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Original article
peer-reviewed

Robotic Radiosurgery for Adrenal Gland Metastases



Abstract

Introduction

The purpose of this study was to investigate the safety and efficacy of CyberKnife (CK) robotic radiosurgery for treatment of adrenal metastases.

Methods

We performed a retrospective analysis of 23 patients with adrenal metastases who had been treated with CK between October 2006 and December 2015. Fifteen patients received chemotherapy prior to radiosurgery, all patients underwent computer tomography (CT) fluoroscopically guided percutaneous placement of one to three gold fiducials into the adrenal gland. Nineteen patients were selected for single-fraction radiosurgery with a median dose of 22 Gy, four patients were treated in three fractions with a median dose of 13.5 Gy.

Results

Median follow-up time was 23.6 months. Four patients (17%) experienced local relapse during the evaluation period with a mean time of 19 months to tumor progression. The actuarial local tumor control rate was 95% after one year and 81% after two years. Three of the four patients with local recurrence were retreated with CK radiosurgery. Dynamic tumor tracking enabled accurate treatment with correlation errors less than 2 mm, despite extensive respiration-induced target motion up to 22 mm. Apart from nausea directly after treatment in five patients, we observed no early or late treatment-related side effects.

Conclusions

Single fraction robotic radiosurgery for adrenal gland metastases is a safe and effective treatment option for patients who are not eligible for surgical resection.



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Original article
peer-reviewed

Robotic Radiosurgery for Adrenal Gland Metastases


Author Information

Alfred Haidenberger Corresponding Author

Radiation Oncologist, European CyberKnife Center Munich

Sarah-Charlotta Heidorn

Medical Physicist, European CyberKnife Center Munich

Nikolaus Kremer

Medical Physicist, European CyberKnife Center Munich

Alexander Muacevic

European CyberKnife Center Munich

Christoph Fürweger

Chief Medical Physicist, European CyberKnife Center Munich


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Original article
peer-reviewed

Robotic Radiosurgery for Adrenal Gland Metastases


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Original article
peer-reviewed

Robotic Radiosurgery for Adrenal Gland Metastases

Alfred Haidenberger">Alfred Haidenberger , Sarah-Charlotta Heidorn">Sarah-Charlotta Heidorn, Nikolaus Kremer">Nikolaus Kremer, Alexander Muacevic">Alexander Muacevic, Christoph Fürweger">Christoph Fürweger

  • Author Information
    Alfred Haidenberger Corresponding Author

    Radiation Oncologist, European CyberKnife Center Munich

    Sarah-Charlotta Heidorn

    Medical Physicist, European CyberKnife Center Munich

    Nikolaus Kremer

    Medical Physicist, European CyberKnife Center Munich

    Alexander Muacevic

    European CyberKnife Center Munich

    Christoph Fürweger

    Chief Medical Physicist, European CyberKnife Center Munich


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: March 26, 2017

    DOI

    10.7759/cureus.1120

    Cite this article as:

    Haidenberger A, Heidorn S, Kremer N, et al. (March 26, 2017) Robotic Radiosurgery for Adrenal Gland Metastases. Cureus 9(3): e1120. doi:10.7759/cureus.1120

    Publication history

    Received by Cureus: March 09, 2017
    Peer review began: March 10, 2017
    Peer review concluded: March 14, 2017
    Published: March 26, 2017

    Copyright

    © Copyright 2017
    Haidenberger et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction

The purpose of this study was to investigate the safety and efficacy of CyberKnife (CK) robotic radiosurgery for treatment of adrenal metastases.

Methods

We performed a retrospective analysis of 23 patients with adrenal metastases who had been treated with CK between October 2006 and December 2015. Fifteen patients received chemotherapy prior to radiosurgery, all patients underwent computer tomography (CT) fluoroscopically guided percutaneous placement of one to three gold fiducials into the adrenal gland. Nineteen patients were selected for single-fraction radiosurgery with a median dose of 22 Gy, four patients were treated in three fractions with a median dose of 13.5 Gy.

Results

Median follow-up time was 23.6 months. Four patients (17%) experienced local relapse during the evaluation period with a mean time of 19 months to tumor progression. The actuarial local tumor control rate was 95% after one year and 81% after two years. Three of the four patients with local recurrence were retreated with CK radiosurgery. Dynamic tumor tracking enabled accurate treatment with correlation errors less than 2 mm, despite extensive respiration-induced target motion up to 22 mm. Apart from nausea directly after treatment in five patients, we observed no early or late treatment-related side effects.

Conclusions

Single fraction robotic radiosurgery for adrenal gland metastases is a safe and effective treatment option for patients who are not eligible for surgical resection.



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Create a free account to continue reading this article.

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Alfred Haidenberger, M.D.

Radiation Oncologist, European CyberKnife Center Munich

For correspondence:
alfred.haidenberger@cyber-knife.net

Sarah-Charlotta Heidorn

Medical Physicist, European CyberKnife Center Munich

Nikolaus Kremer

Medical Physicist, European CyberKnife Center Munich

Alexander Muacevic, M.D., Professor

European CyberKnife Center Munich

Christoph Fürweger, Ph.D.

Chief Medical Physicist, European CyberKnife Center Munich

Alfred Haidenberger, M.D.

Radiation Oncologist, European CyberKnife Center Munich

For correspondence:
alfred.haidenberger@cyber-knife.net

Sarah-Charlotta Heidorn

Medical Physicist, European CyberKnife Center Munich

Nikolaus Kremer

Medical Physicist, European CyberKnife Center Munich

Alexander Muacevic, M.D., Professor

European CyberKnife Center Munich

Christoph Fürweger, Ph.D.

Chief Medical Physicist, European CyberKnife Center Munich