{"id":42804,"date":"2025-11-19T16:49:40","date_gmt":"2025-11-19T21:49:40","guid":{"rendered":"https:\/\/www.accuray.com\/?post_type=studies&p=42804"},"modified":"2025-11-24T16:01:25","modified_gmt":"2025-11-24T21:01:25","slug":"excellent-outcomes-with-stereotactic-body-radiotherapy-in-an-elderly-patient-with-locally-progressive-immunotherapy-resistant-renal-cell-carcinoma","status":"publish","type":"studies","link":"https:\/\/www.accuray.com\/ja\/case-studies\/excellent-outcomes-with-stereotactic-body-radiotherapy-in-an-elderly-patient-with-locally-progressive-immunotherapy-resistant-renal-cell-carcinoma\/","title":{"rendered":"Excellent Outcomes With Stereotactic Body Radiotherapy in an Elderly Patient With Locally Progressive Immunotherapy-resistant Renal Cell Carcinoma"},"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 | IRCCS OSPEDALE SAN RAFFAELE \u00b7 MILANO, ITALY<\/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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Excellent Outcomes With Stereotactic Body Radiotherapy in an Elderly Patient With Locally Progressive Immunotherapy-resistant Renal Cell Carcinoma<\/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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Torrisi, Laura Giannini, Roberta Tummineri, Chiara Lucrezia Deantoni, Andrei Fodor, (IRCCS Ospedale San Raffaele \u2013 Milano, Italy)<\/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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Purpose:<\/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\tSystemic therapies, particularly targeted agents and immune checkpoint inhibitors (ICIs), have long been the primary\ntreatment approach for metastatic renal cell carcinoma (mRCC). However, when immune-related toxicities arise, alternative\napproaches to treatment are required.\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\tTechnological advancements in radiotherapy, especially stereotactic body radiotherapy\n(SBRT) has allowed for the precise delivery of high-dose, hypofractionated radiation with\nsteep dose gradients and sub-millimeter accuracy.\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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Study Design:<\/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>
  • 80-year-old male<\/li>
  • History of hypertension and mild chronic kidney disease<\/li><\/ul><\/span><\/td><\/tr>
Diagnosis<\/strong><\/span><\/td>Diagnosed with clear cell RCC and pulmonary metastases<\/span><\/td><\/tr>
2019
Treatment History<\/strong><\/span><\/td>
  • Initially treated with nivolumab + ipilimumab (CheckMate 214 protocol)<\/li>
  • Immunotherapy discontinued due to immune-mediated pancreatitis and nephritis<\/li><\/ul><\/span><\/td><\/tr>
2021
Treatment History<\/strong><\/span><\/td>
  • A progressive renal lesion was identified<\/li>
  • Given patients comorbidities and oligoprogressive status, SBRT was proposed as definitivelocal treatment<\/li><\/ul><\/span><\/td><\/tr>
Treatment<\/strong><\/span><\/td>Radixact SBRT, 36.25 Gy in five consecutive fractions. Daily ClearRT\u00ae kVCT imaging for patient alignment (see Figure 1)<\/span><\/td><\/tr>
Follow-up<\/strong><\/span><\/td>Minimum of 5-6 months<\/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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Treatment Details:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Technology<\/strong><\/span><\/td>CyberKnife\u00ae System with Synchrony\u00ae Fiducial Tracking\u2122 with Respiratory Modelling<\/span><\/td><\/tr>
Fiducials<\/strong><\/span><\/td>Four markers implanted; 3 in and 1 near the tumor<\/span><\/td><\/tr>
Planning Margins<\/strong><\/span><\/td>3 mm PTV margin; no CTV margin<\/span><\/td><\/tr>
Organs at Risk<\/strong><\/span><\/td>Kidneys, bowel, spinal cord, liver (figure 1)<\/span><\/td><\/tr>
Prescription<\/strong><\/span><\/td>40 Gy in 5 consecutive fractions over one week (figure 2)<\/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: Left renal volume delineation from the treatment CT scan in the axial and coronal planes.<\/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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Figure 2: Axial and coronal views from the patient\u2019s SBRT plan illustrating the radiation dose distribution.<\/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 grade \u22652 toxicity reported<\/span><\/td><\/tr>
Clinical Outcome<\/strong><\/span><\/td>
  • Lesion size reduced from 38 mm to 30 mm within 3 months<\/li>
  • Durable disease control observed at 42-month follow-up, despite discontinuation of immunotherapy<\/li><\/ul><\/span><\/td><\/tr>
Renal Function<\/strong><\/span><\/td>Renal function preserved; creatinine remained stable post-SBRT<\/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\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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\u201cThis case highlights the potential feasibility and safety of SBRT as a local treatment option for RCC in patients with mRCC. The durable disease control observed despite discontinuation of immunotherapy suggests that SBRT may have a valuable role in selected clinical scenarios.\u201d<\/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

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Torrisi M, Giannini L, Tummineri R, et al. (June 05, 2025) Excellent Outcomes With Stereotactic Body Radiotherapy in an Elderly Patient With Locally Progressive Immunotherapy-Resistant Renal Cell Carcinoma. Cureus 17(6): e85399. doi:10.7759\/cureus.85399<\/p>

Synchrony\u00ae is available in the US and EU markets. This feature may not be commercially available in all markets and is subject to regulatory clearance or approval. Kindly contact your regional Accuray representative or distributor to confirm the regulatory status.<\/p>

Important Safety Information:<\/p>

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>

\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. MKTCKCSCC280925#10<\/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":"

Systemic therapies, particularly targeted agents and immune checkpoint inhibitors (ICIs), have long been the primary treatment approach for metastatic renal cell carcinoma (mRCC). However, when immune-related toxicities arise, alternative approaches to treatment are required.<\/p>\n","protected":false},"featured_media":42814,"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-42804","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\/excellent-outcomes-with-stereotactic-body-radiotherapy-in-an-elderly-patient-with-locally-progressive-immunotherapy-resistant-renal-cell-carcinoma\/\" \/>\n<meta property=\"og:locale\" content=\"ja_JP\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Excellent Outcomes With Stereotactic Body Radiotherapy in an Elderly Patient With Locally Progressive Immunotherapy-resistant Renal Cell Carcinoma\" \/>\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\/excellent-outcomes-with-stereotactic-body-radiotherapy-in-an-elderly-patient-with-locally-progressive-immunotherapy-resistant-renal-cell-carcinoma\/\" \/>\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=\"2025-11-24T21:01:25+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.accuray.com\/wp-content\/uploads\/Fig1-1-scaled.png\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"957\" \/>\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\\\/excellent-outcomes-with-stereotactic-body-radiotherapy-in-an-elderly-patient-with-locally-progressive-immunotherapy-resistant-renal-cell-carcinoma\\\/\",\"url\":\"https:\\\/\\\/www.accuray.com\\\/case-studies\\\/excellent-outcomes-with-stereotactic-body-radiotherapy-in-an-elderly-patient-with-locally-progressive-immunotherapy-resistant-renal-cell-carcinoma\\\/\",\"name\":\"Pediatric Total Body Irradiation on the Radixact System - 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