Phase II trial of SBRT for adrenal metastases: efficacy and impact on hormonal production.
PD-0582
Abstract
Phase II trial of SBRT for adrenal metastases: efficacy and impact on hormonal production.
Authors: Ciro Franzese1, Sara Stefanini1, Maria Massaro1, Tiziana Comito2, Pierina Navarria2, Elena Clerici1, Ausilia Teriaca2, Davide Franceschini2, Giacomo Reggiori2, Stefano Tomatis2, Andrea Lania3, Marta Scorsetti1
1Humanitas University, Humanitas Research Hospital IRCCS, Radiotherapy and Radiosurgery, Milano, Italy; 2Humanitas Research Hospital IRCCS, Radiotherapy and Radiosurgery, Milano, Italy; 3Humanitas University, Humanitas Research Hospital IRCCS, Endocrinology, Diabetology and Medical Andrology Unit, Milano, Italy
Show Affiliations
Hide Affiliations
Purpose or Objective
The purpose of this study was to assess prospectively the efficacy and safety of Stereotactic body radiation therapy (SBRT) for adrenal gland metastasis, with a focus on the assessment of the irradiated subjects’ endocrinological function.
Material and Methods
A total of 36 patients were enrolled from 2017 to 2020 in this prospective phase II trial. Patients were treated with Linac-based SBRT, with a dose of 45 Gy in 3 consecutive fractions. Primary end-point was local control (LC) of the treated lesions and secondary end-points included evaluation of acute and late toxicity, progression free survival (PFS), overall survival (OS) and the impact on the hormonal production of adrenal glands.
Results
With a median follow-up of 9.5 months, LC rates at 1 and 2 years were 94.7% and 88.4%, respectively. Rates of PFS at 1 and 2 years were 50.5% and 29.8%, with a median PFS of 14.7 months. Rates of OS at 1 and 2 years were 62.9% and 44.1%. At univariate analysis, oligorecurrence was associated with better OS compared to oligoprogressive or synchronous metastatic disease. No grade 3 or greater toxicities were registered and only a minority of patients (22.2%) reported mild treatment-related side effects. Hormonal and electrolytes production was assessed before and after treatment, showing only a slight and transient variation within the reference ranges.
Conclusion
SBRT on adrenal metastases has been confirmed to be a feasible and effective treatment. With an excellent disease control and the preservation of the endocrine function, SBRT with ablative dose can be considered a viable alternative to more invasive approaches