Department of Biomedical Sciences, Humanitas University, Milan, Italy; Humanitas Research Hospital IRCCS, Dept of Radiotherapy and Radiosurgery, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy; Humanitas Research Hospital IRCCS, Dept of Radiotherapy and Radiosurgery, Milan, Italy.
Semin Radiat Oncol. 2023 Apr;33(2):193-202. doi: 10.1016/j.semradonc.2022.11.001.
Adrenal glands represent a common site of metastases from several primary tumors, including lung cancer, breast cancer and melanoma. Surgical resection is considered the standard of care, but surgery is not always feasible given the challenges related to anatomical site and/or due to patient and/or disease characteristics. Stereotactic body radiation therapy (SBRT) represents a promising treatment for oligometastases, though the literature on its role for adrenal metastases is still heterogeneous. Herein are summarized the most relevant published studies on the efficacy and safety of SBRT for adrenal gland metastases. The preliminary data suggests that SBRT yields high local control rates and symptom relief with a mild pattern of toxicity. Advanced radiotherapy techniques including IMRT and VMAT, a BED10 > 72 Gy and the use of 4DCT for motion control should be considered for a high quality ablative treatment of adrenal gland metastases.
肾上腺是多种原发性肿瘤（包括肺癌、乳腺癌和黑色素瘤）转移的常见部位。手术切除被认为是标准的治疗方法，但由于解剖部位的相关挑战和/或由于患者和/或疾病特征，手术并非总是可行。立体定向体部放射治疗（SBRT）是寡转移瘤的一种有前途的治疗方法，尽管关于其治疗肾上腺转移的文献仍然存在异质性。本文总结了关于 SBRT 治疗肾上腺转移的疗效和安全性的最相关的已发表研究。初步数据表明，SBRT 可获得较高的局部控制率和症状缓解，且毒性较轻。对于高质量的肾上腺转移消融治疗，应考虑使用先进的放射治疗技术，包括调强放疗（IMRT）和容积旋转调强放疗（VMAT）、生物等效剂量（BED10）>72Gy 以及 4DCT 用于运动控制。
