Stereotactic body radiotherapy (SBRT) for adrenal metastases of oligometastatic or oligoprogressive tumor patients

König, Laila; Häfner, Matthias; Katayama, Sonja; Koerber, Stefan A.; Tonndorf-Martini, Eric; Bernhardt, Denise; Nettelbladt, Bastian von; Weykamp, Fabian; Hoegen, Philipp; Klüter, Sebastian; Susko, Matthew; Debus, Jürgen; Hörner-Rieber, Juliane

doi:10.1186/s13014-020-1480-0

Cited by 49 publications

(53 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Zhao 13 reported that BED≥85.5 Gy and a volume of GTV<30 cm 3 were correlated with LCR in univariate analysis. Konig et al 22 found a superior local control if BED 10 was ≥75 Gy or the volume of PTV was <100 mL, but these findings were not significant. Buergy et al 12 reported that neither lesion size nor radiation dose were significant factors for local control.…”

Section: Discussionmentioning

confidence: 93%

“…Therefore, BED 10 of adrenal metastases was often lower than lung or liver metastases. 3 , 23 The range of BED varied from 30 Gy 9 to 151 Gy 22 in published studies about adrenal metastasis, and the median BED ranged from 60 Gy 24 to 112.5 Gy. 14 In our study, a portion of the lesions was given lower BED to protect the adjacent vital organs; the median BED was 84 Gy, and hence consistent with other studies.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Hypofractionated Radiotherapy for 35 Patients with Adrenal Metastases: A Single-Institution Experience</p>

Zhao

Yang

et al. 2020

CMAR

View full text Add to dashboard Cite

Objective To investigate the clinical outcomes of hypofractionated radiotherapy for adrenal metastases. Materials and Methods We retrospectively reviewed patients diagnosed with adrenal metastases and treated with hypofractionated radiotherapy, who did not receive adrenalectomy or have disease progression after chemotherapy, from 2007 to 2019. The Kaplan–Meier method was used to estimate local control rate (LCR), progression-free survival (PFS), and overall survival (OS). Univariate analysis was performed using Log rank test. Results Thirty-five patients with 42 lesions were enrolled, and the lung was the most common primary site (80.0%). The median follow-up time was 46.4 months. The median volume of GTV and PTV was 23.2 cm 3 (range: 3.5–97.8 cm 3 ) and 38.3 cm 3 (range: 10.2–135.6 cm 3 ), respectively. The main dose regimens were 60 Gy delivered in 4–15 fractions, with the median dose of PTV being 60 Gy (range: 40–66.3 Gy) and the biologically effective dose (BED) being 84 Gy (range: 56–110 Gy). The 1-year and 2-year LCR, OS, and PFS were 92.7% and 88.1%, 76.9% and 45.4%, and 25.1% and 14.4%, respectively. Univariate analysis showed that chemotherapy, disease-free interval from primary disease diagnosis to adrenal metastases diagnosis, and age were significant factors for LCR, OS, and PFS, respectively (p=0.017, 0.049, and 0.004, respectively). No more than grade III toxicities were observed. Conclusion As a non-invasive approach, hypofractionated radiotherapy is safe and effective for metastatic adrenal lesions, without serious complications.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

<p>Hypofractionated Radiotherapy for 35 Patients with Adrenal Metastases: A Single-Institution Experience</p>

Zhao

Yang

et al. 2020

CMAR

View full text Add to dashboard Cite

show abstract

“…Late toxicity occurred in only three patients. Two patients each suffered from grade I and II fatigue, and one patient had grade I gastrointestinal toxicity [30].…”

Section: Discussionmentioning

confidence: 99%

Adrenal Gland Irradiation Causes Fatigue Accompanied by Reactive Changes in Cortisol Levels

