CyberKnife Robotic Radiosurgery of Three Pancreatic Metastases of Renal Cell Cancer in One Treatment Session

Introduction: Pancreatic metastasis accounts for 2% to 11% of all renal cell cancer (RCC) metastases. In good clinical status, patients are selected for surgery, and in more advanced disease, for systemic chemotherapy. Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) do not play a therapeutic role so far. Materials Methods: A 57-year-old patient was treated with CyberKnife robotic radiosurgery (CKRS) on three pancreatic RCC metastases with 22 Gy to the 75% isodose line in one treatment session. Tumor volumes were 29, 13, and 5 cc. Total non-zero beams were 121. Results: No immediate adverse events were detected. The patient did develop a serious complication with the occlusion of the bile duct and an infection of the implanted stent six months after the treatment that required systemic antibiotic treatment for six weeks. After that, the follow-up course was uneventful. Two and a half years after SRS, the treated tumors are no longer visible on imaging follow-up. Conclusions: In selected cases, it may be feasible to treat multiple pancreatic metastases of RCC in only one treatment session with CyberKnife robotic radiosurgery. Categories: Radiation Oncology, Internal Medicine, General Surgery