방사선의학 웹진

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Abstract
Background: To evaluate tumor response, local control (LC), survival, and toxicity after radiotherapy for adrenal metastases from hepatocellular carcinoma (HCC), we conducted a retrospective, bi-institutional study spanning two decades.

Methods: Twenty patients received radiotherapy for adrenal metastases (2005-2025). Techniques included three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, stereotactic body radiotherapy, and MR-guided radiotherapy. Tumor response was assessed using Response Evaluation Criteria in Solid Tumors version 1.1. LC, overall survival (OS), and progression-free survival (PFS) were estimated using Kaplan-Meier; the association between biologically effective dose (BED10) and local recurrence was assessed using Fisher's exact test.

Results: The objective response rate was 55.0%, and the disease control rate was 95.0%. The 6- and 12-month adrenal LC rates were 94.4% and 87.2%; local recurrence occurred in three patients (15.0%). No local recurrence was observed at BED10 ≥ 75 Gy (0/8) versus 25.0% (3/12) at BED10 < 75 Gy. However, this difference did not reach statistical significance (p = 0.242, Fisher's exact test) and should be interpreted as exploratory and hypothesis-generating given the limited sample size. Median OS was 13.4 months, and median PFS was 6.3 months. Systemic progression was the predominant failure pattern. No grade ≥3 radiotherapy-related toxicity was observed.

Conclusions: Radiotherapy achieved favorable LC with acceptable toxicity across a 20-year bi-institutional experience, supporting its role as an effective local treatment modality for adrenal metastases from HCC.

Affiliations

Jeongshim Lee 1, Myungsoo Kim 2
1Department of Radiation Oncology, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of Korea.
2Department of Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.