Organ At Risk (OAR) Data on Clinical Toxicity in The Treatment of Bulky Adrenal Metastases With Stereotactic Ablative Radiotherapy (SABR)

Abstract

Aim Effectiveness of the treatment was investigated in terms of treatment responses and side effects with OAR in oligometastatic patients whose adrenal metastases were treated with SABR. Methods Patients who underwent radiosurgery for adrenal gland metastasis in our clinic were evaluated retrospectively for the patient, tumor, treatment characteristics, survival outcomes, and dosimetric parameters with toxicity. Results Of the 22 patients in our study. The primary tumor site was the lung in 20 (90.9%) of 22 patients, while ten (45.5%) of the patients had isolated adrenal metastasis. The median dose was 30 Gy (R:18–50) with a median fraction of five (R:3–10). The median PTV volume was 55 cc. (IQR:44-120cc). From the first diagnosis to adrenal gland radiotherapy, the median time was 6.9 months. The median follow-up was 7 months (R:2–48), and the median survival was 9.5 months (R:2–48). The local control rate was 72.7% in the 6th month, 63.6% in the 1st year, and 59.0% in the 2nd year, and overall survival was 72.7%, 50%, and 31.8%, respectively. The median overall survival was 9.5 months for all patients (p = 0.049) and 6.5 months in the presence of diffuse disease. Deaths of patients due to distant progression were also found to be significant (p = 0.03). Patients with isolated adrenal metastasis survived for 14.4 months after the treatment; while extra-adrenal metastasis lived for a median of 6.6 months (P = 0.01). Conclusion SABR in patients with oligometastatic adrenal disease not only provides symptom control but may also provide prolonged survival with minimal toxicity.