title: Treating adrenal tumors in 26 patients with CyberKnife: a mono-institutional experience.
abstract: BACKGROUND
  CyberKnife (CK) is a novel stereotactic radiosurgery system for treating tumors in any part of the body. It is a non-invasive or minimally invasive tumor treatment modality that can deliver high doses of spatially precise radiation and minimize exposure to neighboring healthy tissues or vital organs. The purpose of this study was to investigate the safety and efficacy of CK in the treatment of adrenal tumors.
  
  
  RESULTS
  We performed a retrospective analysis of 26 patients with adrenal tumors who had been treated with CK in the radiotherapy center of our hospital between March 2009 and March 2012. Eight patients had primary adrenal tumors and 18 patients had metastatic adrenal tumors. In addition to CK, 4 patients received chemotherapy and 2 patients received immunotherapy. The average tumor volume was 72.1 cm(3) and the prescribed radiation dosage ranged from 30 to 50 Gy and was fractionated 3 to 5 times with a 58% to 80% isodose line. Abdominal CT was performed between 1 to 3 months after the CK treatment to evaluate the short-term efficacy with follow-up examinations once every 3 months. Three patients had complete remission, 12 patients had partial remission, 5 patients had stable disease, and 6 patients had progressive illness. The effective rate of pain relief was 93.8% and the disease control rate was 77% with a median overall survival of 17 months and a median progression-free survival of 14 months. Treatment Related toxicity was well-tolerated, but preventative measure need to be taken for radiation enteritis.
  
  
  CONCLUSIONS
  CK is safe and effective for treating adrenal tumors with few adverse reactions. Nonetheless, its long-term effects requires further follow-up.
authors.affiliation: Jinling Hospital, Department of Radiotherapy Center, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Zhaorong
authors.initials: Z
authors.lastname: Shi
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Zhibing
authors.initials: Z
authors.lastname: Liu
authors.forename: Xinhu
authors.initials: X
authors.lastname: Wu
authors.forename: Zetian
authors.initials: Z
authors.lastname: Shen
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Yong
authors.initials: Y
authors.lastname: Song
authors.forename: Xixu
authors.initials: X
authors.lastname: Zhu
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011874:Radiometry; D016634:Radiosurgery / Q000009:adverse effects; D011879:Radiotherapy Dosage; D016896:Treatment Outcome