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Radiotherapy treatment of adrenal gland metastases from hepatocellular carcinoma: clinical features and prognostic factors.

Zhou LY, Zeng ZC, Fan J, Chen B, Rao SX, He J, Yang P, Hou JZ, Wu ZF, Zhang JY, Hu Y - BMC Cancer (2014)

Bottom Line: Adverse effects were mild to moderate.Radiotherapy as treatment for adrenal metastases in HCC is a good palliative therapy that is associated with reasonable safety.It appears reasonable that such patients should be considered to be treated with radiotherapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai 200032, China. zeng.zhaochong@zs-hospital.sh.cn.

ABSTRACT

Background: The optimal treatment for adrenal metastases from hepatocellular carcinoma (HCC) has not been established. This study analyzed the effects of radiation therapy (RT) for such metastases and identified clinical features and predictors of survival in these patients.

Methods: We retrospectively investigated 55 patients with adrenal metastasis from HCC who had been treated with RT. Radiation doses to the adrenal lesions ranged from 26 to 60 Gy, while the intrahepatic lesions were treated by surgical resection, transarterial chemoembolization (TACE), liver transplantation, and/or RT. RT was conducted to adrenal lesions after their intrahepatic lesions were controlled more than 2 months. The parameters studied included survival rates and tumor responses to RT. The Kaplan-Meier method was used to evaluate survival rate and the Cox regression model was used to identify potential predictors of outcome.

Results: The patients treated by RT had adrenal metastasis on the right side (41), the left (6), or on both sides (8). In all 55 patients, the median survival duration was 13.6 months and there was 100% pain relief after completion of RT. Adverse effects were mild to moderate. Unfavorable pretreatment predictors determined by univariate analysis were associated with multiple intrahepatic foci, metastases to additional organs, high γ-glutamyltransferase and alpha-fetoprotein levels, liver function of Child-Pugh classification B and uncontrolled primary HCC. By multivariate analysis, unfavorable predictors were multiple intrahepatic foci, metastases to additional organs and uncontrolled primary HCC.

Conclusions: Radiotherapy as treatment for adrenal metastases in HCC is a good palliative therapy that is associated with reasonable safety. It appears reasonable that such patients should be considered to be treated with radiotherapy. Multiple intrahepatic foci, metastases to additional organs and uncontrolled primary HCC were unfavorable predictors.

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Related in: MedlinePlus

Survival curves are shown based on solitary or multiple intrahepatic tumors (A), with or without additional organ metastasis (B), controlled or uncontrolled primary HCC (C).
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Fig2: Survival curves are shown based on solitary or multiple intrahepatic tumors (A), with or without additional organ metastasis (B), controlled or uncontrolled primary HCC (C).

Mentions: Multivariate analysis indicated that unfavorable pretreatment predictors were associated with multiple intrahepatic tumors (P = .042) (Figure 2A), metastasis to additional organ(s) (P = .00) (Figure 2B), and uncontrolled primary HCC (P = .003) (Figure 2C) as also shown in Table 1.Figure 2


Radiotherapy treatment of adrenal gland metastases from hepatocellular carcinoma: clinical features and prognostic factors.

Zhou LY, Zeng ZC, Fan J, Chen B, Rao SX, He J, Yang P, Hou JZ, Wu ZF, Zhang JY, Hu Y - BMC Cancer (2014)

Survival curves are shown based on solitary or multiple intrahepatic tumors (A), with or without additional organ metastasis (B), controlled or uncontrolled primary HCC (C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4289365&req=5

Fig2: Survival curves are shown based on solitary or multiple intrahepatic tumors (A), with or without additional organ metastasis (B), controlled or uncontrolled primary HCC (C).
Mentions: Multivariate analysis indicated that unfavorable pretreatment predictors were associated with multiple intrahepatic tumors (P = .042) (Figure 2A), metastasis to additional organ(s) (P = .00) (Figure 2B), and uncontrolled primary HCC (P = .003) (Figure 2C) as also shown in Table 1.Figure 2

Bottom Line: Adverse effects were mild to moderate.Radiotherapy as treatment for adrenal metastases in HCC is a good palliative therapy that is associated with reasonable safety.It appears reasonable that such patients should be considered to be treated with radiotherapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai 200032, China. zeng.zhaochong@zs-hospital.sh.cn.

ABSTRACT

Background: The optimal treatment for adrenal metastases from hepatocellular carcinoma (HCC) has not been established. This study analyzed the effects of radiation therapy (RT) for such metastases and identified clinical features and predictors of survival in these patients.

Methods: We retrospectively investigated 55 patients with adrenal metastasis from HCC who had been treated with RT. Radiation doses to the adrenal lesions ranged from 26 to 60 Gy, while the intrahepatic lesions were treated by surgical resection, transarterial chemoembolization (TACE), liver transplantation, and/or RT. RT was conducted to adrenal lesions after their intrahepatic lesions were controlled more than 2 months. The parameters studied included survival rates and tumor responses to RT. The Kaplan-Meier method was used to evaluate survival rate and the Cox regression model was used to identify potential predictors of outcome.

Results: The patients treated by RT had adrenal metastasis on the right side (41), the left (6), or on both sides (8). In all 55 patients, the median survival duration was 13.6 months and there was 100% pain relief after completion of RT. Adverse effects were mild to moderate. Unfavorable pretreatment predictors determined by univariate analysis were associated with multiple intrahepatic foci, metastases to additional organs, high γ-glutamyltransferase and alpha-fetoprotein levels, liver function of Child-Pugh classification B and uncontrolled primary HCC. By multivariate analysis, unfavorable predictors were multiple intrahepatic foci, metastases to additional organs and uncontrolled primary HCC.

Conclusions: Radiotherapy as treatment for adrenal metastases in HCC is a good palliative therapy that is associated with reasonable safety. It appears reasonable that such patients should be considered to be treated with radiotherapy. Multiple intrahepatic foci, metastases to additional organs and uncontrolled primary HCC were unfavorable predictors.

Show MeSH
Related in: MedlinePlus