Abstract
The adrenal gland is a common site of cancer metastasis. Surgery remains a mainstay of treatment for solitary adrenal metastasis. For patients who cannot undergo surgery, radiation is an alternative option. Stereotactic body radiotherapy (SBRT) is an ablative treatment option allowing larger doses to be delivered over a shorter period of time. In this study, we report on our experience with the use of SBRT to treat adrenal metastases using CyberKnife technology. We retrospectively reviewed the Winthrop University radiation oncology data base to identify 14 patients for whom SBRT was administered to treat malignant adrenal disease. Of the factors examined, the biological equivalent dose (BED) of radiation delivered was found to be the most important predictor of local adrenal tumor control. We conclude that CyberKnife-based SBRT is a safe, non-invasive modality that has broadened the therapeutic options for the treatment of isolated adrenal metastases.
Highlights
IntroductionIn an autopsy series involving 91 patients with metastatic cancer, metastatic spread to the adrenal gland was demonstrated in 30% of patients [1]
The adrenal gland is a common site of cancer metastasis
Two patients had pain associated with adrenal metastases in the setting of widespread metastatic disease and received Stereotactic body radiotherapy (SBRT) with palliative intent
Summary
In an autopsy series involving 91 patients with metastatic cancer, metastatic spread to the adrenal gland was demonstrated in 30% of patients [1]. This propensity for adrenal metastasis, exhibited by many different primary tumor types, is likely a consequence of the adrenal glands’ rich sinusoidal blood supply [2]. The most prevalent form of metastatic cancer, is the most common primary tumor type responsible for adrenal metastases [1, 3]. The adrenal gland is made up of adrenal cortex and medulla. The adrenal medulla synthesizes and secretes catecholamines, which modulate the body’s sympathetic response to stress. The onset of adrenal insufficiency is often very gradual and it may go undetected until an illness or other stress precipitates adrenal crisis
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