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Abstract：
UNASSIGNED: Stereotactic body radiotherapy (SBRT) is an effective treatment for adrenal gland metastases, but it is technically challenging and there are concerns about toxicity. We performed a multi-institutional pooled retrospective analysis to study clinical outcomes and toxicities after MR-guided SBRT (MRgSBRT) using for adrenal gland metastases.
UNASSIGNED: Clinical and dosimetric data of patients treated with MRgSBRT on a 0.35 T MR-Linac at 11 institutions between 2016 and 2022 were analyzed. Local control (LC), local progression-free survival (LPFS), distant progression-free survival (DPFS) and overall survival (OS) were estimated using Kaplan-Meier method and log-rank test.
UNASSIGNED: A total of 255 patients (269 adrenal metastases) were included. Metastatic pattern was solitary in 25.9 % and oligometastatic in 58.0 % of patients. Median total dose was 45 Gy (range, 16-60 Gy) in a median of 5 fractions, and the median BED10 was 100 Gy (range, 37.5-132.0 Gy). Adaptation was done in 87.4 % of delivered fractions based on the individual clinicians\' judgement. The 1- and 2- year LPFS rates were 94.0 % (95 % CI: 90.7-97.3 %) and 88.3 % (95 % CI: 82.4-94.2 %), respectively and only 2 patients (0.8 %) experienced grade 3 + toxicity. No local recurrences were observed after treatment to a total dose of BED10 > 100 Gy, with single fraction or fractional dose of > 10 Gy.
UNASSIGNED: This is a large retrospective multi-institutional study to evaluate the treatment outcomes and toxicities with MRgSBRT in over 250 patients, demonstrating the need for frequent adaptation in 87.4 % of delivered fractions to achieve a 1- year LPFS rate of 94 % and less than 1 % rate of grade 3 + toxicity. Outcomes analysis in 269 adrenal lesions revealed improved outcomes with delivery of a BED10 > 100 Gy, use of single fraction SBRT and with fraction doses > 10 Gy, providing benchmarks for future clinical trials.
UNASSIGNED: Clinical and dosimetric data of patients treated with MRgSBRT on a 0.35 T MR-Linac at 11 institutions between 2016 and 2022 were analyzed. Local control (LC), local progression-free survival (LPFS), distant progression-free survival (DPFS) and overall survival (OS) were estimated using Kaplan-Meier method and log-rank test.
UNASSIGNED: A total of 255 patients (269 adrenal metastases) were included. Metastatic pattern was solitary in 25.9 % and oligometastatic in 58.0 % of patients. Median total dose was 45 Gy (range, 16-60 Gy) in a median of 5 fractions, and the median BED10 was 100 Gy (range, 37.5-132.0 Gy). Adaptation was done in 87.4 % of delivered fractions based on the individual clinicians\' judgement. The 1- and 2- year LPFS rates were 94.0 % (95 % CI: 90.7-97.3 %) and 88.3 % (95 % CI: 82.4-94.2 %), respectively and only 2 patients (0.8 %) experienced grade 3 + toxicity. No local recurrences were observed after treatment to a total dose of BED10 > 100 Gy, with single fraction or fractional dose of > 10 Gy.
UNASSIGNED: This is a large retrospective multi-institutional study to evaluate the treatment outcomes and toxicities with MRgSBRT in over 250 patients, demonstrating the need for frequent adaptation in 87.4 % of delivered fractions to achieve a 1- year LPFS rate of 94 % and less than 1 % rate of grade 3 + toxicity. Outcomes analysis in 269 adrenal lesions revealed improved outcomes with delivery of a BED10 > 100 Gy, use of single fraction SBRT and with fraction doses > 10 Gy, providing benchmarks for future clinical trials.
摘要：
■立体定向放疗（SBRT）是肾上腺转移瘤的有效治疗方法，但它在技术上具有挑战性，并且存在对毒性的担忧。我们进行了多机构汇总回顾性分析，以研究MR引导的SBRT（MRgSBRT）用于肾上腺转移的临床结果和毒性。
■分析了2016年至2022年在11个机构的0.35TMR-Linac上接受MRgSBRT治疗的患者的临床和剂量学数据。本地控制（LC），局部无进展生存期（LPFS），采用Kaplan-Meier法和log-rank检验估计远端无进展生存期(DPFS)和总生存期(OS).
■共纳入255例患者（269例肾上腺转移）。25.9％的患者为单发转移，58.0％的患者为寡转移。中位总剂量为45Gy（范围，16-60Gy)，中位数为5个分数，BED10的中位数为100Gy(范围，37.5-132.0Gy）。根据个别临床医生的判断，87.4%的交付部分进行了适应。1年和2年LPFS率分别为94.0%（95%CI：90.7-97.3%）和88.3%（95%CI：82.4-94.2%），分别和只有2例患者(0.8%)出现3级+毒性.治疗总剂量为BED10>100Gy后未观察到局部复发，单部分或部分剂量>10Gy。
这是一项大型回顾性多机构研究，旨在评估250多名患者使用MRgSBRT的治疗结果和毒性，证明需要在87.4％的递送部分中频繁适应，以实现94％的1年LPFS率和低于1％的3级毒性率。269个肾上腺病变的结果分析显示，BED10>100Gy的结果改善，使用单部分SBRT和部分剂量>10Gy，为未来的临床试验提供基准。
■分析了2016年至2022年在11个机构的0.35TMR-Linac上接受MRgSBRT治疗的患者的临床和剂量学数据。本地控制（LC），局部无进展生存期（LPFS），采用Kaplan-Meier法和log-rank检验估计远端无进展生存期(DPFS)和总生存期(OS).
■共纳入255例患者（269例肾上腺转移）。25.9％的患者为单发转移，58.0％的患者为寡转移。中位总剂量为45Gy（范围，16-60Gy)，中位数为5个分数，BED10的中位数为100Gy(范围，37.5-132.0Gy）。根据个别临床医生的判断，87.4%的交付部分进行了适应。1年和2年LPFS率分别为94.0%（95%CI：90.7-97.3%）和88.3%（95%CI：82.4-94.2%），分别和只有2例患者(0.8%)出现3级+毒性.治疗总剂量为BED10>100Gy后未观察到局部复发，单部分或部分剂量>10Gy。
这是一项大型回顾性多机构研究，旨在评估250多名患者使用MRgSBRT的治疗结果和毒性，证明需要在87.4％的递送部分中频繁适应，以实现94％的1年LPFS率和低于1％的3级毒性率。269个肾上腺病变的结果分析显示，BED10>100Gy的结果改善，使用单部分SBRT和部分剂量>10Gy，为未来的临床试验提供基准。
