A Retrospective Review of CyberKnife Stereotactic Body Radiotherapy for Adrenal Tumors (Primary and Metastatic): Winthrop University Hospital Experience

Desai, Amishi; Rai, Hema; Haas, J.A.; Witten, M.R.; Blacksburg, S.R.; Schneider, Jeffrey

doi:10.3389/fonc.2015.00185

Cited by 37 publications

(36 citation statements)

References 31 publications

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“…On the contrary, active motion management strategies like gating and tracking, allow for real-time target monitoring during radiotherapy [22,45]. When applying gating or tracking, the ITV-concept is no longer needed and PTV sizes can be substantially decreased.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Introduction: Local ablative treatment strategies are frequently offered to patients diagnosed with oligometastatic disease. Stereotactic body radiotherapy (SBRT), as ablative treatment option, is well established for lung and liver metastases, whereas for isolated adrenal gland metastases the level of evidence is scarce. Material and methods: This single-institution analysis of oligometastatic or oligoprogressive disease was limited to patients who received SBRT to adrenal metastasis between 2012 and 2019. Patient, tumor, treatment characteristics, and dosimetric parameters were analyzed for evaluation of their effect on survival outcomes. Results: During the period of review 28 patients received ablative SBRT to their adrenal gland metastases. Most common primary tumors were non-small cell lung cancers (46%) with most patients diagnosed with a single adrenal gland metastasis (61%), which occurred after a median time of 14 months. SBRT was delivered to a median biological effective dose at α/β of 10 (BED 10) of 75 Gy (range: 58-151 Gy). Median gross tumor volume (GTV) and median planning target volume (PTV) were 42 and 111 mL, respectively. The homogeneity and conformity indices were 1.17 (range: 1.04-1.64) and 0.5 (range: 0.4.0.99), respectively, with the conformity index being affected by dose restrictions to organs at risk (OARs) in 50% of the patients. Overall response rate based on RECIST criteria was 86% (CR = 29%, PR = 57%) with 2-year local control (LC) of 84.8%, 2-year progression-free survival (PFS) of 26.3%, and 1and 2-year overall survival (OS) of 46.6 and 32.0%, respectively. During follow up, only two local recurrences occurred. A trend for superior LC was seen if BED 10 was ≥75Gy (p = 0.101) or if the PTV was < 100 ml (p = 0.072). SBRT was tolerated well with only mild toxicity. Conclusion: SBRT for adrenal metastases resulted in promising LC with low toxicity. Treatment response appeared to be superior, if SBRT was applied with higher BED. As the close proximity of OARs often limits the application of sufficiently high doses, further dose escalations strategies and techniques should be investigated in future.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…Porte et al (31) have also reported that the median survival time is 11 months with 3 of 43 NSCLC patients having survival time of more than 5 years after resection of isolated adrenal metastasis. Compared to surgical resection, conventional external beam radiotherapy has been considered as unreliable for the management of solitary adrenal metastases because treatment responses are typically transient and incomplete (32). Soejima et al (33) have reported a survival time of 6 months in a study of 14 patients with adrenal metastases receiving radiation.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Outcomes and Safety of Computed Tomography-Guided Percutaneous Microwave Ablation of Solitary Adrenal Metastasis from Lung Cancer: A Multi-Center Retrospective Study

Men

Fan

et al. 2016

Korean J Radiol

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ObjectiveTo retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer.Materials and MethodsFrom May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed.ResultsTheir tumors ranged from 1.5 to 5.4 cm in diameter. After a median follow-up period of 11.1 months, primary efficacy rate was 90.3% (28/31). Local tumor progression was detected in 7 (22.6%) of 31 cases. Their median overall survival time was 12 months. The 1-year overall survival rate was 44.3%. Median local tumor progression-free survival time was 9 months. Local tumor progression-free survival rate was 77.4%. Of 36 MWA sessions, two (5.6%) had major complications (hypertensive crisis).ConclusionCT-guided percutaneous MWA may be fairly safe and effective for treating solitary adrenal metastasis from lung cancer.

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“…Recently, growing evidences have supported that stereotactic body radiotherapy (SBRT) is a safe, non-invasive, and effective technology, showing high local control (LC) rate and low incidence of complication in selected metastatic patients, especially when surgery is not allowed or refused567. It is defined by the American Society of Radiation Oncology as external-beam radiotherapy used to precisely deliver high doses of radiation to an extracranial target within the body, either as a single dose or a small limited number of radiation fractions8.…”

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confidence: 99%

Stereotactic body radiation therapy induces fast tumor control and symptom relief in patients with iliac lymph node metastasis

Wang

Zhuang

et al. 2016

Sci Rep

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The CyberKnife is a robotic stereotactic body radiotherapy (SBRT) system which has shown promising results for many malignances with good efficacy and low toxicity. This study aims to evaluate the response and local control (LC) obtained with CyberKnife in the management of iliac lymph node metastases (ILNM). Twenty-two patients with 27 ILNM were treated by CyberKnife from May 2010 to May 2016. Median follow-up time was 33 months (8–97). The complete response, partial response, stable disease and progression disease rates were 37.0%, 48.0%, 7.5% and 7.5% respectively. The 1-, 2-, and 3-year LC rates were all 90.6%, and overall survival rates were 78.8%, 60.6%, and 43.3% respectively. All patients with pelvic pain and ureter obstruction achieved good and fast symptom relief, while leg edema persisted in 2 patients. The general treatment tolerance was acceptable and no severe toxicities were reported. No factors were found correlated with local failure. While overall survival (OS) was better for patients who had received a total dose more than 30 Gy or prior systemic treatment, and whose symptoms were relieved. Taken together, CyberKnife is an effective therapeutic option for ILNM, providing high LC rate and good symptom relief with minimal toxicity.

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A Retrospective Review of CyberKnife Stereotactic Body Radiotherapy for Adrenal Tumors (Primary and Metastatic): Winthrop University Hospital Experience

Cited by 37 publications

References 31 publications

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

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

Short-Term Outcomes and Safety of Computed Tomography-Guided Percutaneous Microwave Ablation of Solitary Adrenal Metastasis from Lung Cancer: A Multi-Center Retrospective Study

Stereotactic body radiation therapy induces fast tumor control and symptom relief in patients with iliac lymph node metastasis

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