Local Control and Survival after Image-Guided Percutaneous Ablation of Adrenal Metastases

Frenk, Nathan E.; Daye, Dania; Tuncalı, Kemal; Arellano, Ronald S.; Shyn, Paul B.; Silverman, Stuart G.; Fintelmann, Florian J.; Uppot, Raul N.

doi:10.1016/j.jvir.2017.07.026

Cited by 39 publications

(50 citation statements)

References 28 publications

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“… 30 2016 20 Retrospective Microwave ablation 84.8% None by SIR Frenk et al. 31 2017 38 Retrospective Radiofrequency, cryoablation, or microwave ablation 1 y 82% 2 y 75% Minor: 6% Major: 12% Botsa et al. 32 2017 71 Retrospective Radiofrequency or Microwave ablation 1 y 67.6% Major: 0% Stereotactic body radiation therapy studies Chawla et al.…”

Section: Discussionmentioning

confidence: 99%

“… 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 Percutaneous ablative procedures such as microwave and radiofrequency ablation are also frequently used, and several retrospective series have reported 3-year OS rates >50%. 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 A noninvasive, ablative modality called stereotactic body radiation therapy (SBRT; also referred to as stereotactic ablative radiation therapy) has emerged as a promising alternative option for the local treatment of oligometastatic disease. 33 , 34 , 35 Preliminary experience with the use of SBRT to treat adrenal metastases demonstrates low toxicity rates with local disease control that ranges between 55% and 95% at 1 year.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stereotactic body radiation therapy for adrenal gland metastases: Outcomes and toxicity

Toesca¹,

Koong²,

Eyben³

et al. 2018

Advances in Radiation Oncology

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PurposeThis study aimed to report on our institutional experience in the use of stereotactic body radiation therapy (SBRT) for the treatment of adrenal gland metastases. Specifically, we examined the outcomes and toxicity from this treatment modality on adjacent organs at risk.Methods and MaterialsData were retrieved from patients with adrenal metastases who were treated with SBRT between 2008 and 2017. Patients with primary adrenal malignancies were excluded. Toxicities were graded in accordance with the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03. Time-to-event rates were calculated from the date of SBRT delivery.ResultsIn total, 35 patients with adrenal metastases were identified. Four patients were treated for bilateral disease. The median dose was 40 Gy (range, 20-54 Gy) in 5 fractions (range, 1-6 fractions). The median follow-up time was 37 months (range, 14-451 months) from disease diagnosis and 7 months (range, 1-54 months) from the SBRT start date. With death treated as a competing risk event, the cumulative incidence of local failure was 7.6% at 1 year after SBRT and 19.2% at 3 years. The median overall survival (OS) time was 19 months (95% confidence interval, 8-54 months) and tumor size correlated with survival (P = .0006). Patients with metastases <2.9 cm had a median OS of 54 months compared with 11 months for those with adrenal metastases ≥2.9 cm (P = .01). Incidence of grade 2 toxicity was 17% with no case of grade ≥3 toxicity. SBRT did not impact renal function with a mean estimated decline in glomerular filtration rate of only 2.6 ± 8 mL/min/1.73 m2 compared with baseline. Combined kidneys V5 and combined renal cortex V17.5 did not correlate with a change in estimated glomerular filtration rate (P = .7 and P = .9, respectively).ConclusionsSBRT offers excellent local control for the treatment of adrenal gland metastases with very low toxicity rates and no significant short-term impact on renal function.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stereotactic body radiation therapy for adrenal gland metastases: Outcomes and toxicity

Toesca¹,

Koong²,

Eyben³

et al. 2018

Advances in Radiation Oncology

View full text Add to dashboard Cite

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“…With the growing availability of percutaneous image-guided ablative technology and the development of expertise in treating both primary tumors and metastases in different viscera and regions within the body, both technical success and primary efficacy have been demonstrated in the use of magnetic resonance imaging-directed laser ablation, cryoablation, radiofrequency ablation, and microwave ablation of RCC metastases involving the adrenal gland, 46,47 the appendicular and axial skeleton, 48,49 and the lungs. [50][51][52] Therefore, particularly in patients who have low-volume metastatic disease who may not be surgical candidates, percutaneous thermal ablation appears to be a reasonable approach to consider.…”

Section: Percutaneous Thermal Ablationmentioning

confidence: 99%

Role of metastasis‐directed treatment in kidney cancer

Psutka

Master

2018

Cancer

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Despite the rapid elaboration of multiple, novel systemic agents introduced for metastatic renal cell carcinoma (mRCC) in recent years, a durable complete response remains elusive with systemic therapy alone. Definitive treatment of the metastatic deposit remains the sole potentially curative option and is a cornerstone of mRCC therapy, offering potential for both local control and palliation of tumor-related symptoms. In this review, the evidence supporting the definitive treatment of mRCC is examined and summarized, including the use of surgical metastasectomy, thermal ablation, radiotherapy, and other minimally invasive options. Multimodal approaches, including the combination of metastasectomy with novel systemic agents, are discussed. Finally, the authors review considerations for patient selection for this type of therapy and summarize available risk-stratification tools that may help guide shared decision making.

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“…To date, some research groups of interventional radiologists have reported clinical application of ablative methods to adrenocortical tumors including cortisol-producing adenomas 76 , 77 and adrenal metastatic lesions. 78 , 79 As clinical experiences of the adrenal ablation have been accumulated, initial experiences of CT-guided percutaneous radio-frequency ablation to unilateral APA was reported. 80–83 …”

Section: Treatment Options and Updated Outcomesmentioning

confidence: 99%

Progress in the Management of Primary Aldosteronism

Morimoto

Omata

Ito

et al. 2018

American Journal of Hypertension

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Primary aldosteronism (PA) is now considered as one of leading causes of secondary hypertension, accounting for 5–10% of all hypertensive patients and more strikingly 20% of those with resistant hypertension. Importantly, those with the unilateral disease could be surgically cured when diagnosed appropriately. On the other hand, only a very limited portion of those suspected to have PA has been screened, diagnosed, or treated to date. With current advancement in medical technologies and genetic research, expanding knowledge of PA has been accumulated and recent achievements have also been documented in the care of those with PA. This review is aimed to have focused description on updated topics of the following; importance of PA screening both in the general and specialized settings and careful interpretation of screening data, recent achievements in hormone assays and sampling methods and their clinical relevance, and expanding knowledge on PA genetics. Improvement in workup processes and novel treatment options, as well as better understanding of the PA pathogenesis based on genetic research, might be expected to result in increased cure and better care of the patients.

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Local Control and Survival after Image-Guided Percutaneous Ablation of Adrenal Metastases

Cited by 39 publications

References 28 publications

Stereotactic body radiation therapy for adrenal gland metastases: Outcomes and toxicity

Stereotactic body radiation therapy for adrenal gland metastases: Outcomes and toxicity

Role of metastasis‐directed treatment in kidney cancer

Progress in the Management of Primary Aldosteronism

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