First program to report the use of stereotactic radiation (SBRT) for tumor extensions into the vena cava (tumor thrombi) (Hannan, Cancer Biol Ther, 2015). Largest reported experience of SBRT use outside the brain with premier program in brain metastases treatment (Wang, Int J Radiat Oncol Biol Phys, 2017). SBRT deployment for (i) small renal masses, (ii) tumor thrombi, (iii) oligometastasis, (iv) oligoprogression, and, (v) extensively, in combination with immunotherapy. National clinical trials registry (clinicaltrials.gov) search with the terms “Kidney Cancer” and “Stereotactic” fails to identify other programs with similar breath of clinical trials. Broadens options for patients, and greater experience reduces complication rates.