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Stereotactic body radiation therapy for adrenal gland metastases: outcome and predictive factors from a multicenter analysis

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Abstract

Adrenal metastases occur in 15–35% of oncological patients. Surgery is the first treatment option. Stereotactic body radiotherapy (SBRT) has been largely explored in oligometastatic patients unfit for surgery, representing an effective and non-invasive local treatment. The results of a multi-institutional experience of SBRT on adrenal metastases in the oligorecurrent or oligoprogressive setting are herein reported. We collected data of adrenal gland metastases treated with SBRT in three Italian centers from 2010 to 2020. End-points of the present study were: Overall survival (OS), Local control of treated metastases (LC), Progression free survival (PFS), and toxicity. 149 adrenal gland metastases were treated with SBRT in 142 patients. The most common primary tumor was lung cancer (58.4%), followed by kidney cancer (9.4%). Median lesion’s volume was 28.5 cm3 (2.5–323.4). The median SBRT dose was 40 Gy (10–60). Median follow-up was 14.4 months. One- and two-year OS were 72.3% and 53.5%. At univariate analysis performance status correlated with survival (HR 1.57, p = 0.006). One- and two-year LC were 85.4% and 79.2%, with lung primary tumor (HR 0.33, p = 0.021) and BED10 (HR 0.97, p = 0.036) significant independent factors. One- and two-year PFS were 37.7% and 24.8%. Median time to polymetastatic disease was 11.3 months. Grade 1 and 2 toxicity occurred in 21 (14.7%) and 3 (2.1%) patients. The results from this large multi-center study confirm the efficacy and safety of SBRT in the management of adrenal gland metastases, as a valid alternative to other more invasive local approaches.

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Funding

No fundings were used for the present study.

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Authors and Affiliations

  1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy

    Ciro Franzese, Lorenzo Lo Faro  & Marta Scorsetti

  2. IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy

    Ciro Franzese, Lorenzo Lo Faro  & Marta Scorsetti

  3. Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Verona, Negrar, Italy

    Luca Nicosia, Francesco Cuccia & Filippo Alongi

  4. Department of Radiation Oncology, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy

    Giuseppe Facondo, Gianluca Vullo & Mattia Falchetto Osti

  5. University of Brescia, Brescia, Italy

    Filippo Alongi

Authors
  1. Ciro Franzese
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  2. Luca Nicosia
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  3. Giuseppe Facondo
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  4. Lorenzo Lo Faro
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  5. Francesco Cuccia
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  6. Gianluca Vullo
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  7. Mattia Falchetto Osti
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  8. Filippo Alongi
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  9. Marta Scorsetti
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Contributions

All authors contributed to the study conception and design. Material preparation, and data collection were performed by GF, LLF, FC, and GV, analysis was performed by CF. The first draft of the manuscript was written by LN, CF, and FC. The final version of the manuscript was performed by MFO, FA, and MS. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Luca Nicosia.

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Franzese, C., Nicosia, L., Facondo, G. et al. Stereotactic body radiation therapy for adrenal gland metastases: outcome and predictive factors from a multicenter analysis. Clin Exp Metastasis 38, 511–518 (2021). https://doi.org/10.1007/s10585-021-10124-9

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  • DOI: https://doi.org/10.1007/s10585-021-10124-9

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