Stereotactic MR-Guided Radiotherapy for Adrenal Gland Metastases: First Clinical Results

• Published in: Journal of clinical medicine Vol. 12; no. 1; p. 291
• Main Authors: Michalet, Morgan, Bettaïeb, Ons, Khalfi, Samia, Ghorbel, Asma, Valdenaire, Simon, Debuire, Pierre, Aillères, Norbert, Draghici, Roxana, De Méric De Bellefon, Mailys, Charissoux, Marie, Boisselier, Pierre, Demontoy, Sylvain, Marguerit, Alexis, Cabaillé, Morgane, Cantaloube, Marie, Keskes, Aïcha, Bouhafa, Touria, Farcy-Jacquet, Marie-Pierre, Fenoglietto, Pascal, Azria, David, Riou, Olivier
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30-12-2022; MDPI
• Subjects: Adaptation; Adrenal glands; Algorithms; Cancer; Contraindications; Dosimetry; Magnetic resonance imaging; Medical imaging; Metastasis; Patients; Planning; Radiation therapy; Registration; Reproducibility; Simulation; Surgery; Tumors; United States > US; magnetic resonance-guided radiotherapy (MRgRT); stereotactic body radiotherapy (SBRT); adaptive radiotherapy; adrenal gland metastases (AGM)
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12010291

Stereotactic MR-guided Radiotherapy (MRgRT) is an interesting treatment option for adrenal gland metastases (AGM). We reviewed data from 12 consecutive patients treated with MRgRT for an AGM in our center between 14 November 2019 and 17 August 2021. Endpoints were tolerance assessment, the impact of adaptive treatment on target volume coverage and organs at risk (OAR) sparing, local control (LC), and overall survival (OS). The majority of patients were oligometastatic (58.3%), with 6 right AGM, 5 left AGM and 1 left and right AGM. The prescribed dose was 35 to 50 Gy in 3 to 5 fractions. The median PTV V95% on the initial plan was 95.74%. The median V95% of the PTVoptimized (PTVopt) on the initial plan was 95.26%. Thirty-eight (69%) fractions were adapted. The PTV coverage was significantly improved for adapted plans compared to predicted plans (median PTV V95% increased from 89.85% to 91.17%, p = 0.0478). The plan adaptation also significantly reduced Dmax for the stomach and small intestine. The treatment was well tolerated with no grade > 2 toxicities. With a median follow-up of 15.5 months, the 1−year LC and OS rate were 100% and 91.7%. Six patients (50%) presented a metastatic progression, and one patient (8.3%) died of metastatic evolution during the follow-up. Adaptation of the treatment plan improved the overall dosimetric quality of MRI-guided radiotherapy. A longer follow-up is required to assess late toxicities and clinical results.