Zhao Ruizhi, Ma Yuchao, Yang Siran, Liu Qingfeng, Tang Yuan, Wang Kai, Zhang Ye, Bi Nan, Zhang Hongmei, Yi Junlin, Li Yexiong, Luo Jingwei, Xiao Jianping
Department 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.
Department 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.
Cancer Manag Res. 2020 Nov 12;12:11563-11571. doi: 10.2147/CMAR.S278781. eCollection 2020.
To investigate the clinical outcomes of hypofractionated radiotherapy for adrenal metastases.
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.
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 cm (range: 3.5-97.8 cm) and 38.3 cm (range: 10.2-135.6 cm), 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.
As a non-invasive approach, hypofractionated radiotherapy is safe and effective for metastatic adrenal lesions, without serious complications.
探讨肾上腺转移瘤大分割放疗的临床疗效。
我们回顾性分析了2007年至2019年期间诊断为肾上腺转移瘤并接受大分割放疗的患者，这些患者未接受肾上腺切除术或化疗后疾病未进展。采用Kaplan-Meier法估计局部控制率（LCR）、无进展生存期（PFS）和总生存期（OS）。使用Log rank检验进行单因素分析。
共纳入35例患者的42个病灶，最常见的原发部位是肺（80.0%）。中位随访时间为46.4个月。GTV和PTV的中位体积分别为23.2 cm（范围：3.5 - 97.8 cm）和38.3 cm（范围：10.2 - 135.6 cm）。主要剂量方案为4 - 15次分割给予60 Gy，PTV的中位剂量为60 Gy（范围：40 - 66.3 Gy），生物等效剂量（BED）为84 Gy（范围：56 - 110 Gy）。1年和2年的LCR、OS和PFS分别为92.7%和88.1%、76.9%和45.4%、25.1%和14.4%。单因素分析显示，化疗、从原发性疾病诊断到肾上腺转移瘤诊断的无病间期和年龄分别是LCR、OS和PFS的显著影响因素（p分别为0.017、0.049和0.004）。未观察到超过III级的毒性反应。
作为一种非侵入性方法，大分割放疗对肾上腺转移瘤安全有效，无严重并发症。
