Stereotactic Body Radiation Therapy (SBRT) for treatment of adrenal gland metastases from non-small cell lung cancer

Holý, Richard; Piroth, Marc D.; Pinkawa, Michael; Eble, Michael J.

doi:10.1007/s00066-011-2192-z

Cited by 117 publications

(89 citation statements)

References 35 publications

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“…In effect, in the study by Holy et al 24 patients with solitary metastasis (72.2%) had a median PFS of 12 months and a median OS of 23 months, comparable to some of the surgical series. 31 Furthermore, in the study conducted by Rudra et al, 32 which included only patients with oligometastatic disease, the reported 1 year OS was 90% with a median survival of 17.3 months.…”

Section: Efficacymentioning

confidence: 64%

“…Particularly in the series by Oshiro et al 27 , patients who developed duodenal ulcer received 30 Gy in 3 fractions (BED 60 Gy, ˛/ˇ = 10) with a maximum dose of 30 Gy at the duodenum (BED 130 Gy, ˛/ˇ = 3). In contrast, in the series by Holy et al 24 patients who were developing ulcers were treated with a BED of 72 Gy (˛/ˇ = 10), but the corresponding dose-volume load to the stomach and the small intestine was below the tolerance level of these organs. The authors concluded that there might have been some uncertainties in dose-volume load because patients were not treated on an empty stomach, thus resulting in organ movement from different filling.…”

Section: Toxicitymentioning

confidence: 95%

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SBRT: A viable option for treating adrenal gland metastases

Ippolito

D’Angelillo

Fiore

et al. 2015

Reports of Practical Oncology & Radiotherapy

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a b s t r a c tThe management strategy of adrenal metastases depends on different clinical situations.Adrenal metastasectomy in selected patients with isolated adrenal metastases is considered the treatment of choice, showing prolonged survival compared to chemotherapy alone.More recently, Stereotactic Body Radiation Therapy (SBRT) has emerged as an alternative local ablative treatment modality although limited data are available on the use of SBRT in treating adrenal gland metastases. Preliminary results are, however, encouraging, especially in selected patients with oligometastatic disease. We herewith review and discuss the potential role of SBRT as a local ablative treatment modality for adrenal metastases.

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Section: Efficacymentioning

confidence: 64%

Section: Toxicitymentioning

confidence: 95%

SBRT: A viable option for treating adrenal gland metastases

Ippolito

D’Angelillo

Fiore

et al. 2015

Reports of Practical Oncology & Radiotherapy

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“…40 Simulation and treatment were performed with an empty stomach (nil by mouth [NPO] 3-4 hours) for more reproducible anatomy. 39,41 Baseline diagnostic scans (CT, magnetic resonance imaging [MRI], PET) were fused with the simulation scan for contouring. 10,42,43 Respiratory motion management…”

Section: Simulationmentioning

confidence: 99%

“…37,41 Respiratory gating or end-expiratory breath hold were employed as other approaches, often implemented if organ motion was greater than a predetermined threshold, such as 5 mm. Implanted fiducials, used by Katoh et al for real-time tumor tracking, were not associated with complications or migration during treatment.…”

Section: Simulationmentioning

confidence: 99%

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Thomsen¹,

Fairchild²

2017

Oncology &Amp; Hematology Review (US)

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B ackground: Five-year overall survival (OS) for patients with stage IV non-small cell lung cancer (NSCLC) is a dismal 1%. However, approximately 7% have limited or solitary metastases, including to the adrenal gland. Radical treatment of these oligometastases (OM) could increase local control and improve OS. Our objective was to critically analyze data describing aggressive treatment of adrenal OM secondary to NSCLC. Methods: A literature search examining English publications describing surgery or radiotherapy (RT) was performed, supplemented by searching reference lists. Case reports of three or fewer patients, and articles from which NSCLC-or adrenal-specific clinical outcomes could not be abstracted, were excluded. Results: Twenty-nine studies met eligibility criteria (521 patients), 26 retrospective. No publications directly compare modalities. Four surgery studies described contemporaneous patients treated with palliative chemotherapy (CH) alone. Reported median OS ranged from 9.5-64 months after adrenalectomy, 8-23 months after RT, and 6-8.5 months after CH. Local failure after surgery was 14%, with response rates after RT 57-75%. Both appear well-tolerated. Conclusions: In patients with an adrenal OM secondary to NSCLC, aggressive treatment should be considered. However, due to the paucity of high quality evidence, it is unclear at present whether this approach alters the natural history of the disease.

