文章：

实体肿瘤肾上腺转移的立体定向体部放疗与手术切除疗效及毒性回顾性分析

Retrospective Analysis of Efficacy and Toxicity of Stereotactic Body Radiotherapy and Surgical Resection of Adrenal Metastases from Solid Tumors

原文发布日期：26 July 2024

DOI: 10.3390/cancers16152655

类型: Article

开放获取: 是

英文摘要：

Background: This single-center retrospective study aimed to evaluate the efficacy and toxicity profiles of stereotactic body radiotherapy (SBRT) and surgical resection in patients with adrenal metastases originating from solid tumors. Methods/Materials: Patients with advanced tumor conditions or comorbidities typically received SBRT, whereas those considered physically fit underwent standard surgical treatment. Endpoints included local control (LC), progression free survival (PFS), overall survival (OS), and complication rates (CR). Results: 41 patients with 48 adrenal metastases were included, with 27 (65.9%) patients receiving SBRT and 14 (34.1%) patients undergoing adrenalectomy. One- and two-year LC values were 100% for both periods after adrenalectomy, and 70.0% and 52.5% after SBRT (p= 0.001). PFS showed values of 40.2% and 32.1% at one and two years after adrenalectomy and of 10.6% for both periods after SBRT (p= 0.223). OS was 83.3% both one and two years after surgery and 67.0% and 40.2% after SBRT (p= 0.031). There was no statistically significant difference between the two groups regarding acute complications (p= 0.123). Conclusion: Despite potential confounders, adrenalectomy exhibited statistically significant superior LC and OS compared to SBRT in managing adrenal metastases, while both treatment methods displayed acceptable toxicity profiles. However, patient selection bias must be taken into account when directly comparing the two therapy modalities. Nevertheless, the study provides new and important results for the scientific and medical communities regarding oncological outcomes after SBRT or surgical resection of adrenal metastases.

摘要翻译： 

背景：本单中心回顾性研究旨在评估立体定向放射治疗（SBRT）与手术切除对实体肿瘤来源肾上腺转移瘤患者的疗效及毒性特征。方法/材料：肿瘤晚期或合并症患者通常接受SBRT治疗，而身体状况良好的患者则接受标准手术治疗。研究终点包括局部控制率（LC）、无进展生存期（PFS）、总生存期（OS）及并发症发生率（CR）。结果：共纳入41例患者的48处肾上腺转移灶，其中27例（65.9%）接受SBRT治疗，14例（34.1%）接受肾上腺切除术。肾上腺切除术后1年及2年LC均为100%，SBRT组则分别为70.0%和52.5%（p=0.001）。肾上腺切除术后1年及2年PFS分别为40.2%和32.1%，SBRT组两个时间点均为10.6%（p=0.223）。术后1年及2年OS均为83.3%，SBRT组分别为67.0%和40.2%（p=0.031）。两组急性并发症发生率无统计学显著差异（p=0.123）。结论：尽管存在潜在混杂因素，在治疗肾上腺转移瘤时，肾上腺切除术在LC和OS方面均显示出统计学显著优势，且两种治疗方法均表现出可接受的毒性特征。但直接比较两种治疗方式时需考虑患者选择偏倚。本研究为科学界和医学界提供了关于SBRT与手术切除肾上腺转移瘤后肿瘤学结局的新重要证据。

原文链接：

Retrospective Analysis of Efficacy and Toxicity of Stereotactic Body Radiotherapy and Surgical Resection of Adrenal Metastases from Solid Tumors