Felipe Couñago
Felipe Couñago/genesiscare.com

Felipe Couñago: Pushing the Boundaries of Adaptive Radiotherapy in Complex RCC Cases

Felipe Couñago, Medical Director at GenesisCare Spain, shared a post on LinkedIn:

“Title: Pushing the Boundaries of Adaptive Radiotherapy in Complex RCC Cases

Today I’d like to share the story of an extraordinary patient.

Diagnosed with kidney cancer 12 years ago, living with a single kidney, and with metastatic disease for the last 6 years while on TKI therapy.

Recently, she developed a challenging >3 cm oligometastatic lesion in the left adrenal gland (in direct contact with the stomach) and a small tumor lesion in her only functioning kidney.

A scenario where every millimeter counts.

Given the complexity — monorenal patient + proximity to critical organs — we treated her with:

  • MR-guided Adaptive Radiotherapy (MRIdian MR-Linac)
  • 50 Gy in 5 fractions (SBRT)
  • Simultaneous treatment of both lesions
  • With automatic real-time gating

Thanks to real-time MRI guidance, daily adaptive planning, and automatic gating, we individualized each fraction to safely protect the stomach and her only kidney.

She completed treatment asymptomatic and living a completely normal life.

Adaptive MR-radiotherapy is redefining what is possible for complex RCC cases — and this patient is a powerful reminder of that.”

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