Two-institution results of Stereotactic Body Radiation Therapy (SBRT) for treating adrenal gland metastases from liver cancer

• Published in: BMC cancer 2023-01, Vol.23 (1), p.73-9, Article 73
• Main Authors: Xu, Bichun, Zhao, Xianzhi, Chen, Di, Zhao, Wenjuan, Wang, Xiaoyan, Ding, Changhua, Yuan, Zhiyong, Zhang, Huojun
• Format: Article
• Language: English
• Subjects: Adrenal gland metastases (AGM); Adrenal Gland Neoplasms; Adrenal Glands; Adverse events; Apoptosis; Back pain; Cancer therapies; Care and treatment; Cholangiocarcinoma; Development and progression; Female; Health aspects; Humans; Immunotherapy; Liver cancer; Liver Neoplasms - secondary; Local control; Male; Medical prognosis; Metastases; Metastasis; Multivariate analysis; Patient outcomes; Patients; Prevention; Radiation therapy; Radiosurgery; Radiosurgery - methods; Retrospective Studies; Risk factors; Statistical analysis; Stereotactic body radiotherapy (SBRT); Survival; Terminology; Tomography; Toxicity; Tumors
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-023-10519-9

Stereotactic Body Radiation Therapy (SBRT) has been found beneficial for adrenal gland metastases (AGMs) with a high local control rate and low toxicity. The role of SBRT for AGMs in patients with liver cancer has not been well-discussed before. We, therefore, report our two-institution experience to further elaborate on the feasibility and effectiveness of SBRT in the treatment of AGMs from liver cancer. A total of 23 liver cancer patients (19 males, 4 females) with 24 AGMs treated by SBRT from July 2006 to April 2021 were retrospectively included in this study. Toxicity was assessed based on clinical adverse events using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The effectiveness was assessed based on local control (LC), progression-free survival (PFS), and overall survival (OS), which were calculated using the Kaplan-Meier method. Univariate analyses were compared by log-rank test. The relevant covariates were evaluated using Cox proportional hazards models. The median dose was 40 Gy in 5 fractions, with the corresponding median biological effective dose (BED10, α/β = 10 Gy) of 72 Gy. The median overall follow-up time was 15.4 months (range: 4.2-70.6 months). The complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) rates were 25.0%, 20.8%, 33.3%, and 20.8%, respectively. All 6 patients with AGMs accompanying symptoms had varying degrees of alleviation after SBRT. The 0.5-, 1-year and 2-year LC rates were 87.5%, 77.8%, and 77.8%, respectively. The 0.5-, 1-year and 2-year OS rates were 95.5%, 66.8%, and 41.1%, respectively. The treatments were all tolerated with only one patient reporting a grade-3 hepatic injury. The univariate analysis concluded that only gross tumor volume (GTV)