%0 Journal Article
%T Factors influencing local control after MR-guided stereotactic body radiotherapy (MRgSBRT) for adrenal metastases.
%A Ugurluer G
%A Schneiders FL
%A Corradini S
%A Boldrini L
%A Kotecha R
%A Kelly P
%A Portelance L
%A Camilleri P
%A Ben-David MA
%A Poiset S
%A Marschner SN
%A Panza G
%A Kutuk T
%A Palacios MA
%A Castelluccia A
%A Zoto Mustafayev T
%A Atalar B
%A Senan S
%A Ozyar E
%J Clin Transl Radiat Oncol
%V 46
%N 0
%D 2024 May
%M 38450219
%F 4.739
%R 10.1016/j.ctro.2024.100756
%X <B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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.