{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:54:34Z","timestamp":1773924874788,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objectives Radiosurgery (RS) using high-dose hypo-fractionated radiation is a novel treatment for renal cell carcinoma. This study investigates long-term oncological outcomes of RS for upper tract urothelial carcinoma (UTUC) in patients unfit for surgery or with a solitary kidney. Methods We performed a retrospective analysis of three prospective institutional databases from tertiary referral centers, including patients with UTUC treated with RS between 2008 and 2024. Results The study included 45 patients with a median age of 71.9 years (range 47.8\u201389.1). Of these, 28 had high-grade disease, and 9 carcinoma in situ (CIS). Twenty-eight patients had a solitary kidney. The median RS dose per fraction was 25 Gy (range 10\u201325). The median number of fractions was 1 (range 1\u20134 fractions). The median follow-up was 27.6 months (range 3.1\u2013150.3), and the median overall survival (OS) was 91.7 months (95% CI 72.0\u2013111.5). OS did not correlate with tumor grade or CIS. The median OS for low-grade patients was 52.06 months, while for high-grade patients, it was 87.90 months. Treatment response included complete response in 37 patients (82.2%), partial response in 2 (4.4%), stable disease in 2 (4.4%), and progression in 2 (4.4%). The median baseline and follow-up CKD-EPI were 64.2 and 53.5 mL\/min\/1.73 m2, respectively. Three patients (6.7%) required hemodialysis. Conclusions RS for UTUC is an effective local ablation therapy with durable long-term control and should be considered in patients not suitable for surgical approaches. It should be evaluated as a potential new standard of care in prospective studies in conjunction with peri-interventional systemic therapy.<\/jats:p>","DOI":"10.3390\/cancers18060991","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T08:54:37Z","timestamp":1773910477000},"page":"991","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiosurgery in Upper Tract Urothelial Carcinoma (UTUC)"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4574-6522","authenticated-orcid":false,"given":"Michael","family":"Staehler","sequence":"first","affiliation":[{"name":"Department of Urology, University of Munich, D-81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iulia","family":"Blajan","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Munich, D-81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1486-183X","authenticated-orcid":false,"given":"Can","family":"Aydogdu","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Munich, D-81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0056-1230","authenticated-orcid":false,"given":"Annabel","family":"Graser","sequence":"additional","affiliation":[{"name":"European Radiosurgery Center Munich (ERCM), D-81377 M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Munich, D-81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Brinkmann","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Munich, D-81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0340-0304","authenticated-orcid":false,"given":"Gerald B.","family":"Schulz","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Munich, D-81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allen","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan J.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Washington, Seattle, WA 98195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"F\u00fcrweger","sequence":"additional","affiliation":[{"name":"European Radiosurgery Center Munich (ERCM), D-81377 M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4207-7490","authenticated-orcid":false,"given":"Sarah P.","family":"Psutka","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Washington, Seattle, WA 98195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquibul","family":"Hannan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX 75390, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Muacevic","sequence":"additional","affiliation":[{"name":"European Radiosurgery Center Munich (ERCM), D-81377 M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"ref_1","first-page":"12","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J. 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