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

Buergy, Daniel; Wuerschmidt, Florian; Gkika, Eleni; Hoerner-Rieber, Juliane; Knippen, Stefan; Gerum, Sabine; Balermpas, Panagiotis; Henkenberens, Christoph; Voglhuber, Theresa; Kornhuber, Christine; Barczyk, Steffen; Roeper, Barbara; Rashid, Ali; Blanck, Oliver; Wittig, Andrea; Herold, Hans-Ulrich; Brunner, Thomas B.; Klement, Rainer J.; Kahl, Klaus Henning; Ciernik, Ilja F.; Ottinger, Annette; Izaguirre, Victor; Putz, Florian; Koenig, Laila; Hoffmann, Michael; Combs, Stephanie E.; Guckenberger, Matthias und Boda-Heggemann, Judit (2021): Stereotactic or conformal radiotherapy for adrenal metastases: Patient characteristics and outcomes in a multicenter analysis. In: International Journal of Cancer, Bd. 149, Nr. 2: S. 358-370

Abstract

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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0020-7136
• Sprache: Englisch