{"id":42692,"date":"2025-11-19T16:52:11","date_gmt":"2025-11-19T21:52:11","guid":{"rendered":"https:\/\/www.accuray.com\/?post_type=studies&p=42692"},"modified":"2025-11-24T16:00:57","modified_gmt":"2025-11-24T21:00:57","slug":"stereotactic-body-radiotherapy-for-multiple-renal-cell-carcinoma-lesions-in-a-patient-with-polycystic-kidney-disease-after-partial-nephrectomy","status":"publish","type":"studies","link":"https:\/\/www.accuray.com\/ja\/case-studies\/stereotactic-body-radiotherapy-for-multiple-renal-cell-carcinoma-lesions-in-a-patient-with-polycystic-kidney-disease-after-partial-nephrectomy\/","title":{"rendered":"Stereotactic Body Radiotherapy for Multiple Renal Cell Carcinoma Lesions in a Patient With Polycystic Kidney Disease After Partial Nephrectomy"},"content":{"rendered":"\t\t
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\n\t\t\t\t\t\t\t\t\t< View All Case Studies<\/a>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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CASE STUDY | OSPEDALE SAN RAFFAELE<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Stereotactic Body Radiotherapy for Multiple Renal Cell\nCarcinoma Lesions in a Patient With Polycystic Kidney\nDisease After Partial Nephrectomy<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tDownload Case Study<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Authors:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tLaura Giannini, Miriam Torrisi, Chiara Lucrezia Deantoni, Roberta Tummineri, Andrei Fodor\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Challenge:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tNot all primary renal cell carcinoma (RCC) patients are suitable for surgery due to the\ntypically late onset of the disease, which is often associated with comorbidities and\nan increased perioperative risk.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Solution:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tRecently evidence has emerged supporting the use of stereotactic ablative radiotherapy\n(SBRT) in RCC, with promising local control and preservation of renal function.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Case Information:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Patient<\/strong><\/span><\/td>69-year-old male<\/span><\/td><\/tr>
Presentation<\/strong><\/span><\/td>History of RCC (pT1 G3), partial nephrectomy, polycystic kidney disease, Crohn\u2019s disease, hypertension<\/span><\/td><\/tr>
MRI<\/strong><\/span><\/td>Four new renal lesions identified in the right kidney (figure 1)<\/span><\/td>\t\t\t<\/tr>\r\n\t\t<\/tbody>\r\n\r\n\t\t\r\n\t\t\t<\/table>\r\n\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Figure 1: Renal lesions identified on MRIadaptive radiotherapy, and (Conventional Linac) ITV-method<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Treatment:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Goal<\/strong><\/span><\/td>Prioritize renal function preservation and minimize risk of toxicity<\/span><\/td><\/tr>
Prescription<\/strong><\/span><\/td>30 Gy in 5 consecutive fractions<\/span><\/td><\/tr>
Technology<\/strong><\/span><\/td>CyberKnife\u00ae System with Synchrony\u00ae Lung TrackingTM<\/span><\/td><\/tr>
Fiducials<\/strong><\/span><\/td>Four markers placed for real-time motion tracking<\/span><\/td><\/tr>
Organs at Risk<\/strong><\/span><\/td>Small bowel, stomach, spinal cord, liver, contralateral kidney (figure 2)<\/span><\/td><\/tr>
Planning<\/strong><\/span><\/td>3 mm PTV margin; no CTV margin used (Figure 3)<\/span><\/td>\t\t\t<\/tr>\r\n\t\t<\/tbody>\r\n\r\n\t\t\r\n\t\t\t<\/table>\r\n\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Figure 2: Delineation of the GTVs and OARs on the planning CT scan<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Figure 3: Treatment planning in axial and coronal views for four RCC lesions<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Outcomes:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Toxicity<\/strong><\/span><\/td>No acute toxicity during or after treatment<\/span><\/td><\/tr>
Renal Function<\/strong><\/span><\/td>Renal function preserved, eGFR improved slightly from 29 to 35 mL\/min<\/span><\/td><\/tr>
Follow-up<\/strong><\/span><\/td>Stable disease confirmed by MRI at 29 month follow-up<\/span><\/td><\/tr>
Adjuvant Therapy<\/strong><\/span><\/td>No adjuvant therapy administered<\/span><\/td>\t\t\t<\/tr>\r\n\t\t<\/tbody>\r\n\r\n\t\t\r\n\t\t\t<\/table>\r\n\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\t\u201cThe integration of precision robotics and image-guided localization, through the Synchrony respiratory tracking system, compensates for tumor motion, making it a highly effective procedure to reduce the irradiated volume for lesions that move with breathing.\u201d\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Conclusion:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\t\u201cSBRT has proven to be a valuable treatment option for our patient with multiple renal lesions from RCC, with contraindications to surgery and pre-existing renal dysfunction.\u201d\n\u201cEven with a reduced dose, SBRT achieved long-term disease control and preservation of renal function suggesting its suitability in selected complex cases.\u201d\nFurther studies and larger cohorts are needed to fully establish the optimal dose-fractionation schedules for SBRT in complex cases with multiple lesions from RCC.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Important Safety Information:<\/p>\n

