Long-term local control achieved after hypofractionated stereotactic body radiotherapy for adrenal gland metastases: A retrospective analysis of 34 patients

Scorsetti, Marta; Alongi, Filippo; Filippi, Andrea Riccardo; Pentimalli, S.; Navarria, Pierina; Clerici, Elena; Castiglioni, S.; Tozzi, A.; Reggiori, G.; Mancosu, P.; Ricardi, Umberto

doi:10.3109/0284186x.2011.652738

Cited by 80 publications

(58 citation statements)

References 19 publications

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“…It should be noted that in the four studies which showed a lower rate of local control, the median biologically equivalent dose delivered was lower than 60 Gy. 21,22,25,26 In contrast, studies delivering higher biologically equivalent doses (BED median > 85 Gy, BED maximum value 132-137 Gy, ˛/ˇ = 10) 20,27,28 reported a 2-year local control ≥ 90%. These data are consistent with that indicating that a BED greater or equal to 100 Gy is necessary to control primary NSCLC.…”

Section: Efficacymentioning

confidence: 99%

SBRT: A viable option for treating adrenal gland metastases

Ippolito

D’Angelillo

Fiore

et al. 2015

Reports of Practical Oncology & Radiotherapy

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a b s t r a c tThe management strategy of adrenal metastases depends on different clinical situations.Adrenal metastasectomy in selected patients with isolated adrenal metastases is considered the treatment of choice, showing prolonged survival compared to chemotherapy alone.More recently, Stereotactic Body Radiation Therapy (SBRT) has emerged as an alternative local ablative treatment modality although limited data are available on the use of SBRT in treating adrenal gland metastases. Preliminary results are, however, encouraging, especially in selected patients with oligometastatic disease. We herewith review and discuss the potential role of SBRT as a local ablative treatment modality for adrenal metastases.

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Section: Efficacymentioning

confidence: 99%

SBRT: A viable option for treating adrenal gland metastases

Ippolito

D’Angelillo

Fiore

et al. 2015

Reports of Practical Oncology & Radiotherapy

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“…Historically, surgical excision provided better outcome in terms of median survival and overall survival than other local treatments. The advent of SABR led to promising clinical results in this setting in terms of local control, even though most of the case series have a slender sample size and short follow-up time, as summarized in TABLE 2 [34][35][36][37][38]. In a series of homogeneously treated patients from Florence University [37], in the majority the prescription dose was 36 Gy in three fractions, with eight patients treated with a single-fraction.…”

Section: Adrenal Metastasesmentioning

confidence: 96%

New concepts and insights into the role of radiation therapy in extracranial metastatic disease

Ricardi

Filippi

Franco

2013

Expert Review of Anticancer Therapy

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Stereotactic ablative radiotherapy (SABR) is a form of very precise radiotherapy that delivers high doses to tumors while sparing adjacent organs at risk. Recent data show that SABR is a low-toxic and highly effective local treatment for metastatic localizations in various organs, obtaining local control rates of approximately 80%. Experimental evidence also suggests that SABR may play an important therapeutic role in oligometastatic/oligorecurrent/oligoprogressive patients, a subset of cancer patients who are probably in an intermediate disease state between localized disease and widespread dissemination. There is a strong biological and clinical rationale in combining the high local control rates achievable with SABR with effective systemic therapies, and recent results of pilot studies indicate that SABR may have a potential impact on prognosis in this subgroup of patients, being 'curative' in around 20-25% of cases. This paper reviews and discusses basic concepts and clinical applications of SABR in oligometastatic patients.

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“…Imaging should ideally have been performed within 2 months of therapy. 38 Biopsy of an adrenal mass in this setting remains controversial. It has been proposed as mandatory by some, 20,21,24,50,53 especially in a patient with potentially curable intrathoracic disease.…”

Section: Work-up and Patient Selectionmentioning

confidence: 99%

“…Patients in three of the studies received systemic therapy before, after, or concurrent with RT (Table 5). However, cytotoxic systemic therapy was commonly held for 2-4 weeks 23,38 before SBRT and restarted up to 8 weeks after its completion. 38 …”

Section: Radiation Therapymentioning

confidence: 99%

“…37 Oral and intravenous contrast were often employed. 38 CTsimulation-derived 3D datasets contained images in three different breathing phases: non-contrast free-breathing, contrast-enhanced end-expiration, and contrast-enhanced end-inspiration. 40 Simulation and treatment were performed with an empty stomach (nil by mouth [NPO] 3-4 hours) for more reproducible anatomy.…”

Section: Simulationmentioning

confidence: 99%

See 1 more Smart Citation

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Thomsen¹,

Fairchild²

2017

Oncology &Amp; Hematology Review (US)

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B ackground: Five-year overall survival (OS) for patients with stage IV non-small cell lung cancer (NSCLC) is a dismal 1%. However, approximately 7% have limited or solitary metastases, including to the adrenal gland. Radical treatment of these oligometastases (OM) could increase local control and improve OS. Our objective was to critically analyze data describing aggressive treatment of adrenal OM secondary to NSCLC. Methods: A literature search examining English publications describing surgery or radiotherapy (RT) was performed, supplemented by searching reference lists. Case reports of three or fewer patients, and articles from which NSCLC-or adrenal-specific clinical outcomes could not be abstracted, were excluded. Results: Twenty-nine studies met eligibility criteria (521 patients), 26 retrospective. No publications directly compare modalities. Four surgery studies described contemporaneous patients treated with palliative chemotherapy (CH) alone. Reported median OS ranged from 9.5-64 months after adrenalectomy, 8-23 months after RT, and 6-8.5 months after CH. Local failure after surgery was 14%, with response rates after RT 57-75%. Both appear well-tolerated. Conclusions: In patients with an adrenal OM secondary to NSCLC, aggressive treatment should be considered. However, due to the paucity of high quality evidence, it is unclear at present whether this approach alters the natural history of the disease.

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Long-term local control achieved after hypofractionated stereotactic body radiotherapy for adrenal gland metastases: A retrospective analysis of 34 patients

Abstract: (2012) Long-term local control achieved after hypofractionated stereotactic body radiotherapy for adrenal gland metastases: A retrospective analysis of 34 patients, Acta Oncologica, 51:5, 618-623,

Cited by 80 publications

References 19 publications

SBRT: A viable option for treating adrenal gland metastases

SBRT: A viable option for treating adrenal gland metastases

New concepts and insights into the role of radiation therapy in extracranial metastatic disease

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

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