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Renal cell carcinoma (RCC) has long been termed a radioresistant histology owing to older data demonstrating a lack of benefit with conventional fractionated radiation. More modern series have demonstrated that highdose regimens delivered using stereotactic body radiation therapy (SBRT) offer impressive tumor control. Preservation of normal kidney function is a priority when using radiation therapy (RT). Investigators have previously noted decreased renal function after SBRT, especially in patients with pre-existing renal disease. The effectiveness of SBRT correlates with accurate tumor delineation and avoidance of high-dose radiation to normal tissue. Furthermore, treatment planning must compensate for respiratory motion of renal tumors. We report a case illustrating a patient with metastatic RCC who responded on systemic therapy with nivolumab and underwent SBRT to the primary renal mass for a cytoreductive effect. This SBRT regimen was delivered using a magnetic resonance (MR) imaging (MRI)-guided RT system that allows for MR-based simulation imaging, real-time tumor tracking, and respiratory gating. We

Magnetic Resonance Image Guided Stereotactic Body Radiation Therapy to the Primary Renal Mass in Metastatic Renal Cell Carcinoma