Fractionated stereotactic radiation therapy for adrenal metastases: contributing to local tumor control with low toxicity
Fractionated stereotactic radiation therapy for adrenal metastases: contributing to local tumor control with low toxicity
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DOI：
10.1007/s00066-018-1390-3
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发表时间：
2019-03-01
影响因子：
3.1
通讯作者：
Knippen, Stefan
中科院分区：
文献类型：
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作者：
Burjakow, Kim;Fietkau, Rainer;Knippen, Stefan
目的报告埃尔兰根（UK-Er）直线加速器立体定向体部放射治疗（LINAC SBRT）治疗各种原发肿瘤肾上腺转移瘤的经验。原发部位包括肺癌（n=19）、黑色素瘤（n=8）、结直肠癌（n=2）、肝细胞癌（n=1）、食管癌（n=2）和乳腺癌（n=1）。14例患者接受姑息治疗，19例患者接受局部根治性治疗。放射治疗根据呼气、中度通气和吸气CT系列进行治疗计划。进行进一步计划CT检查呼吸模式的正确性。使用aNOVALIS（Varian，Palo Alto，CA，USA; Brainlab AG，Munchen，德国）直线加速器进行辐照。每次治疗前，使用BrainLab ExacTrac（R）（BrainlabAG，Munchen，德国）系统验证等中心点，以最大限度地减少设置错误。剂量被规定为计划靶体积（PTV）周围的90%等剂量。随访根据他们的整体性能状态和预后，患者接受临床检查和放射成像。统计学分析采用IBM SPSS v.24进行单变量分析，采用Kaplan-Meier曲线、非参数Kruskal-Wallis检验和卡方检验进行频率分布。根据NCI CTCAE v4.0对毒性进行分级。根据影像学检查，患者分为稳定，回归，和progress.ResultsMedian生存期为11个月，中位PFS为5个月。中位局部无失败生存期为21个月。接受根治性治疗的患者生存曲线较好（p
PurposeTo report on the Erlangen (UK-Er) experience with linear accelerator stereotactic body radiation therapy (LINAC SBRT) for adrenal metastasis from various primary tumors.Materials and methods33patients were treated. Primary sites included lung (n=19), melanoma (n=8), colorectal (n=2), hepatocellular (n=1), esophageal (n=2), and breast cancer (n=1). 14patients were treated palliatively, 19patients were treated with local curative intent.Radiation treatmentTreatment planning was done based on an exhale, mid-ventilation, and inspiration CT series. Further planning CTs were done to check for the correctness of the breathing pattern. Irradiation was performed using aNOVALIS (Varian, Palo Alto, CA, USA; Brainlab AG, Munchen, Germany) linear accelerator. The isocenter was verified before each treatment session using the BrainLab ExacTrac (R) (BrainlabAG, Munchen, Germany) system to minimize setup errors. Dose was prescribed to the planning target volume (PTV) surrounding 90% isodose.Follow-upDepending on their overall performance status and prognosis, patients received clinical check-ups and radiological imaging. Median follow-up was 11months.Statistical analysisIBM SPSS v.24 was used for univariate analysis using Kaplan-Meier curves, nonparametric Kruskal-Wallis test, and the chi-square test for frequency distributions. Toxicity was graded according to NCI CTCAE v4.0. Depending on radiologic imaging, patients were classified as stable, regression, and progression.ResultsMedian survival was 11months, median PFS was 5months. Median local failure-free survival was 21months. Patients who were treated with curative intent showed abetter survival curve (p