Journal article
SBRT to adrenal metastases provides high local control with minimal toxicity
Advances in radiation oncology, Vol.2(4), pp.581-587
10/2017
DOI: 10.1016/j.adro.2017.07.011
PMCID: PMC5707423
PMID: 29204525
Abstract
The adrenal glands are a common site of metastases because of their rich blood supply. Previously, adrenal metastases were treated with systemic chemotherapy or, more rarely, with surgical resection or palliative radiation therapy. Stereotactic body radiation therapy (SBRT) has recently emerged as an attractive noninvasive approach to definitively treat these lesions. We present our experience in treating adrenal metastases using SBRT and review the current literature.
This is a single-institution retrospective review of patients who received SBRT to adrenal metastases originating from various primary malignancies. Patients who were eligible for SBRT included those with limited metastatic disease (≤5 sites) with otherwise controlled metastatic disease and uncontrolled adrenal metastases.
Ten patients met the study's inclusion criteria and received SBRT doses of 30 to 48 Gy in 3 to 5 fractions. Acute sequelae of SBRT treatment included 4 patients with grades 1 or 2 nausea, 3 patients with grade 1 fatigue, and 1 with grade 1 diarrhea. The median follow-up was 6 months with a median overall survival of 9.9 months. One patient demonstrated progressive adrenal gland disease 18.8 months after SBRT treatment. Seven patients developed new distant metastases after treatment, with a median progression-free survival of 3.4 months. Three months after SBRT to the adrenal gland, 1 patient developed a gastrointestinal bleed.
These results complement the limited existing body of literature by demonstrating that SBRT provides good control of treated adrenal gland metastasis; however, high-grade late toxicities may occur. More stringent dose constraint limits may prevent associated serious adverse events.
Details
- Title: Subtitle
- SBRT to adrenal metastases provides high local control with minimal toxicity
- Creators
- Kristin Plichta - Department of Radiation Oncology, University of Iowa, Iowa City, IowaNathan Camden - Department of Radiation Oncology, University of Iowa, Iowa City, IowaMuhammed Furqan - Department of Internal Medicine, Division of Hematology and Oncology, University of Iowa, Iowa City, IowaTaher Abu Hejleh - Department of Internal Medicine, Division of Hematology and Oncology, University of Iowa, Iowa City, IowaGerald H Clamon - Department of Internal Medicine, Division of Hematology and Oncology, University of Iowa, Iowa City, IowaJun Zhang - Department of Internal Medicine, Division of Hematology and Oncology, University of Iowa, Iowa City, IowaRyan T Flynn - Department of Radiation Oncology, University of Iowa, Iowa City, IowaSudershan K Bhatia - Department of Radiation Oncology, Albany Stratton VA Medical Center, Albany, New YorkMark C Smith - Department of Radiation Oncology, University of Iowa, Iowa City, IowaJohn M Buatti - Department of Radiation Oncology, University of Iowa, Iowa City, IowaBryan G Allen - Department of Radiation Oncology, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Advances in radiation oncology, Vol.2(4), pp.581-587
- DOI
- 10.1016/j.adro.2017.07.011
- PMID
- 29204525
- PMCID
- PMC5707423
- NLM abbreviation
- Adv Radiat Oncol
- ISSN
- 2452-1094
- eISSN
- 2452-1094
- Publisher
- Elsevier Inc
- Grant note
- CCSG 5P30-CA08686 / National Institute of Health Department of Radiation Oncology
- Language
- English
- Date published
- 10/2017
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Radiation Oncology; Neurosurgery; Otolaryngology; Internal Medicine
- Record Identifier
- 9984047690802771
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