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Clinical efficacy of CyberKnife radiosurgery in treatment of adrenal metastases:a study of 42 patients
Zhao Xianzhi, Zhuang Hongqing, Yuan Zhiyong,Wamg Jingsheng, Dong Yang, Chen Huaming, Li Fengtong, Song Yongchun, Wang Ping
CyberKnife Center, Department of Radiotherapy, Tianjin Medical University Cancer Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin 300060, China
Abstract Objective To investigate the safety and efficacy of stereotactic body radiotherapy (SBRT) in the treatment of patients with adrenal metastases. Methods The clinical data of 42 patients with adrenal metastases who were treated with CyberKnife radiosurgery from 2006 to 2013 were retrospectively analyzed. Short-term outcomes at 1 month after treatment were evaluated. The evaluation was performed using RECIST 1.1 criteria by the World Health Organization. The adverse reactions were assessed using RTOG/EORTC radiation injury grading criteria, and the overall survival (OS) and local control (LC) rates were calculated using the Kaplan-Meier method. Results Among 47 targets in 42 patients, 14 lesions showed a complete response, and 13 lesions showed a partial response, with an overall response rate of 57%. The sample sizes at 1 year and 2 years were 25 and 19, respectively. The 1-and 2-year LC rates were 87% and 60%, respectively. The 1-and 2-year OS rates were 53% and 41%, respectively, and the 1-and 2-year progression-free survival (PFS) rates were 17% and 8%, respectively. The PFS was substantially improved in patients with a gross target volume less than 2.5 cm3, a biologically equivalent dose higher than 80 Gy, and older than 60 years of age. The adverse reactions after treatment were mainly grade 1 or 2 gastrointestinal reactions including fatigue, anorexia, nausea, and vomit, and grade 1 or 2 bone marrow suppression. Only one patient showed grade 3 gastrointestinal reactions. Conclusion SBRT is a safe and effective method in the treatment of adrenal metastases with mild adverse reactions and good LC rates.
Zhao Xianzhi,Zhuang Hongqing,Yuan Zhiyong et al. Clinical efficacy of CyberKnife radiosurgery in treatment of adrenal metastases:a study of 42 patients[J]. Chinese Journal of Radiation Oncology, 2015, 24(3): 271-274.
Zhao Xianzhi,Zhuang Hongqing,Yuan Zhiyong et al. Clinical efficacy of CyberKnife radiosurgery in treatment of adrenal metastases:a study of 42 patients[J]. Chinese Journal of Radiation Oncology, 2015, 24(3): 271-274.
[1] Lo CY, van Heerden JA, Soreide JA, et al. Adrenalectomy for metastatic disease to the adrenal glands[J].Br J Surg,1996,83(4):528-531. [2] Tanvetyanon T, Robinson LA, Schell MJ, et al. Outcomes ofadrenalectomy for isolated synchronous versus metachronous adre nal metastases in non-small-cell lung cancer:a systematic review and pooled analysis[J].J Clin Oncol,2008,26(7):1142-1147.DOI:10.1200/JCO.2007.14.2091. [3] Prevost JB, Voet P, Hoogeman M, et al. Four-dimensional stereotactic radiotherapy for early stage non-small cell lung cancer:a comparative planning study[J].Technol Cancer Res Treat,2008,7(1):27-33. [4] 王晓光,刘群,袁智勇,等.Cyberknife治疗脊柱脊髓肿瘤的初步观察[J].中华放射肿瘤学杂志,2008,17(4):317-318. [5] 李兵,封其卉,沈君姝.射波刀-全身肿瘤立体定向放射外科新设备[J].医疗卫生装备,2009,30(1):37-39. [6] 董洋,李丰彤,王境生,等.置入软组织金标数目对射波刀系统影像定位精度影响[J].中华放射肿瘤学杂志,2010,19(5):465-467.DOI:10.3760/cma.j.issn.1004-4221.2010.05.026. [7] 王境生,李丰彤,董洋,等.肾上腺肿块病变的运动规律及影响因素的临床研究[J].国际医学放射学杂志,2013,36(6):511-513. [8] Li J, Shi Z, Wang Z, et al. Treating adrenal tumors in 26 patients with CyberKnife:a mono-institutional experience[J/OL]. PLoS One,2013,8(11):e80654[2014-07-08].http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835566/.DOI:10.1371/journal.pone.0080654. [9] Rudra S, Malik R, Ranck MC,et al. Stereotactic body radiation therapy for curative treatment of adrenal metastases[J].Technol Cancer Res Treat,2013,12(3):217-224.DOI:10.7785/tcrt.2012.500320. [10] Casamassima F, Livi L, Masciullo S, et al. Stereotactic radiotherapy for adrenal gland metastases:university of florence experience[J].Int J Radiat Oncol Biol Phys,2012,82(2):919-923.DOI:10.1016/j.ijrobp.2010.11.060. [11] Soejima T, Hirota S, Hishikawa Y, et al. Radiation therapy for adrenal metastases[J]. Nihon Igaku Hoshasen Gakkai Zasshi,1997,57(12):801-804. [12] Katoh N, Onimaru R, Sakuhara Y, et al. Real-time tumor-tracking radiotherapy for adrenal tumors[J].Radiother Oncol,2008,87(3):418-424.DOI:10.1016/j.radonc.2008.03.013. [13] Chawla S, Chen Y, Katz AW, et al. Stereotactic body radiotherapy for treatment of adrenal metastases[J]. Int J Radiat Oncol Biol Phys,2009,75(1):71-75.DOI:10.1016/j.ijrobp.2008.10.079. [14] Holy R, Piroth M, Pinkawa M,et al. Stereotactic body radiation therapy (SBRT) for treatment of adrenal gland metastases from non-small cell lung cancer[J]. Strahlenther Onkol,2011,187(4):245-251.DOI:10.1007/s00066-011-2192-z. [15] Oshiro Y, Takeda Y, Hirano S, et al. Role of radiotherapy for local control of asymptomatic adrenal metastasis from lung cancer[J].Am J Clin Oncol,2011,34(3):249-253.DOI:10.1097/COC.0b013e3181 dbb727. [16] Scorsetti M, Alongi F, Filippi AR,et al. Long-term local control achieved after hypofractionated stereotactic body radiotherapy for adrenal gland metastases:a retrospective analysis of 34 patients[J]. Acta Oncol,2012,51(5):618-623.DOI:10.3109/0284186X.2011.652738. [17] Torok J, Wegner RE, Burton SA,et al. Stereotactic body radiation therapy for adrenal metastases:a retrospective review of a noninvasive therapeutic strategy[J].Future Oncol,2011,7(1):145-151.DOI:10.2217/fon.10.165. [18] Guiou M, Mayr NA, Kim EY,et al. Stereotactic body radiotherapy for adrenal metastases from lung cancer[J].J Radiat Oncol,2012,1(2):155-163.DOI:10.1007/s13566-012-0037-8. [19] van der Voort van Zyp NC, Prévost JB, Hoogeman MS,et al. Stereotactic radiotherapy with real-time tumor tracking for non-small cell lung cancer:clinical outcome[J].Radiother Oncol,2009,91(3):296-300.DOI:10.1016/j.radonc.2009.02.011.
2015, Vol. 24 
