Lütscher Jamie, Gelpke Hans, Zehnder Adrian, Mauti Laetitia, Padevit Christian, John Hubert, Batifi Nidar, Zwahlen Daniel Rudolf, Förster Robert, Schröder Christina
Department of Radiation Oncology, Cantonal Hospital Winterthur, 8401 Winterthur, Switzerland.
Department of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, 8401 Winterthur, Switzerland.
Cancers (Basel). 2024 Jul 26;16(15):2655. doi: 10.3390/cancers16152655.
This single-center retrospective study aimed to evaluate the efficacy and toxicity profiles of stereotactic body radiotherapy (SBRT) and surgical resection in patients with adrenal metastases originating from solid tumors.
METHODS/MATERIALS: Patients with advanced tumor conditions or comorbidities typically received SBRT, whereas those considered physically fit underwent standard surgical treatment. Endpoints included local control (LC), progression free survival (PFS), overall survival (OS), and complication rates (CR).
41 patients with 48 adrenal metastases were included, with 27 (65.9%) patients receiving SBRT and 14 (34.1%) patients undergoing adrenalectomy. One- and two-year LC values were 100% for both periods after adrenalectomy, and 70.0% and 52.5% after SBRT ( = 0.001). PFS showed values of 40.2% and 32.1% at one and two years after adrenalectomy and of 10.6% for both periods after SBRT ( = 0.223). OS was 83.3% both one and two years after surgery and 67.0% and 40.2% after SBRT ( = 0.031). There was no statistically significant difference between the two groups regarding acute complications ( = 0.123).
Despite potential confounders, adrenalectomy exhibited statistically significant superior LC and OS compared to SBRT in managing adrenal metastases, while both treatment methods displayed acceptable toxicity profiles. However, patient selection bias must be taken into account when directly comparing the two therapy modalities. Nevertheless, the study provides new and important results for the scientific and medical communities regarding oncological outcomes after SBRT or surgical resection of adrenal metastases.
本单中心回顾性研究旨在评估立体定向体部放疗（SBRT）和手术切除对实体瘤肾上腺转移患者的疗效和毒性特征。
方法/材料：肿瘤病情晚期或合并症患者通常接受SBRT，而身体状况良好的患者接受标准手术治疗。观察指标包括局部控制（LC）、无进展生存期（PFS）、总生存期（OS）和并发症发生率（CR）。
纳入41例有48处肾上腺转移灶的患者，其中27例（65.9%）接受SBRT，14例（34.1%）接受肾上腺切除术。肾上腺切除术后1年和2年的LC值均为100%，SBRT后分别为70.0%和52.5%（P = 0.001）。肾上腺切除术后1年和2年的PFS值分别为40.2%和32.1%，SBRT后两个时期均为10.6%（P = 0.223）。术后1年和2年的OS均为83.3%，SBRT后分别为67.0%和40.2%（P = 0.031）。两组急性并发症发生率无统计学差异（P = 0.123）。
尽管存在潜在混杂因素，但在处理肾上腺转移瘤方面，肾上腺切除术在LC和OS方面显示出统计学上显著优于SBRT，而两种治疗方法的毒性特征均可接受。然而，在直接比较两种治疗方式时必须考虑患者选择偏倚。尽管如此，该研究为科学界和医学界提供了关于SBRT或手术切除肾上腺转移瘤后肿瘤学结局的新的重要结果。
