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

Buergy D, Wuerschmidt F, Gkika E, Hoerner-Rieber J, Knippen S, Gerum S, Balermpas P, Henkenberens C, Voglhuber T, Kornhuber C, Barczyk S, Roeper B, Rashid A, Blanck O, Wittig A, Herold HU, Brunner TB, Klement RJ, Kahl KH, Ciernik IF, Ottinger A, Izaguirre V, Putz F, Koenig L, Hoffmann M, Combs SE, Guckenberger M, Boda-Heggemann J (2021)

Publication Type: Journal article

Publication year: 2021

Journal

DOI: 10.1002/ijc.33546

Abstract

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.

Authors with CRIS profile

Involved external institutions

MEDICLIN Robert Janker Klinik Germany (DE) Klinikum Westmünsterland GmbH Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Universitätsklinikum Halle (Saale) Germany (DE) Technische Universität München (TUM) Germany (DE) Ruprecht-Karls-Universität Heidelberg Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) CyberKnife Centrum Mitteldeutschland GmbH Germany (DE) Radiologische Allianz GbR Germany (DE) Universitätsklinikum Jena Germany (DE) Klinikum der Universität München (Großhadern und Innenstadt) Germany (DE) University of Zurich / Universität Zürich (UZH) Switzerland (CH) Ludwig-Maximilians-Universität (LMU) Germany (DE) Universitätsklinikum Freiburg Germany (DE) Städtisches Klinikum Dessau Germany (DE) Klinikum Darmstadt Germany (DE) Klinikum Augsburg Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (HMGU) / Helmholtz Munich Germany (DE) Universitätsklinikum Magdeburg A.ö.R. Germany (DE)

How to cite

APA:

Buergy, D., Wuerschmidt, F., Gkika, E., Hoerner-Rieber, J., Knippen, S., Gerum, S.,... Boda-Heggemann, J. (2021). Stereotactic or conformal radiotherapy for adrenal metastases: Patient characteristics and outcomes in a multicenter analysis. International Journal of Cancer. https://doi.org/10.1002/ijc.33546

MLA:

Buergy, Daniel, et al. "Stereotactic or conformal radiotherapy for adrenal metastases: Patient characteristics and outcomes in a multicenter analysis." International Journal of Cancer (2021).

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