Dataset Information

Multi-institutional experience of MR-guided stereotactic body radiation therapy for adrenal gland metastases.

ABSTRACT:

Purpose

While dose escalation is associated with improved local control (LC) for adrenal gland metastases (AGMs), the proximity of gastrointestinal (GI) organs-at-risk (OARs) limits the dose that can be safely prescribed via CT-based stereotactic body radiation therapy (SBRT). The advantages of magnetic resonance-guided SBRT (MRgSBRT), including tumor tracking and online plan adaptation, facilitate safe dose escalation.

Methods

This is a multi-institutional review of 57 consecutive patients who received MRgSBRT on a 0.35-T MR linac to 61 AGMs from 2019 to 2021. The Kaplan-Meier method was used to estimate overall survival (OS), progression-free survival (PFS), and LC, and the Cox proportional hazards model was utilized for univariate analysis (UVA).

Results

Median follow up from MRgSBRT was 16.4 months (range [R]: 1.1-39 months). Median age was 67 years (R: 28-84 years). Primary histologies included non-small cell lung cancer (N = 38), renal cell carcinoma (N = 6), and melanoma (N = 5), amongst others. The median maximum diameter was 2.7 cm (R: 0.6-7.6 cm), and most AGMs were left-sided (N = 32). The median dose was 50 Gy (R: 30-60 Gy) in 5-10 fractions with a median BED₁₀ of 100 Gy (R: 48-132 Gy). 45 cases (74 %) required adaptation for at least 1 fraction (median: 4 fractions, R: 0-10). Left-sided AGMs required adaptation in at least 1 fraction more frequently than right-sided AGMs (88 % vs 59 %, p = 0.018). There were 3 cases of reirradiation, including 60 Gy in 10 fractions (N = 1) and 40 Gy in 5 fractions (N = 2). One-year LC, PFS, and OS were 92 %, 52 %, and 78 %, respectively. On UVA, melanoma histology predicted for inferior 1-year LC (80 % vs 93 %, p = 0.012). There were no instances of grade 3+ toxicity.

Conclusions

We demonstrate that MRgSBRT achieves favorable early LC and no grade 3 + toxicity despite prescribing a median BED₁₀ of 100 Gy to targets near GI OARs.

SUBMITTER: Mills M

PROVIDER: S-EPMC10824679 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Multi-institutional experience of MR-guided stereotactic body radiation therapy for adrenal gland metastases.

Mills Matthew M Kotecha Rupesh R Herrera Roberto R Kutuk Tugce T Fahey Matthew M Wuthrick Evan E Grass G Daniel GD Hoffe Sarah S Frakes Jessica J Chuong Michael D MD Rosenberg Stephen A SA

Clinical and translational radiation oncology 20240105

<h4>Purpose</h4>While dose escalation is associated with improved local control (LC) for adrenal gland metastases (AGMs), the proximity of gastrointestinal (GI) organs-at-risk (OARs) limits the dose that can be safely prescribed via CT-based stereotactic body radiation therapy (SBRT). The advantages of magnetic resonance-guided SBRT (MRgSBRT), including tumor tracking and online plan adaptation, facilitate safe dose escalation.<h4>Methods</h4>This is a multi-institutional review of 57 consecutiv ...[more]

PMID: 38292332

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Dataset Information

Multi-institutional experience of MR-guided stereotactic body radiation therapy for adrenal gland metastases.

Purpose

Methods

Results

Conclusions

Publications

Multi-institutional experience of MR-guided stereotactic body radiation therapy for adrenal gland metastases.

Similar Datasets

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