立体定向体放射线治疗（SBRT）已被证明对延迟转移性肾癌（mRCC）患者的全身治疗有安全且有效的作用。在这项研究中，我们旨在评估接受SBRT治疗的mRCC患者基因组标记。总共识别了30名患有少突变的疾病患者，大多数患者患有透明细胞肾癌（83.3％），同时接受第一线治疗（53.3％）。20名患者的基因组和16名患者的转录组测序可供使用。全身治疗持续时间（DOT）分为放射治疗前（DOT [P]）和放射治疗后（DOT [S]）。 DOT（P）和DOT（S）的中位数分别为15.1和18.3个月，DOT（S）/ DOT（P）比率的中位数为1.4。 DOT（S）/ DOT（P）比率≥1的患者在与细胞增殖和发育相关的途径中表达增加。相比之下，比率≤1的患者中富集了反应性氧化应激途径。本研究突出了基因组和转录组在精细化mRCC放射治疗选择中的潜在作用。患者摘要：在此研究中，我们查看了对立体定向体放射线治疗反应更好的肾癌患者的突变和基因组表达。我们发现富集表达某些途径可能在放射治疗反应中起到作用。版权所有©2022 Elsevier B.V.。

Stereotactic body radiation therapy (SBRT) has been shown to be safe and effective for delaying systemic treatment change among patients with metastatic renal cell carcinoma (mRCC). In this study, we sought to assess the genomic signatures of patients with mRCC who underwent SBRT for oligoprogression. A total of 30 patients with oligoprogressive disease were identified, the majority of whom had clear cell renal cell carcinoma (83.3%) and were receiving first-line treatment (53.3%). Genomic and transcriptomic sequencing were available in 20 and 16 patients, respectively. Duration of systemic treatment (DOT) was categorized as that prior (DOT[P]) and subsequent (DOT[S]) to radiation treatment. The median DOT(P) and DOT(S) were 15.1 and 18.3 mo, respectively, with a median DOT(S)/DOT(P) ratio of 1.4. Patients who had a DOT(S)/DOT(P) ratio of ≥1 had increased expression in pathways related to cell proliferation and development. In contrast, among patients with a ratio of ≤1, the reactive oxygen species pathway was enriched. This study highlights the potential role of genomics and transcriptomics to refine radiation treatment selection in patients with mRCC. PATIENT SUMMARY: In this study, we looked at mutations and genomic expressions among kidney cancer patients who responded better to stereotactic body radiotherapy. We found that enriched expression of certain pathways might play a role in response to radiotherapy.Copyright © 2022. Published by Elsevier B.V.