title: Evaluation of stereotactic body radiation therapy in the management of adrenal metastases from non-small cell lung cancer.
abstract: OBJECTIVE
  In this retrospective analysis, we evaluated the use of stereotactic body radiation therapy in the management of adrenal metastases from non-small cell lung cancer and report our single center experience.
  
  
  METHODS
  Fifteen non-small cell lung cancer patients (9 male, 6 female) with 17 adrenal metastases referred to Gulhane Military Medical Academy Radiation Oncology Department were treated using active breathing control-guided stereotactic body radiation therapy between December 2009 and October 2013. Dose per fraction was 10 Gy to deliver a total dose of 30 Gy over 3 consecutive days for all metastatic adrenal lesions. The mean gross tumor volume was 28.4 cc (range 6.6-101.5) and mean planning target volume was 57.4 cc (range 16.5-143.8).
  
  
  RESULTS
  At a median follow-up of 16 months, local control was 86.7% and overall survival was 33.3%. Median disease-free survival was 10 months. Treatment response according to RECIST was categorized as complete response in 3 patients (20%), partial response in 5 patients (33.3%), stable disease in 5 patients (33.3%), and progressive disease in 2 patients (13.3%). Most common acute toxicity was grade 1 nausea (n = 7) and grade 1 fatigue (n = 12). There was no case of grade ≥3 acute or late toxicity.
  
  
  CONCLUSIONS
  Stereotactic body radiation therapy offers a safe and efficacious management strategy for adrenal metastases from non-small cell lung cancer by providing excellent local control with negligible treatment related toxicity.
authors.affiliation: Department of Radiation Oncology, Gulhane Military Medical Academy, Ankara - Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Gamsiz
authors.forename: Murat
authors.initials: M
authors.lastname: Beyzadeoglu
authors.forename: Omer
authors.initials: O
authors.lastname: Sager
authors.forename: Selcuk
authors.initials: S
authors.lastname: Demiral
authors.forename: Ferrat
authors.initials: F
authors.lastname: Dincoglan
authors.forename: Bora
authors.initials: B
authors.lastname: Uysal
authors.forename: Elif
authors.initials: E
authors.lastname: Onal
authors.forename: Bahar
authors.initials: B
authors.lastname: Dirican
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D000310:Adrenal Gland Neoplasms / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey