Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Buergy, D; Würschmidt, F; Gkika, E; Hörner-Rieber, J; Knippen, S; Gerum, S; Balermpas, P; Henkenberens, C; Voglhuber, T; Kornhuber, C; Barczyk, S; Röper, B; Rashid, A; Blanck, O; Wittig, A; Herold, HU; Brunner, TB; Sweeney, RA; Kahl, KH; Ciernik, IF; Ottinger, A; Izaguirre, V; Putz, F; König, L; Hoffmann, M; Combs, SE; Guckenberger, M; Boda-Heggemann, J.
Stereotactic body radiotherapy of adrenal metastases-A dose-finding study.
Int J Cancer. 2022; 151(3): 412-421.
Doi: 10.1002/ijc.34017
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Brunner Thomas Baptist
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- Abstract:
- Optimal doses for the treatment of adrenal metastases with stereotactic radiotherapy (SBRT) are unknown. We aimed to identify dose-volume cut-points associated with decreased local recurrence rates (LRR). A multicenter database of patients with adrenal metastases of any histology treated with SBRT (biologically effective dose, BED10 ≥50 Gy, ≤12 fractions) was analyzed. Details on dose-volume parameters were required (planning target volume: PTV-D98%, PTV-D50%, PTV-D2%; gross tumor volume: GTV-D50%, GTV-mean). Cut-points for LRR were optimized using the R maxstat package. One hundred and ninety-six patients with 218 lesions were included, the largest histopathological subgroup was adenocarcinoma (n = 101). Cut-point optimization resulted in significant cut-points for PTV-D50% (BED10: 73.2 Gy; P = .003), GTV-D50% (BED10: 74.2 Gy; P = .006), GTV-mean (BED10: 73.0 Gy; P = .007), and PTV-D2% (BED10: 78.0 Gy; P = .02) but not for the PTV-D98% (P = .06). Differences in LRR were clinically relevant (LRR ≥ doubled for cut-points that were not achieved). Further dose-escalation was not associated with further improved LRR. PTV-D50%, GTV-D50%, and GTV-mean cut-points were also associated with significantly improved LRR in the adenocarcinoma subgroup. Separate dose optimizations indicated a lower cut-point for the PTV-D50% (BED10: 69.1 Gy) in adenocarcinoma lesions, other values were similar (<2% difference). Associations of cut-points with overall survival (OS) and progression-free survival were not significant but durable freedom from local recurrence was associated with OS in a landmark model (P < .001). To achieve a significant improvement of LRR for adrenal SBRT, a moderate escalation of PTV-D50% BED10 >73.2 Gy (adenocarcinoma: 69.1 Gy) should be considered.
- Find related publications in this database (using NLM MeSH Indexing)
- Adenocarcinoma - radiotherapy
- Adrenal Gland Neoplasms - radiotherapy, secondary
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- Lung Neoplasms - pathology
- Neoplasms, Second Primary - administration & dosage
- Radiosurgery - methods
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- Find related publications in this database (Keywords)
- adrenal
- dose-finding
- oligometastases
- SBRT