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“…Holy et al, implemented SBRT to patients having 13 solitary adrenal metastases with NSCLC at 5 fractions and between 20 and 40 Gy total doses. They found disease-free survival as median 12 months, overall survival as median 23 months and local control rate as 77% [9]. In SBRT implementations for different cancer types determined 30 adrenal metastases, Chawla et al, reported the rates of one-year survival, local control and distant metastasis as 44%, 55% and 13% respectively [10].…”

mentioning

confidence: 99%

Adrenal insufficiency in Bilateral Adrenal Metastasis implemented SBRT

Cihan¹

2018

J Radiol Oncol

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Today, there is a considerable increase in localizing adrenal bulks with the bringing radiologic diagnosis methods having high technology into use and improvement in diagnostic tests. Adrenal glands are vital tissues for the organism due to the hormones they secrete. Death is a natural result in the absence of adrenal cortex. Adrenal bulks can be seen with different clinical, laboratory and radiological data. These bulks are often benign and rarely malign. They can be functional or non-functional. Major treatment methods used fort he treatment of adrenal gland primary tumors or metastases are surgery, arterial embolisation, chemical ablation, radiofrequency ablation and radiotherapy [1][2][3][4].Adrenal glands are one of the metastatic ields. In wide autopsy series, adrenal metastasis has been determined between the rates of 13-17% [5]. While unilateral metastasis is common, bilateral metastasis' rate of incidence is between 4-20%. It has been stated that lung (35%), gastric (14%), esophageal (12%) and hepatobiliary (10%) primary carcinomas adrenal metastasis are prevalent most frequently [2]. Curative treatments are tested on patients having cancer with oligo metastasis limited with adrenal gland and primary source is under control because of the expectation of longterm survival, and the surgery is the irst choice. These bulks can be treated with open and laparoscopic surrenalectomy in a curative way. It was reported in studies that overall survival was longer in resection of clinically isolated adrenal metastases when compared with nonsurgical therapy (including RFA, external beam radiotherapy, arterial embolization, radioembolization, chemical ablation, and cryoablation) [1,2,5,7]. Lo et al., found one-year survival as 73% and two-year survival as 40% in their study conducted on 52 patients having curative resection for solitary adrenal metastasis [3]. Tanvetyanon et al., demonstrated 5-year survival rates of 25% following resection of isolated synchronous adrenal metastases and reported 26% after resection of metachronous adrenal metastases in their study conducted on NSCLC patients developing solitary adrenal metastasis [4]. Conducted studies revealed that the rate of complication was 9-20% in patients having adrenalectomy for solitary adrenal metastasis [2][3][4]7].In recent years, the use of radiotherapy, which is a treatment modality as effective as surgical resection, has become prevalent for the management of oligometastases. Today, three different modalities have been tested in the radiotherapy treatment of adrenal gland metastases. In the irst one, total 50 Gy treatment dose with 3D-CRT as daily 2 Gy fraction dose is given [8]. The second one is IMRT implementations for adrenal gland metastases but it isn't thought as suitable according to Practice Guidelines for Neuroendocrine Tumors published by NCCN in 2010. The third radiotherapy modality is stereotactic body radiotherapy (SBRT). SBRT implementations have started to be preferred today since they are completed in a few fractions in addition to tha...

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Stereotactic Body Radiation Therapy (SBRT) for treatment of adrenal gland metastases from non-small cell lung cancer

Abstract: SBRT is a feasible and safe technique for lung cancer patients with adrenal gland metastasis. In patients with an isolated adrenal metastasis median OS of 23 months was excellent and comparable to data after surgical removal, but noninvasive. Acute side effects were mild.

Cited by 117 publications

References 35 publications

SBRT: A viable option for treating adrenal gland metastases

SBRT: A viable option for treating adrenal gland metastases

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Adrenal insufficiency in Bilateral Adrenal Metastasis implemented SBRT

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