Abstract
Adrenal metastases can arise from multiple malignancies, mainly lung, breast, renal, gastric, hepatocellular carcinomas, melanoma, and many others. The greatest risk for spread to the adrenal glands is seen with lung carcinoma (Abrams et al., Cancer 3:74–85, 1950). Multiple treatment options are available to treat adrenal metastases, including open and laparoscopic adrenalectomy, radiofrequency ablation, transarterial chemoembolization, palliative radiation, and more recently stereotactic body radiation therapy (SBRT). Here we discuss the role and the benefit of SBRT in the management of adrenal metastases, including technical aspects, clinical applications, and treatment toxicities. We also include clinical case examples to illustrate the treatment plan, isodose lines, and dose–volume histograms. We conclude with future directions in the use of SBRT for adrenal metastases.
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References
Abrams RL, Spiro R, Goldstein N (1950) Metastases in carcinoma: analysis of 1000 autopsied cases. Cancer 3:74–85
Adler JT, Mack E, Chen H (2007) Equal oncologic results for laparoscopic and open resection of adrenal metastases. J Surg Res 140(2):159–164
Ayabe H, Tsuji H, Hara S, Tagawa Y, Kawahara K, Tomita M (1995) Surgical management of adrenal metastasis from bronchogenic carcinoma. J Surg Oncol 58:149–154
Blumenschein GR Jr, Khuri FR, von Pawel J et al (2008) Phase III trial comparing carboplatin, paclitaxel, and bexarotene with carboplatin and paclitaxel in chemotherapy-naive patients with advanced or metastatic non-small-cell lung cancer: SPIRIT II. J Clin Oncol 26:1879–1885
Casamassima F, Livi L, Masciullo S, Menichelli C, Masi L, Meattini I, Bonucci I, Agresti B, Simontacchi G, Doro R (2012) Stereotactic radiotherapy for adrenal gland metastases: University of Florence experience. Int J Radiat Oncol Biol Phys 82(2):919–923
Castillo OA, Vitagliano G, Kerkebe M, Parma P, Pinto I, Diaz M (2007) Laparoscopic adrenalectomy for suspected metastasis of adrenal glands: our experience. Urology 69:637–641
Chawla S, Chen Y, Katz AW, Muhs AG, Philip A, Okunieff P, Milano MT (2009) Stereotactic body radiotherapy for treatment of adrenal metastases. Int J Radiat Oncol Biol Phys 75(1):71–75
Chen B, Zhou M, Cappelli MC, Wolf JS Jr (2002) Port site, retroperitoneal and intra-abdominal recurrence after laparoscopic adrenalectomy for apparently isolated metastasis. J Urol 168:2528–2529
Eldaya RW, Paulino AC, Blanco AI et al (in press) Preservation of adrenal function after successful stereotactic body radiation therapy of metastatic renal cell carcinoma involving the remaining contralateral adrenal gland. Pract Radiat Oncol
Guiou M, Mayr NA, Kim EY, Williams T, Lo SS (2012) Stereotactic body radiotherapy for adrenal metastases from lung cancer. J Radiat Oncol. doi:10.1007/s13566-012-0037-8 (online first 16 May 2012)
Heniford BT, Arca MJ, Walsh RM, Gill IS (1999) Laparoscopic adrenalectomy for cancer. Semin Surg Oncol 16:293–306
Higashiyama M, Doi O, Kodama K, Yokouchi H, Imaoka S, Koyama H (1994) Surgical treatment of adrenal metastasis following pulmonary resection for lung cancer: comparison of adrenalectomy with palliative therapy. Int Surg 79:124–135
Holy R, Piroth M, Pinkawa M, Eble MJ (2011) Stereotactic body radiation therapy (SBRT) for treatment of adrenal gland metastases from non-small cell lung cancer. Strahlenther Onkol 187(4):245–251
Katoh N, Onimaru R, Sakuhara Y et al (2008) Real-time tumor-tracking radiotherapy for adrenal tumors. Radiother Oncol 87:418–424
Kebebew E, Siperstein AE, Clark OH, Duh QY (2002) Results of laparoscopic adrenalectomy for suspected and unsuspected malignant adrenal neoplasms. Arch Surg 137:948–951
Kim SH, Brennan MF, Russo P et al (1998) The role of surgery in the treatment of clinically isolated adrenal metastasis. Cancer 82:389–394
Kirsch AJ, Oz MC, Stoopler M, Ginsburg M, Steinglass K (1993) Operative management of adrenal metastases from lung carcinoma. Urology 42:716–719
Kocijancic I, Vidmar K, Zwitter M et al (2003) The significance of adrenal metastases from lung carcinoma. Eur J Surg Oncol 29:87–88