Most side effects of radiotherapy, including radiotherapy delivered with Accuray systems, are mild and temporary, often involving fatigue, nausea, and skin irritation. Side effects can be severe, however, leading to pain, alterations in normal body functions (for example, urinary or salivary function), deterioration of quality of life, permanent injury, and even death. Side effects can occur during or shortly after radiation treatment or in the months and years following radiation. The nature and severity of side effects depend on many factors, including the size and location of the treated tumor, the treatment technique (for example, the radiation dose), and the patient\u2019s general medical condition, to name a few. For more details about the side effects of your radiation therapy, and to see if treatment with an Accuray product is right for you, ask your doctor. Accuray Incorporated as a medical device manufacturer cannot and does not recommend specific treatment approaches. Individual results may vary.<\/p>\n

\u00a9 2025 Accuray Incorporated. All Rights Reserved. Accuray, the Accuray logo, and other trademarks are trademarks or registered trademarks of Accuray Incorporated and may not be used without permission. For more information on Accuray and its trademarks, please visit www.accuray.com\/trademarks. MKTCKCSCC250925#9<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Not all primary renal cell carcinoma (RCC) patients are suitable for surgery due to the typically late onset of the disease, which is often associated with comorbidities and an increased perioperative risk.<\/p>\n","protected":false},"featured_media":42693,"menu_order":0,"template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"_links_to":"","_links_to_target":""},"categories":[1865],"studies_products":[],"case_studies_products":[1269,1861],"class_list":["post-42692","studies","type-studies","status-publish","has-post-thumbnail","hentry","category-synchrony-on-cyberknife","case_studies_products-cyberknife","case_studies_products-synchrony"],"acf":[],"yoast_head":"\nPediatric Total Body Irradiation on the Radixact System - Accuray<\/title>\n<meta name=\"description\" content=\"Learn how the Radixact System was used to treat pediatric total body irradiation (TBI) treatment at University Hospitals Birmingham\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.accuray.com\/case-studies\/stereotactic-body-radiotherapy-for-multiple-renal-cell-carcinoma-lesions-in-a-patient-with-polycystic-kidney-disease-after-partial-nephrectomy\/\" \/>\n<meta property=\"og:locale\" content=\"ja_JP\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Stereotactic Body Radiotherapy for Multiple Renal Cell Carcinoma Lesions in a Patient With Polycystic Kidney Disease After Partial Nephrectomy\" \/>\n<meta property=\"og:description\" content=\"Learn how the Radixact System was used to treat pediatric total body irradiation (TBI) treatment at University Hospitals Birmingham\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.accuray.com\/case-studies\/stereotactic-body-radiotherapy-for-multiple-renal-cell-carcinoma-lesions-in-a-patient-with-polycystic-kidney-disease-after-partial-nephrectomy\/\" \/>\n<meta property=\"og:site_name\" content=\"Accuray\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/AccurayIncorporated\" \/>\n<meta property=\"article:modified_time\" content=\"2025-11-24T21:00:57+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.accuray.com\/wp-content\/uploads\/Fig2-1024x775.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"775\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@Accuray\" \/>\n<meta name=\"twitter:label1\" content=\"\u63a8\u5b9a\u8aad\u307f\u53d6\u308a\u6642\u9593\" \/>\n\t<meta name=\"twitter:data1\" content=\"4\u5206\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.accuray.com\\\/case-studies\\\/stereotactic-body-radiotherapy-for-multiple-renal-cell-carcinoma-lesions-in-a-patient-with-polycystic-kidney-disease-after-partial-nephrectomy\\\/\",\"url\":\"https:\\\/\\\/www.accuray.com\\\/case-studies\\\/stereotactic-body-radiotherapy-for-multiple-renal-cell-carcinoma-lesions-in-a-patient-with-polycystic-kidney-disease-after-partial-nephrectomy\\\/\",\"name\":\"Pediatric Total Body Irradiation on the Radixact System - 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