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Stereotactic or conformal radiotherapy for adrenal metastases: Patient characteristics and outcomes in a multicenter analysis
Author(s) -
Buergy Daniel,
Würschmidt Florian,
Gkika Eleni,
HörnerRieber Juliane,
Knippen Stefan,
Gerum Sabine,
Balermpas Panagiotis,
Henkenberens Christoph,
Voglhuber Theresa,
Kornhuber Christine,
Barczyk Steffen,
Röper Barbara,
Rashid Ali,
Blanck Oliver,
Wittig Andrea,
Herold HansUlrich,
Brunner Thomas B.,
Klement Rainer J.,
Kahl Klaus Henning,
Ciernik Ilja F.,
Ottinger Annette,
Izaguirre Victor,
Putz Florian,
König Laila,
Hoffmann Michael,
Combs Stephanie E.,
Guckenberger Matthias,
BodaHeggemann Judit
Publication year - 2021
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.33546
Subject(s) - medicine , toxicity , oncology , radiosurgery , radiation therapy , retrospective cohort study , cohort , urology
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.