Stereotactic or conformal radiotherapy for adrenal metastases: Patient characteristics and outcomes in a multicenter analysis

被引：27

作者：

Buergy, Daniel ^{[1
]}

Wuerschmidt, Florian ^{[2
]}

Gkika, Eleni ^{[3
]}

Hoerner-Rieber, Juliane ^{[4
]}

Knippen, Stefan ^{[5
,6
]}

Gerum, Sabine ^{[7
,8
]}

Balermpas, Panagiotis ^{[9
]}

Henkenberens, Christoph ^{[10
]}

Voglhuber, Theresa ^{[11
]}

Kornhuber, Christine ^{[12
]}

Barczyk, Steffen ^{[13
]}

Roeper, Barbara ^{[14
]}

Rashid, Ali ^{[15
]}

Blanck, Oliver ^{[16
]}

Wittig, Andrea ^{[5
]}

Herold, Hans-Ulrich ^{[17
]}

Brunner, Thomas B. ^{[18
]}

Klement, Rainer J. ^{[11
,19
]}

Kahl, Klaus Henning ^{[20
]}

Ciernik, Ilja F. ^{[21
]}

Ottinger, Annette ^{[22
]}

Izaguirre, Victor ^{[12
]}

Putz, Florian ^{[6
]}

Koenig, Laila ^{[4
]}

Hoffmann, Michael ^{[23
]}

Combs, Stephanie E. ^{[24
,25
]}

Guckenberger, Matthias ^{[11
]}

Boda-Heggemann, Judit ^{[1
]}

机构：

[1] Heidelberg Univ, Klin Strahlentherapie & Radioonkol, Med Fak Mannheim, Univ Med Mannheim, Mannheim, Germany

[2] Radiol Allianz, Strahlentherapie, Hamburg, Germany

[3] Univ Klinikum Freiburg, Strahlenheilkunde, Freiburg, Germany

[4] Univ Klinikum Heidelberg, Klin Radioonkol & Strahlentherapie, Heidelberg, Germany

[5] Univ Klinikum Jena, Klin Strahlentherapie & Radioonkol, Jena, Germany

[6] Univ Klinikum Erlangen, Strahlenklin, Erlangen, Germany

[7] Radioonkol LMU Munchen, Strahlentherapie & Radioonkol, Munich, Germany

[8] Paracelsus Univ Salzburg, Klin Radiotherapie & Radioonkol, Salzburg, Austria

[9] Univ Zurich, Universitatsspital Zurich, Klin Radioonkol, Zurich, Switzerland

[10] Hannover Med Sch, Klin Strahlentherapie & Spezielle Onkol, Hannover, Germany

[11] Tech Univ Munchen TUM, Dept Radiat Oncol, Munich, Germany

[12] Univ Klinikum Halle Saale, Halle, Saale, Germany

[13] St Agnes Hosp, Belegklin, Zentrum Strahlentherapie & Radioonkol, Bocholt, Germany

[14] Gemeinschaftspraxis Strahlentherapie Bogenhause, Munich, Germany

[15] MediClin Robert Janker Klin, Klin Strahlentherapie & Radioonkol, Bonn, Germany

[16] Univ Klinikum Schleswig Holstein, Klin Strahlentherapie, Kiel, Germany

[17] Cyberknife Ctr Mitteldeutsch GmbH, Inst Radiochirurg & Prazisionsbestrahlung, Erfurt, Germany

[18] Univ Klinikum Magdeburg, Klin Strahlentherapie, Magdeburg, Germany

[19] Leopoldina Krankenhaus Schweinfurt, Klin Strahlentherapie, Schweinfurt, Germany

[20] Univ Klinikum Augsburg, Klin Strahlentherapie & Radioonkol, Augsburg, Germany

[21] Stadt Klinikum Dessau, Klin Strahlentherapie & Radioonkol, Dessau, Germany

[22] Klinikum Darmstadt GmbH, Inst Radioonkol & Strahlentherapie, Darmstadt, Germany

[23] Klinikum Univ Munchen, LMU, Klin & Poliklin Strahlentherapie & Radioonkol, Munich, Germany

[24] Helmholtz Zentrum Munchen HMGU, Neuherberg, Germany

[25] Deutsch Zentrum Translat Krebsforsch DKTK, Partner Site Munich, Munich, Germany

来源：

INTERNATIONAL JOURNAL OF CANCER | 2021年 / 149卷 / 02期

关键词：

adrenal; oligometastases; outcome; patterns of care; SBRT; BODY RADIATION-THERAPY; CELL LUNG-CANCER; LOCAL CONSOLIDATIVE THERAPY; LAPAROSCOPIC ADRENALECTOMY; MAINTENANCE THERAPY; GLAND METASTASES; SBRT; PATTERNS; TESTS; LIVER;

D O I：

10.1002/ijc.33546

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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.

