than 5% of patients with RMC survive beyond 3 years with standard systemic therapies. RMC responds poorly to treatments effective for other renal malignancies. This highlights the urgent need for more effective therapeutic strategies for this lethal disease. Patients and Methods This analysis focuses on all five patients with oligometastatic or oligoprogressive RMC treated at MD Anderson Cancer Center with radiotherapy, either as a standalone treatment or in combination with chemotherapy until June 2023. Results While the two patients that received radiotherapy alone ultimately succumbed to their disease, the three patients treated with definitive radiotherapy combined with chemotherapy achieved radiographic complete responses lasting more than 12 months after radiation and transitioned to post-chemotherapy surveillance. The findings underscore the potential utility of combining radiation and chemotherapy for the management of carefully selected patients with metastatic RMC.