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Buergy, Daniel; Würschmidt, Florian; Gkika, Eleni; Hörner‐Rieber, Juliane; Knippen, Stefan; Gerum, Sabine; Balermpas, Panagiotis; Henkenberens, Christoph; Voglhuber, Theresa; Kornhuber, Christine; Barczyk, Steffen; Röper, Barbara; Rashid, Ali; Blanck, Oliver; Wittig, Andrea; Herold, Hans‐Ulrich; Brunner, Thomas Baptist; Sweeney, Reinhart A.; Kahl, Klaus Henning; Ciernik, Ilja Frank; Ottinger, Annette; Izaguirre, Victor; Putz, Florian; König, Laila; [...]

Stereotactic body radiotherapy of adrenal metastases—A dose‐finding study

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  • Media type: E-Article
  • Title: Stereotactic body radiotherapy of adrenal metastases—A dose‐finding study
  • Contributor: Buergy, Daniel; Würschmidt, Florian; Gkika, Eleni; Hörner‐Rieber, Juliane; Knippen, Stefan; Gerum, Sabine; Balermpas, Panagiotis; Henkenberens, Christoph; Voglhuber, Theresa; Kornhuber, Christine; Barczyk, Steffen; Röper, Barbara; Rashid, Ali; Blanck, Oliver; Wittig, Andrea; Herold, Hans‐Ulrich; Brunner, Thomas Baptist; Sweeney, Reinhart A.; Kahl, Klaus Henning; Ciernik, Ilja Frank; Ottinger, Annette; Izaguirre, Victor; Putz, Florian; König, Laila; [...]
  • Published: Wiley, 2022
  • Published in: International Journal of Cancer, 151 (2022) 3, Seite 412-421
  • Language: English
  • DOI: 10.1002/ijc.34017
  • ISSN: 0020-7136; 1097-0215
  • Keywords: Cancer Research ; Oncology
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:p>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; <jats:italic>P</jats:italic> = .003), GTV‐D50% (BED10: 74.2 Gy; <jats:italic>P</jats:italic> = .006), GTV‐mean (BED10: 73.0 Gy; <jats:italic>P</jats:italic> = .007), and PTV‐D2% (BED10: 78.0 Gy; <jats:italic>P</jats:italic> = .02) but not for the PTV‐D98% (<jats:italic>P</jats:italic> = .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 (&lt;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 (<jats:italic>P</jats:italic> &lt; .001). To achieve a significant improvement of LRR for adrenal SBRT, a moderate escalation of PTV‐D50% BED10 &gt;73.2 Gy (adenocarcinoma: 69.1 Gy) should be considered.</jats:p>
  • Access State: Open Access