Two-institution results of Stereotactic Body Radiation Therapy (SBRT) for treating adrenal gland metastases from liver cancer
Abstract Objective 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-insti...
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-10519-9 |
| _version_ | 1797945901769031680 |
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| author | Bichun Xu Xianzhi Zhao Di Chen Wenjuan Zhao Xiaoyan Wang Changhua Ding Zhiyong Yuan Huojun Zhang |
| author_facet | Bichun Xu Xianzhi Zhao Di Chen Wenjuan Zhao Xiaoyan Wang Changhua Ding Zhiyong Yuan Huojun Zhang |
| author_sort | Bichun Xu |
| collection | DOAJ |
| description | Abstract Objective 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. Methods 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. Results 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) < 34.5 ml (p = 0.039) was associated with a favorable LC rate. After multivariate analysis, favorable predictors correlated with OS were GTV < 34.5 ml (p = 0.043), systemic therapy (p = 0.017), and without additional organ metastasis after SBRT (p = 0.009). Conclusion Our results suggest that SBRT is a safe and effective technique to treat AGM from liver cancer, especially for small GTV (< 34.5ml). Moreover, the small metastatic lesion volume, fewer metastatic lesions, and intervention of systemic therapy are more likely to improve OS. |
| first_indexed | 2024-04-10T21:02:28Z |
| format | Article |
| id | doaj.art-bf53523ced4c4ee58a68599e987f5fd8 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-10T21:02:28Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-bf53523ced4c4ee58a68599e987f5fd82023-01-22T12:16:39ZengBMCBMC Cancer1471-24072023-01-012311910.1186/s12885-023-10519-9Two-institution results of Stereotactic Body Radiation Therapy (SBRT) for treating adrenal gland metastases from liver cancerBichun Xu0Xianzhi Zhao1Di Chen2Wenjuan Zhao3Xiaoyan Wang4Changhua Ding5Zhiyong Yuan6Huojun Zhang7Department of Radiation Oncology, Shanghai Changhai Hospital, the Navy Medical UniversityDepartment of Radiation Oncology, Shanghai Changhai Hospital, the Navy Medical UniversityDepartment of Radiation Oncology, Shanghai Changhai Hospital, the Navy Medical UniversityDepartment of Radiation Oncology, Shanghai Changhai Hospital, the Navy Medical UniversityDepartment of Radiation Oncology, Shanghai Changhai Hospital, the Navy Medical UniversityDepartment of Radiation Oncology, Shanghai Changhai Hospital, the Navy Medical UniversityDepartment of Radiation Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for CancerDepartment of Radiation Oncology, Shanghai Changhai Hospital, the Navy Medical UniversityAbstract Objective 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. Methods 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. Results 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) < 34.5 ml (p = 0.039) was associated with a favorable LC rate. After multivariate analysis, favorable predictors correlated with OS were GTV < 34.5 ml (p = 0.043), systemic therapy (p = 0.017), and without additional organ metastasis after SBRT (p = 0.009). Conclusion Our results suggest that SBRT is a safe and effective technique to treat AGM from liver cancer, especially for small GTV (< 34.5ml). Moreover, the small metastatic lesion volume, fewer metastatic lesions, and intervention of systemic therapy are more likely to improve OS.https://doi.org/10.1186/s12885-023-10519-9Adrenal gland metastases (AGM)Stereotactic body radiotherapy (SBRT)Liver cancerLocal controlSurvival |
| spellingShingle | Bichun Xu Xianzhi Zhao Di Chen Wenjuan Zhao Xiaoyan Wang Changhua Ding Zhiyong Yuan Huojun Zhang Two-institution results of Stereotactic Body Radiation Therapy (SBRT) for treating adrenal gland metastases from liver cancer BMC Cancer Adrenal gland metastases (AGM) Stereotactic body radiotherapy (SBRT) Liver cancer Local control Survival |
| title | Two-institution results of Stereotactic Body Radiation Therapy (SBRT) for treating adrenal gland metastases from liver cancer |
| title_full | Two-institution results of Stereotactic Body Radiation Therapy (SBRT) for treating adrenal gland metastases from liver cancer |
| title_fullStr | Two-institution results of Stereotactic Body Radiation Therapy (SBRT) for treating adrenal gland metastases from liver cancer |
| title_full_unstemmed | Two-institution results of Stereotactic Body Radiation Therapy (SBRT) for treating adrenal gland metastases from liver cancer |
| title_short | Two-institution results of Stereotactic Body Radiation Therapy (SBRT) for treating adrenal gland metastases from liver cancer |
| title_sort | two institution results of stereotactic body radiation therapy sbrt for treating adrenal gland metastases from liver cancer |
| topic | Adrenal gland metastases (AGM) Stereotactic body radiotherapy (SBRT) Liver cancer Local control Survival |
| url | https://doi.org/10.1186/s12885-023-10519-9 |
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