Huang¹,

Chi²,

Wu³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Fatigue is a complicated syndrome associated with multiple factors. The development of fatigue after incidental radiotherapy (RT) to the adrenal gland has been observed in clinical practice. This study aimed to investigate the effect of adrenal RT on fatigue and related physiological impacts.Methods: Three patients with inevitable RT to the adrenal gland were enrolled. Serum levels of cortisol, aldosterone, and adrenocorticotropic hormone (ACTH) were measured before, during, and after RT. Fatigue was scored according to the validated fatigue severity scale, and dosimetric parameters were collected. BALB/c mice were surgically explored for the identification of the left adrenal gland. Intra-operative RT was delivered with an electron beam. The swimming endurance test was applied for endurance assessment to represent fatigue. Plasma levels of stress hormones and histopathological features were examined.Results: In the enrolled patients, serum baseline cortisol levels declined after RT. Alterations in levels of morning cortisol and aldosterone showed a similar trend to baseline cortisol, whereas ACTH levels increased, indicating possible compensatory feedback from the hypothalamic-pituitary-adrenal axis. In an experimental mouse model, RT to a unilateral adrenal gland decreased baseline cortisol levels and swimming endurance time. In the histopathological assessment, the irradiated adrenal glands showed characteristic RT injury features in the adrenal cortex.Conclusions: The preliminary clinical observation of fatigue development and characteristic hormone alterations indicated that the adrenal glands could be regarded as an organ at risk from RT adverse effects. This observation was supported by functional and histopathological evidence from an experimental animal model.

show abstract

“…Evidence of the effectiveness of Stereotactic Body Radiation Therapy (SBRT) has recently been published [1][2][3][4][5][6][7][8][9][10][11]. It has also been reported that curative treatment for oligometastasis from primary tumor in the setting of local tumor control improves disease-free recurrence time and overall survival.…”

Section: Introductionmentioning

confidence: 99%

“…It has also been reported that curative treatment for oligometastasis from primary tumor in the setting of local tumor control improves disease-free recurrence time and overall survival. The adrenal glands are often the site of a solitary metastasis, especially from lung cancer [3][4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Adrenal Stereotactic Body Radiation Therapy: The Effects of a Full and Empty Stomach on Radiation Dose to Organs at Risk

Tanaka

Taniguchi

Ono

et al. 2021

Preprint

View full text Add to dashboard Cite

IntroductionAdrenal recurrence after radical resection of the primary lesion is common. However, the adrenal glands are surrounded by radiosensitive organs such as the pancreas, kidneys, small intestine, and stomach. Treatment planning therefore requires many regulations due to the dose limit to the organ at risk. Radiotherapy can be adjusted for gastric capacity. We therefore performed an OAR analysis for SBRT to the left adrenal gland based on gastric state (empty or full stomach) at the time of irradiation. We examined whether it was possible to reduce the dose to OAR.Materials and MethodsA sample of 20 randomly selected stomachs was arranged in descending order from largest to the smallest size and divided into two groups of 10. The “empty group” is defined as the smaller stomach group (n = 10), while the “full group” is the larger stomach group (n = 10). Planning target volume (PTV) adds a 3 mm margin to the GTV. The prescribed PTV dose was 54 Gy / 6 fx and D 95 coverage of PTV(CTV) (the dose to 95% of the PTV volume). We compared the difference in OAR radiation dose between the two stomach volume groups.ResultsGastric OAR dose in the empty group was significantly lower than in the full group (D5 and D10). However, the OAR dose to the left kidney in the empty group was statistically significantly higher than in the full group (V12, V15, and V21).ConclusionWhen SBRT was performed on the left adrenal gland, it was found that the smaller the stomach size, the lower the radiation dose to the stomach. The stomach is an abdominal organ that can be artificially resized. It is therefore better to perform SBRT on patients who have an empty stomach.

show abstract

Stereotactic body radiotherapy (SBRT) for adrenal metastases of oligometastatic or oligoprogressive tumor patients

Cited by 49 publications

References 49 publications

<p>Hypofractionated Radiotherapy for 35 Patients with Adrenal Metastases: A Single-Institution Experience</p>

<p>Hypofractionated Radiotherapy for 35 Patients with Adrenal Metastases: A Single-Institution Experience</p>

Adrenal Gland Irradiation Causes Fatigue Accompanied by Reactive Changes in Cortisol Levels

Adrenal Stereotactic Body Radiation Therapy: The Effects of a Full and Empty Stomach on Radiation Dose to Organs at Risk

Contact Info

Product

Resources

About