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Hypofractionated Radiotherapy for 35 Patients with Adrenal Metastases: A Single-Institution Experience

Authors Zhao R, Ma Y, Yang S, Liu Q, Tang Y, Wang K, Zhang Y, Bi N, Zhang H, Yi J, Li Y, Luo J, Xiao J

Received 27 August 2020

Accepted for publication 27 October 2020

Published 12 November 2020 Volume 2020:12 Pages 11563—11571

DOI https://doi.org/10.2147/CMAR.S278781

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Sanjeev Srivastava


Ruizhi Zhao,1 Yuchao Ma,1 Siran Yang,1 Qingfeng Liu,1 Yuan Tang,1 Kai Wang,1 Ye Zhang,1 Nan Bi,1 Hongmei Zhang,2 Junlin Yi,1 Yexiong Li,1 Jingwei Luo,1 Jianping Xiao1

1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People’s Republic of China; 2Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People’s Republic of China

Correspondence: Jianping Xiao; Jingwei Luo
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academic of Medical Sciences, Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, People’s Republic of China
Tel +86-10-87788281
; Tel +86-10-87788288
Fax +86-10-67706153
Email jpxiao8@163.com; jingwei-luo@outlook.com

Objective: To investigate the clinical outcomes of hypofractionated radiotherapy for adrenal metastases.
Materials and Methods: We retrospectively reviewed patients diagnosed with adrenal metastases and treated with hypofractionated radiotherapy, who did not receive adrenalectomy or have disease progression after chemotherapy, from 2007 to 2019. The Kaplan–Meier method was used to estimate local control rate (LCR), progression-free survival (PFS), and overall survival (OS). Univariate analysis was performed using Log rank test.
Results: Thirty-five patients with 42 lesions were enrolled, and the lung was the most common primary site (80.0%). The median follow-up time was 46.4 months. The median volume of GTV and PTV was 23.2 cm3 (range: 3.5– 97.8 cm3) and 38.3 cm3 (range: 10.2– 135.6 cm3), respectively. The main dose regimens were 60 Gy delivered in 4– 15 fractions, with the median dose of PTV being 60 Gy (range: 40– 66.3 Gy) and the biologically effective dose (BED) being 84 Gy (range: 56– 110 Gy). The 1-year and 2-year LCR, OS, and PFS were 92.7% and 88.1%, 76.9% and 45.4%, and 25.1% and 14.4%, respectively. Univariate analysis showed that chemotherapy, disease-free interval from primary disease diagnosis to adrenal metastases diagnosis, and age were significant factors for LCR, OS, and PFS, respectively (p=0.017, 0.049, and 0.004, respectively). No more than grade III toxicities were observed.
Conclusion: As a non-invasive approach, hypofractionated radiotherapy is safe and effective for metastatic adrenal lesions, without serious complications.

Keywords: adrenal metastases, hypofractionated radiotherapy, prognosis, toxicities

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