Stereotactic body radiotherapy (SBRT) of adrenal metastases


Sponsor-Investigator:

PD Dr. Judit Boda-Heggemann /PD Dr. Daniel Buergy
Universitätsmedizin Mannheim
daniel.buergy@medma.uni-heidelberg.de

Study objective:

To analyze the toxicity and efficacy of targeted radiotherapy to adrenal metastases

Project status

  • Data collection completed
  • Two full articles published

Major findings and results

Buergy D, Würschmidt F, Gkika E, et al. Stereotactic body radiotherapy of adrenal metastases-A dose-finding study. Int J Cancer. 2022; 151(3):412-421.  https://pubmed.ncbi.nlm.nih.gov/35383919/

  • Dose-volume parameters available in 218 patients treated with SBRT
  • Biologically effective dose (BED10) cut-point analyses indicated optimal dose cut-points as follows:
    • PTV-D50%: 73.2 Gy
    • PTV-D2%: 78.0 Gy
    • GTV-D50%: 74.2 Gy
    • GTV-mean: 73.0 Gy
  • If these dose levels were achieved, local recurrence rates (LRR) were significantly reduced compared to patients who received lower doses.
  • Further dose escalation was not associated with improved LRR in our patient cohort (e.g., PTV-D50% values of 73.2-85.9 Gy compared to doses above 85.9 Gy)

Buergy D, Würschmidt F, Gkika E, et al. Stereotactic or conformal radiotherapy for adrenal metastases: Patient characteristics and outcomes in a multicenter analysis. Int J Cancer. 2021; 149(2):358-370. https://pubmed.ncbi.nlm.nih.gov/33682927/

  •  366 lesions included in the analysis (260 treated with SBRT)
  • Toxicity mostly mild; however, four cases of adrenal insufficiency occurred, 2 of which were likely caused by immunotherapy or tumor progression
  • Freedom from local progression after one year was associated with improved overall survival

Project status:

  • Study closed (219 patients recruited)
  • Follow-up ongoing