Open Access

ARTICLE

CyberKnife for inoperable renal tumors: Canadian pioneering experience

Vimoj J. Nair¹, Janos Szanto², Eric Vandervoort², Ilias Cagiannos³, Rodney Breau³, Colin Malone¹, Leonard Avruch⁴, Jason Pantarotto¹, Shawn Malone¹

1 Division of Radiation Oncology, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada
2 Department of Medical Physics, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada
3 Surgical Oncology, Division of Urology, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada
4 Department of Diagnostic Imaging, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada
Address correspondence to Dr. Shawn Malone, Department of Radiation Oncology, The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, ON K1H 8L6 Canada

Canadian Journal of Urology 2013, 20(5), 6944-6949.

Abstract

Introduction: 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.
Materials and 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.
Conclusion: CyberKnife is technically feasible for treatment of medically inoperable renal tumors or tumors in a solitary kidney.

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