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Radiotherapy for adrenal gland metastases from hepatocellular carcinoma

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Abstract

Background

Several studies have found benefits of radiotherapy for adrenal metastasis from hepatocellular carcinoma (HCC). However, the efficacy, safety and outcome issues have not yet been fully addressed. Therefore, we performed this study to further elucidate the feasibility and outcome of radiotherapy in treating adrenal metastasis from HCC.

Methods

We retrospectively analyzed 81 patients with adrenal metastasis from HCC between 2001 and 2015. Eighteen patients received helical tomotherapy and 63 patients received conventional radiotherapy, including two-dimensional (2-D) or three-dimensional conformal radiotherapy (3-D CRT). The median radiation dose was 50 Gy (range 26–64 Gy) with median fraction size of 2.0 Gy (range 2.0–5.0 Gy). Tumor responses, adverse effects, patient outcomes and prognostic factors were analyzed.

Results

An objective response (complete and partial response) was achieved in 55.6% patients. The helical tomotherapy group showed higher objective response rate than the conventional radiotherapy group (P = 0.031). The major adverse effects were anorexia (51.8%), nausea (41.9%), and fatigue (35.8%). Similar toxicity profile occurred in the 2-D, 3-D CRT and helical tomotherapy groups. The overall survival (OS) rate at 1, 2 and 5 years was 59.9, 35.0, and 12.9%, respectively, with a median survival of 15 months. Patients who received helical tomotherapy achieved a better OS compared to the conventional radiotherapy group (P = 0.047). However, multivariate analysis indicated that radiotherapy technique was not an independent prognostic factor for patient outcome.

Conclusion

These results suggest that radiotherapy offers a noninvasive approach in controlling adrenal metastasis from HCC with promising local control and acceptable tolerability.

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Authors and Affiliations

  1. Department of Radiation Oncology, Zhongshan Hospital, Fudan University, No. 180 Feng Lin Road, Shanghai, 200032, China

    B.-Y. Yuan, Y. Hu, L. Zhang, Y.-H. Chen, Y.-Y. Dong & Z.-C. Zeng

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  1. B.-Y. Yuan
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  2. Y. Hu
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  3. L. Zhang
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  4. Y.-H. Chen
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  5. Y.-Y. Dong
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  6. Z.-C. Zeng
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Corresponding author

Correspondence to Z.-C. Zeng.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Yuan, BY., Hu, Y., Zhang, L. et al. Radiotherapy for adrenal gland metastases from hepatocellular carcinoma. Clin Transl Oncol 19, 1154–1160 (2017). https://doi.org/10.1007/s12094-017-1654-x

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  • DOI: https://doi.org/10.1007/s12094-017-1654-x

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