title: CyberKnife for inoperable renal tumors: Canadian pioneering experience.
abstract: BACKGROUND
  Stereotactic ablative body radiotherapy (SABR) is currently under study regarding its clinical application in management of patients with kidney tumors. CyberKnife can accurately deliver ablative tumor radiation doses while preserving kidney function. We report Canada's first use of CyberKnife SABR system in treating primary kidney tumors.
  
  
  METHODS
  Between January 2011 and February 2012, we treated three patients with renal tumors using CyberKnife SABR. Two patients had tumors in solitary kidney. The third patient had a recurrent tumor after two previous radiofrequency ablation treatments. Platinum seed fiducials were used for real time tumor tracking. Magnetic resonance imaging registration was used for tumor delineation in all cases. The patients were followed with regular renal scans and renal function tests.
  
  
  RESULTS
  The mean age was 79 years. Mean tumor size was 21.3 cm3. A dose of 39 Gy in 3 fractions was delivered. The post treatment follow up times were 15 months, 13 months and 12 months. Local control was obtained in all three patients. No acute or chronic toxicity was reported. Kidney functions remained unaffected after treatment.
  
  
  CONCLUSIONS
  CyberKnife is technically feasible for treatment of medically inoperable renal tumors or tumors in a solitary kidney.
authors.affiliation: University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Vimoj J
authors.initials: VJ
authors.lastname: Nair
authors.forename: Janos
authors.initials: J
authors.lastname: Szanto
authors.forename: Eric
authors.initials: E
authors.lastname: Vandervoort
authors.forename: Ilias
authors.initials: I
authors.lastname: Cagiannos
authors.forename: Rodney
authors.initials: R
authors.lastname: Breau
authors.forename: Colin
authors.initials: C
authors.lastname: Malone
authors.forename: Leonard
authors.initials: L
authors.lastname: Avruch
authors.forename: Jason
authors.initials: J
authors.lastname: Pantarotto
authors.forename: Shawn
authors.initials: S
authors.lastname: Malone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D016634:Radiosurgery; D012189:Retrospective Studies; D016896:Treatment Outcome