Lam KY, Lo CY (2002) Metastatic tumours of the adrenal glands: a 30-year experience in a teaching hospital. Clin Endocrinol (Oxf) 56:95–101
Lax I, Blomgren H, Naslund I et al (1994) Stereotactic radiotherapy of malignancies in the abdomen. Acta Oncol 33:677–683
Linos DA, Stylopoulos N, Boukis M, Souvatzoglou A, Raptis S, Papadimitriou J (1997) Anterior, posterior, or laparoscopic approach for the management of adrenal diseases? Am J Surg 173:120–125
Lo CY, van Heerden JA, Soreide CS, Grant CS, Thompson GB, Lloyd RV et al (1995) Adrenalectomy for metastatic disease to the adrenal glands. Br J Surg 83:528–531
Luketich JD, Burt ME (1994) Does resection of isolated adrenal metastases in non-small cell lung cancer (NSCLC) improve survival? Lung Cancer 10:153
Miyaji N, Miki T, Itoh Y et al (1999) Radiotherapy for adrenal gland metastasis from lung cancer: report of three cases. Radiat Med 17:71–75
Moinzadeh A, Gill IS (2005) Laparoscopic radical adrenalectomy for malignancy in 31 patients. J Urol 173:519–525
Oshiro Y, Takeda Y, Hirano S, Ito H, Aruga T (2011) Role of radiotherapy for local control of asymptomatic adrenal metastasis from lung cancer. Am J Clin Oncol 34(3):249–253
Porte HL, Roumilhac D, Graziana JP et al (1998) Adrenalectomy for a solitary adrenal metastasis from lung cancer. Ann Thorac Surg 65:331–335
Raviv G, Klein E, Yellin A, Schneebaum S, Ben-Ari G (1990) Surgical treatment of solitary adrenal metastases from lung carcinoma. J Surg Oncol 4:123–131
Reyes L, Parvez S, Nemoto T, Regal AM, Takita H (1990) Adrenalectomy for adrenal metastasis from lung carcinoma. J Surg Oncol 44:32–34
Sarela AI, Murphy I, Coit DG et al (2003) Metastasis to the adrenal gland: the emerging role of laparoscopic surgery. Ann Surg Oncol 10:1191–1196
Schell SR, Talamini MA, Udelsman R (1999) Laparoscopic adrenalectomy for nonmalignant disease: improved safety, morbidity, and cost-effectiveness. Surg Endosc 13:30–34
Scorsetti M, Mancosu P, Navarria P, Tozzi A, Castiglioni S, Clerici E, Reggiori G, Lobefalo F, Fogliata A, Cozzi L (2011) Stereotactic body radiation therapy (SBRT) for adrenal metastases: a feasibility study of advanced techniques with modulated photons and protons. Strahlenther Onkol 187(4):238–244
Sebag F, Calzolari F, Harding J, Sierra M, Palazzo FF, Henry JF (2006) Isolated adrenal metastasis: the role of laparoscopic surgery. World J Surg 30:888–892
Short S, Chaturvedi A, Leslie MD (1996) Palliation of symptomatic adrenal gland metastases by radiotherapy. Clin Oncol (R Coll Radiol) 8:387–389
Soejima T, Hirota S, Hishikawa Y et al (1997) Radiation therapy for adrenal metastases. Nippon Igaku Hoshasen Gakkai Zasshi 57:801–804
Soffen EM, Solin LJ, Rubenstein JH et al (1990) Palliative radiotherapy for symptomatic adrenal metastases. Cancer 65:1318–1320
Strong VE, D’Angelica M, Tang L et al (2007) Laparoscopic adrenalectomy for isolated adrenal metastasis. Ann Surg Oncol 14:3392–3400
Suzuki K, Ushiyama T, Mugiya S, Kageyama S, Saisu K, Fujita K (1997) Hazards of laparoscopic adrenalectomy in patients with adrenal malignancy. J Urol 158:2227
Tanvetyanon T, Robinson LA, Schell MJ et al (2008) Outcomes of adrenalectomy for isolated synchronous versus metachronous adrenal metastases in non small-cell lung cancer: a systematic review and pooled analysis. J Clin Oncol 26:1142–1147
Torok J, Wegner RE, Burton SA, Heron DE (2011) Stereotactic body radiation therapy for adrenal metastases: a retrospective review of a noninvasive therapeutic strategy. Future Oncol 7(1):145–151
Twomey P, Montgomery C, Clarck O (1982) Successful treatment of adrenal metastases from large-cell carcinoma of the lung. JAMA 248:581–583
Zeng ZC, Tang ZY, Fan J et al (2005) Radiation therapy for adrenal gland metastases from hepatocellular carcinoma. Jpn J Clin Oncol 35:61–67
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Abboud, M., Lo, S.S., Paulino, A.C., Lehane, D.E., Teh, B.S. (2012). Adrenal Metastasis. In: Lo, S., Teh, B., Lu, J., Schefter, T. (eds) Stereotactic Body Radiation Therapy. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_646
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DOI: https://doi.org/10.1007/174_2012_646
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