ABSTRACT
BACKGROUND:
This single-center
retrospective study aimed to evaluate the
efficacy and
toxicity profiles of
stereotactic body radiotherapy (SBRT) and surgical resection in
patients with adrenal
metastases originating from solid
tumors.
METHODS/MATERIALS
Patients with advanced
tumor conditions or comorbidities typically received SBRT, whereas those considered physically fit underwent standard surgical
treatment. Endpoints included local control (LC),
progression free survival (PFS), overall
survival (OS), and complication rates (CR).
RESULTS:
41
patients with 48 adrenal
metastases were included, with 27 (65.9%)
patients receiving SBRT and 14 (34.1%)
patients undergoing
adrenalectomy. One- and two-year LC values were 100% for both periods after
adrenalectomy, and 70.0% and 52.5% after SBRT (p = 0.001). PFS showed values of 40.2% and 32.1% at one and two years after
adrenalectomy and of 10.6% for both periods after SBRT (p = 0.223). OS was 83.3% both one and two years after
surgery and 67.0% and 40.2% after SBRT (p = 0.031). There was no statistically significant difference between the two groups regarding acute
complications (p = 0.123).
CONCLUSION:
Despite potential confounders,
adrenalectomy exhibited statistically significant superior LC and OS compared to SBRT in managing adrenal
metastases, while both
treatment methods displayed acceptable
toxicity profiles. However,
patient selection bias must be taken into account when directly comparing the two
therapy modalities. Nevertheless, the study provides new and important results for the scientific and medical
communities regarding oncological outcomes after SBRT or surgical resection of adrenal
metastases.
