CT-gesteuerte interstitielle Brachytherapie bei Nierentumoren – Eine narrative Übersicht zur Technik, Evidenz und klinischen Perspektive

Renal cell carcinoma ranks among the most common malignant tumours. However, a subset of patients is unsuitable for surgical treatment due to comorbidities, impaired renal function, or challenging tumour location. Thermal ablation techniques such as radiofrequency, microwave, or cryoablation are established alternatives but face limitations in centrally located tumours or lesions adjacent to major vessels. CT-guided interstitial high-dose-rate brachytherapy (HDR-BT) is a minimally invasive, precise, non-thermal ablation technique that can be applied irrespective of tumour size or location. A literature review identified three prospective studies on HDR-BT for renal tumours and renal-adjacent metastases, demonstrating local control rates of up to 95% with low toxicity and only infrequent clinically relevant renal impairment. HDR-BT thus addresses a therapeutic gap in inoperable or thermally challenging cases. Initial data are promising, and further clinical research may help to better define the role of HDR-BT within the overall therapeutic strategy.