Stereotactic body radiotherapy in the treatment of adrenal metastases.
OBJECTIVE
To evaluate the dosimetry, clinical outcomes, and toxicity of patients treated with stereotactic body radiotherapy (SBRT) for adrenal metastases.


METHODS
From February 2009 to February 2011, a total of 13 patients were treated with SBRT for metastases to the adrenal glands. Median age was 71 years (range, 60.8 to 83.2). Primary sites included lung (n=6), kidney (n=2), skin (n=2), bladder (n=1), colon (n=1), and liver (n=1). Nine patients had metastases to the left adrenal gland and 4 to the right. The median prescribed total dose was 45 Gy (range, 33.75 to 60 Gy), all in 5 fractions.


RESULTS
Median follow-up for living patients was 12.3 months (range, 3.1 to 18 mo). Twelve of the 13 patients (92.3%) were evaluable for local control (LC). The crude LC rate was 100%, with no cases of local or marginal failure. Two patients had a complete response to treatment, 9 patients had a partial response, and 1 patient displayed stable disease. One-year overall survival and distant control were 62.9% and 55%, respectively. Median OS was 7.2 months (range, 2 to 18 mo). Grade 2 nausea was noted in 2 patients.


CONCLUSIONS
SBRT seems to be a safe and effective measure to achieve LC for adrenal metastases.
*Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL †Department of Radiation Oncology, Mayo Clinic, Rochester, MN ‡Department of Radiation Oncology, Providence Medical Center, Kansas City, Kansas.
Kamran A
KA
Ahmed
Brandon M
BM
Barney
O Kenneth
OK
Macdonald
Robert C
RC
Miller
Yolanda I
YI
Garces
Nadia N
NN
Laack
Michael G
MG
Haddock
Robert L
RL
Foote
Kenneth R
KR
Olivier
D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D016634:Radiosurgery; D015996:Survival Rate