引用

页码：358 / 370

页数：13

共 48 条

[11] A retrospective review of CyberKnife stereotactic body radiotherapy for adrenal tumors (primary and metastatic): Winthrop University Hospital experience [J].

Desai, Amishi ;

Rai, Hema ;

Haas, Jonathan ;

Witten, Matthew ;

Blacksburg, Seth ;

Schneider, Jeffrey G. .

FRONTIERS IN ONCOLOGY, 2015, 5

[12] Choice and interpretation of statistical tests used when competing risks are present [J].

Dignam, James J. ;

Kocherginsky, Maria N. .

JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (24) :4027-4034

[13] Laparoscopic adrenalectomy for isolated adrenal metastasis: The right thing to do and the right way to do it [J].

Duh, Quan-Yang .

ANNALS OF SURGICAL ONCOLOGY, 2007, 14 (12) :3288-3289

[14] Competing risks in survival data analysis [J].

Dutz, Almut ;

Loeck, Steffen .

RADIOTHERAPY AND ONCOLOGY, 2019, 130 :185-189

[15] Minimally Invasive Stereotactical Radio-ablation of Adrenal Metastases as an Alternative to Surgery [J].

Franzese, Ciro ;

Franceschini, Davide ;

Cozzi, Luca ;

D'Agostino, Giuseppe ;

Comito, Tiziana ;

De Rose, Fiorenza ;

Navarria, Pierina ;

Mancosu, Pietro ;

Tomatis, Stefano ;

Fogliata, Antonella ;

Scorsetti, Marta .

CANCER RESEARCH AND TREATMENT, 2017, 49 (01) :20-28

[16] Local Consolidative Therapy Vs. Maintenance Therapy or Observation for Patients With Oligometastatic Non-Small-Cell Lung Cancer: Long-Term Results of a Multi-Institutional, Phase II, Randomized Study [J].

Gomez, Daniel R. ;

Tang, Chad ;

Zhang, Jianjun ;

Blumenschein, George R., Jr. ;

Hernandez, Mike ;

Lee, J. Jack ;

Ye, Rong ;

Palma, David A. ;

Louie, Alexander, V ;

Camidge, D. Ross ;

Doebele, Robert C. ;

Skoulidis, Ferdinandos ;

Gaspar, Laurie E. ;

Welsh, James W. ;

Gibbons, Don L. ;

Karam, Jose A. ;

Kavanagh, Brian D. ;

Tsao, Anne S. ;

Sepesi, Boris ;

Swisher, Stephen G. ;

Heymach, John, V .

JOURNAL OF CLINICAL ONCOLOGY, 2019, 37 (18) :1558-1565

[17] Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study [J].

Gomez, Daniel R. ;

Blumenschein, George R., Jr. ;

Lee, J. Jack ;

Hernandez, Mike ;

Ye, Rong ;

Camidge, D. Ross ;

Doebele, Robert C. ;

Skoulidis, Ferdinandos ;

Gaspar, Laurie E. ;

Gibbons, Don L. ;

Karam, Jose A. ;

Kavanagh, Brian D. ;

Tang, Chad ;

Komaki, Ritsuko ;

Louie, Alexander V. ;

Palma, David A. ;

Tsao, Anne S. ;

Sepesi, Boris ;

William, William N. ;

Zhang, Jianjun ;

Shi, Qiuling ;

Wang, Xin Shelley ;

Swisher, Stephen G. ;

Heymach, John V. .

LANCET ONCOLOGY, 2016, 17 (12) :1672-1682

[18] A CLASS OF K-SAMPLE TESTS FOR COMPARING THE CUMULATIVE INCIDENCE OF A COMPETING RISK [J].

GRAY, RJ .

ANNALS OF STATISTICS, 1988, 16 (03) :1141-1154

[19] Definition and quality requirements for stereotactic radiotherapy: consensus statement from the DEGRO/DGMP Working Group Stereotactic Radiotherapy and Radiosurgery [J].

Guckenberger, Matthias ;

Baus, Wolfgang W. ;

Blanck, Oliver ;

Combs, Stephanie E. ;

Debus, Juergen ;

Engenhart-Cabillic, Rita ;

Gauer, Tobias ;

Grosu, Anca L. ;

Schmitt, Daniela ;

Tanadini-Lang, Stephanie ;

Moustakis, Christos .

STRAHLENTHERAPIE UND ONKOLOGIE, 2020, 196 (05) :417-420

[20] OLIGOMETASTASES [J].

HELLMAN, S ;

WEICHSELBAUM, RR .

JOURNAL OF CLINICAL ONCOLOGY, 1995, 13 (01) :8-10

← 1 2 3 4 5 →