Fig. 3

a Coronal image of the radiation treatment planning CT depicting the treatment portal, organs at risk, and isodose lines. The white arrow points to the 20-Gy isodose line. b Axial image of the radiation treatment planning CT depicting the dose wash and dose falloff into the left lung. Red depicts the prescription isodose line of 20 Gy, which was given over five daily fractions. The white arrow points to the 20-Gy isodose line. c The immunomodulatory effects of ionizing radiation has the potential for synergism with pembrolizumab. d A tumor biopsy of chest wall lesion was stained with Pax-8 to confirm metastatic RCC