Stereotactic Body Radiation Therapy of Adrenal Metastases: A Pooled Meta-Analysis and Systematic Review of 39 Studies with 1006 Patients

Chen, William; Baal, Joe D.; Baal, Ulysis; Pai, Jonathan; Gottschalk, Alexander; Boreta, Lauren; Braunstein, Steve; Raleigh, David R.

doi:10.1016/j.ijrobp.2020.01.017

Cited by 70 publications

(105 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In an effort to collectively evaluate these data, a recently published meta-analysis/systematic review was conducted of 39 retrospective studies that included 1006 patients with adrenal metastases who were prescribed a median dose of 38 Gy in a median of 5 fractions. 100 Outcomes were favorable, with 2-year LC of 82% and only 1.8% grade 3 or higher toxicity. The majority was treated with multiple fractions, although a single fraction was used with prescription doses ranging from 13 to 30 Gy.…”

Section: Methodsmentioning

confidence: 91%

Single-Fraction Stereotactic Body Radiation Therapy: A Paradigm During the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond?

Ning

Lee

et al. 2020

Advances in Radiation Oncology

View full text Add to dashboard Cite

Purpose Owing to the coronavirus disease 2019 (COVID-19) pandemic, radiation oncology departments have adopted various strategies to deliver radiation therapy safely and efficiently while minimizing the risk of severe acute respiratory syndrome coronavirus–2 transmission among patients and health care providers. One practical strategy is to deliver stereotactic body radiation therapy (SBRT) in a single fraction, which has been well established for treating bone metastases, although it has been infrequently used for other extracranial sites. Methods and Materials A PubMed search of published articles in English related to single-fraction SBRT was performed. A critical review was performed of the articles that described clinical outcomes of single-fraction SBRT for treatment of primary extracranial cancers and oligometastatic extraspinal disease. Results Single-fraction SBRT for peripheral early-stage non-small cell lung cancer is supported by randomized data and is strongly endorsed during the COVID-19 pandemic by the European Society for Radiotherapy and Oncology-American Society for Radiation Oncology practice guidelines. Prospective and retrospective studies supporting a single-fraction regimen are limited, although outcomes are promising for renal cell carcinoma, liver metastases, and adrenal metastases. Data are immature for primary prostate cancer and demonstrate excess late toxicity in primary pancreatic cancer. Conclusions Single-fraction SBRT should be strongly considered for peripheral early-stage non-small cell lung cancer during the COVID-19 pandemic to mitigate the potentially severe consequences of severe acute respiratory syndrome coronavirus–2 transmission. Although single-fraction SBRT is promising for the definitive treatment of other primary or oligometastatic cancers, multi-fraction SBRT should be the preferred regimen owing to the need for additional prospective evaluation to determine long-term efficacy and safety.

show abstract

Section: Methodsmentioning

confidence: 91%

Single-Fraction Stereotactic Body Radiation Therapy: A Paradigm During the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond?

Ning

Lee

et al. 2020

Advances in Radiation Oncology

View full text Add to dashboard Cite

show abstract

“…[14][15][16] Toxicities in these patients include nausea, vomiting, diarrhea, and fatigue. 17,18 Few studies specifically examined SBRT-related adrenal toxicity, though it has been reported in several case series. [6][7][8] The incidence of adrenal insufficiency in patients with bilateral treatment was reported to be 16% (n = 30).…”

Section: Discussionmentioning

confidence: 99%

Acute Adrenal Insufficiency in a Patient with Metastatic Infiltrating Ductal Carcinoma

Sciortino

Karnchanasorn

2020

kjm

View full text Add to dashboard Cite

show abstract

“…SBRT of adrenal metastases has been evaluated by several groups in mostly monocentric and retrospective cohort studies with promising results. 16,[22][23][24][25][26][27][28][29][30][31][32][33] Larger analyses include a retrospective database analysis conducted in Asian patients (n = 75) reporting 1-year LC rate of 83%. 34 Furthermore, multiple prospective and retrospective monocentric studies were included in a recent meta-analysis conducted by Chen et al, which reported a pooled 1-year LC rate of 82% with a strong association of prescribed doses and LC rates.…”

Section: What's New?mentioning

confidence: 99%

“…34 Furthermore, multiple prospective and retrospective monocentric studies were included in a recent meta-analysis conducted by Chen et al, which reported a pooled 1-year LC rate of 82% with a strong association of prescribed doses and LC rates. 32 We conducted this multicenter database analysis of patients with adrenal metastases treated with SBRT or fractionated highly conformal RT (3DCRT/IMRT) within the framework of the SBRT database initiative of the Working Group Radiosurgery and Stereotactic Radiotherapy of the German Society for Radiation Oncology (DEGRO). Patterns of care and outcomes by means of toxicity, LC and OS are detailed in this report.…”

Section: What's New?mentioning

confidence: 99%

Stereotactic or conformal radiotherapy for adrenal metastases: Patient characteristics and outcomes in a multicenter analysis

Buergy

Würschmidt

Gkika

et al. 2021

Intl Journal of Cancer

View full text Add to dashboard Cite

To report outcome (freedom from local progression [FFLP], overall survival [OS] and toxicity) after stereotactic, palliative or highly conformal fractionated (>12) radiotherapy (SBRT, Pall-RT, 3DCRT/IMRT) for adrenal metastases in a retrospective multicenter cohort within the framework of the German Society for Radiation Oncology (DEGRO).Adrenal metastases treated with SBRT (≤12 fractions, biologically effective dose [BED10] ≥ 50 Gy), 3DCRT/IMRT (>12 fractions, BED10 ≥ 50 Gy) or Pall-RT (BED10 < 50 Gy) were eligible for this analysis. In addition to unadjusted FFLP (Kaplan-Meier/log-rank), we calculated the competing-risk-adjusted local recurrence rate (CRA-LRR). Three hundred twenty-six patients with 366 metastases were included by 21 centers (median follow-up: 11.7 months). Treatment was SBRT, 3DCRT/IMRT and Pall-RT in 260, 27 and 79 cases, respectively. Most frequent primary tumors were non-small-cell lung cancer (NSCLC; 52.5%), SCLC (16.3%) and melanoma (6.7%).Unadjusted FFLP was higher after SBRT vs Pall-RT (P = .026) while numerical differences in CRA-LRR between groups did not reach statistical significance (1-year CRA-LRR: 13.8%, 17.4% and 27.7%). OS was longer after SBRT vs other groups (P < .05) and increased in patients with locally controlled metastases in a landmark analysis (P < .0001). Toxicity was mostly mild; notably, four cases of adrenal insufficiency occurred, two of which were likely caused by immunotherapy or tumor progression.Radiotherapy for adrenal metastases was associated with a mild toxicity profile in all groups and a favorable 1-year CRA-LRR after SBRT or 3DCRT/IMRT. One-year FFLP was associated with longer OS. Dose-response analyses for the dataset are underway.

show abstract

Stereotactic Body Radiation Therapy of Adrenal Metastases: A Pooled Meta-Analysis and Systematic Review of 39 Studies with 1006 Patients

Cited by 70 publications

References 57 publications

Single-Fraction Stereotactic Body Radiation Therapy: A Paradigm During the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond?

Single-Fraction Stereotactic Body Radiation Therapy: A Paradigm During the Coronavirus Disease 2019 (COVID-19) Pandemic and Beyond?

Acute Adrenal Insufficiency in a Patient with Metastatic Infiltrating Ductal Carcinoma

Stereotactic or conformal radiotherapy for adrenal metastases: Patient characteristics and outcomes in a multicenter analysis

Contact Info

Product

Resources

About